Vitiligo: what is it, why does it happen and what’s the treatment?

Photo credit: Emma McIntyre - Getty Images
Photo credit: Emma McIntyre - Getty Images

From Harper's BAZAAR

Vitiligo is a long-term condition that causes the skin to pale in areas. Thanks to successful model Winnie Harlow, who has walked for Marc Jacobs and Tommy Hilfiger and also has vitiligo, we are now more aware of the condition.

Harlow has opened up about her vitiligo on her Instagram feed and in interviews, it’s something that she isn’t afraid to talk about, but it’s definitely not something that defines her.

In fact, she called out the Evening Standard in 2018 for describing her as a vitiligo ‘sufferer’ responding on social media and writing: "I am not a “Vitiligo Sufferer”. I’m not a “Vitiligo model”. I am Winnie. I am a model. And I happen to have Vitiligo."

To find about more about vitiligo we called on dermatologist Dr. Emma Wedgeworth to reveal everything there is to know, from the causes and how to care for the skin.

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What is Vitiligo?

“Vitiligo is a disorder of the melanocytes, which is the pigment producing cell within our skin. The melanocyte becomes stressed and produces signals which lead the immune system to react to these cells and subsequently destroy them,” says Wedgeworth. “Once the melanocytes are destroyed, they can no longer produce pigment, which results in the white patches we see in vitiligo.”

What triggers Vitiligo?

We don’t exactly know what causes people to suffer from vitiligo but, according to Wedgeworth, here’s what the experts know so far:

  • There is a genetic component – vitiligo can run in families.

  • It is associated with other autoimmune conditions like patchy hair loss (alopecia areata) and certain types of thyroid disorders.

  • Any trauma or damage to the skin, even minor cuts and abrasions, can result in patches of vitiligo in predisposed individuals.

Other than that, no specific environmental triggers have been identified – like stress, diet or alcohol - that provoke vitiligo, notes Wedgeworth.

Photo credit: Vittorio Zunino Celotto - Getty Images
Photo credit: Vittorio Zunino Celotto - Getty Images

How can vitiligo be identified?

"Vitiligo is a clinical diagnosis," says Wedgeworth. "That means there isn’t one blood test or other clinical test that can identify it. An experienced dermatologist will usually be able to make the diagnosis by carefully examining the skin.

"Sometimes, we use a special ultraviolet light called a Wood’s light, which shows up the patches of vitiligo in a clearer way than normal light."

Is Vitiligo curable?

Wedgeworth explains that there's no cure for vitiligo as yet, but it is treatable. "We use a combination of medical creams, light therapies and sometimes surgery to help improve the condition.

"Recent research has also identified which parts of the immune system are contributing to the development of vitiligo. This may result in targeted immune-based therapies, which could revolutionise the treatment of vitiligo in the future."

Are there any side effects?

"Generally, vitiligo skin is still healthy," says Wedgeworth. "However, there is no doubt that the aesthetic changes and the visible differences can cause significant psychological issues for some people. I think this is potentially the most serious consequence of vitiligo.

"The skin is also more susceptible to sunburn, although recent studies suggest that people with vitiligo actually have lower risks of skin cancers."

Can anyone have vitiligo?

"Yes, however it tends to be more noticeable in darker skins, because the contrast between the affected and unaffected areas is more pronounced," explains Wedgeworth.

"Skin camouflage products contain up to 25 percent more pigment than normal cosmetic foundations and tend to be waterproof, so they can be helpful if people want to temporarily cover up their vitiligo."

"The use of a fixing spray can also be helpful," adds Wedgeworth.

"There are also dedicated camouflage clinics, where people can get advice on this from trained therapists," she tells us. "In the UK, this is run by a charity called “Changing Faces”. Fake tans are another option, particularly for larger areas, but they are very limited in colour ranges, so often won’t match exactly your skin tone and as yet, are not available for darker skins."

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