Vitiligo

Vitiligo is a condition in which patches of skin lose their pigment due to the destruction of melanin-producing cells, resulting in smooth, white patches. It is not contagious or physically harmful, but can have a significant emotional and social impact.

• Smooth, white patches of skin that lack pigment, which can appear anywhere on the body but are often first noticed on the hands, face, or around body openings
• Patches may be symmetrical (matching areas on both sides of the body) in some forms
• Hair in the affected area may also turn white
• Patches can gradually enlarge or spread over time, though the pattern varies between individuals

• Results from the destruction of melanocytes, the cells responsible for producing skin pigment, believed to involve an autoimmune process.
• Family history of vitiligo or other autoimmune conditions increases risk.
• The exact trigger for melanocyte destruction is not fully understood.

• Diagnosed clinically based on the characteristic appearance of well-defined, depigmented patches.
• A special lamp (Wood's lamp) may be used, where available, to better visualise the extent of depigmentation, particularly in lighter-skinned individuals.
• Assessment for associated autoimmune conditions, such as thyroid disease, may be considered given the association.

Vitiligo does not require treatment for physical health, and management decisions are guided by the individual's preferences regarding appearance.

Topical corticosteroids or other topical anti-inflammatory creams may help repigment some patches, particularly if started earlier in the disease course.

Phototherapy (controlled light treatment), where available, can help repigment skin in some people with more widespread vitiligo.

Sun protection for depigmented areas is important, as these patches lack the protective pigment and burn more easily.

Camouflage makeup can help reduce the visible contrast for those who wish to minimise the appearance of patches, and psychological support can be valuable given the potential emotional impact.

• Use sun protection, such as sunscreen or protective clothing, on depigmented patches, which are more vulnerable to sunburn.
• Seek support from family, friends, or counselling if vitiligo is affecting emotional wellbeing or self-esteem.
• Discuss treatment options with a health worker if repigmentation or camouflage is desired.
• There is no known way to prevent vitiligo, since the underlying cause is autoimmune.