Vitiligo Frequently Asked Questions

What Is Vitiligo?

Vitiligo (pronounced vit-ill-EYE-go) is a relatively common skin disease characterized by smooth, white, painless spots or patches on various parts of the body. It does not cause any organic harm, but it can have a devastating effect on the social life of the affected person and their family. The total number of people suffering from vitiligo is estimated at 60 to 90 million people worldwide.

What Causes Vitiligo?

The precise cause of vitiligo is not well understood. The white areas appear due to loss of the pigment (melanin) that gives skin its color and protects it from the sun's ultraviolet rays. Factors such as stress, physical illness, skin damage, certain chemicals and drugs, pregnancy and severe sunburn may trigger or worsen vitiligo.

It remains unclear what causes damage to melanocytes and their subsequent total inactivation and/or disappearance in vitiligo skin. There are several theories; the most prominent are autoimmune, neurohumoral, related to abnormal detachment of melanocytes from the epidermal layers and autocytotoxic. None are mutually exclusive, and it is likely that each of them partially contribute to the disease development.

The current thought is that vitiligo represents a group of different disorders with a similar outcome: the appearance of white patches on the skin.

The convergence theory states that stress, accumulation of toxic compounds, infections, autoimmunity, genetic predisposition, altered cellular environment, and impaired melanocyte migration can all contribute to the vitiligo initiation process. Autoimmune mechanisms are likely to underlie generalized vitiligo, while a more localized phenomenon (i.e. the altered activities of sensitive nerves in the skin) may be responsible for segmental or focal vitiligo. A site of a skin physical trauma may develop vitiligo; it is called a "Koebner phenomenon."

Is Vitiligo Contagious?

Vitiligo is NOT contagious. It cannot be passed on or caught from touching someone with vitiligo, shaking hands, swimming in the same pool, sharing towels, sitting next to someone in sauna, using the same sporting equipment, or eating food prepared by a person who has vitiligo.

I Have Vitiligo: Will My Children Have Vitiligo, Too?

In some cases vitiligo seems to be inherited and run in families, with children whose parents have vitiligo being at increased risk of developing the condition themselves.

The frequency of vitiligo among first degree relatives in white, Indo - Pakistani, and Hispanic populations is 7.1%, 6.1%, and 4.8%, respectively. Identical twins with identical DNA have only a 23% chance of developing vitiligo, suggesting a significant non-genetic component in the disease.

Whether We Can Stop Vitiligo Spreading Or Not?

The vitiligo spreading can be stopped.

There are three steps for treating vitiligo:

• 1. Stop the developing
• 2. Restore the normal skin color
• 3. Prevent it rebound again

The first step is the most important step, it is the foundation of second and third step. However most of the patients put too much attentions on the latter two steps but ignore the first step.

And in order to prevent it spreading we should combine the internal treatment and external treatment together, because of the onset of this disease is related to the whole factors of our body.

Will it Spread?

The vitiligo would probably start to progress when some of our internal factors altering. It related to the trauma, mind, and physical and chemical irritant, or infection. Especially white patches on extremities parts are more easily to spread to facial part, and the white spot shape will integrate to large white spots. Developing and changing of skin surface, the skin color will gradually from the pale white to become the milky white, cloudy white, porcelain white. Meanwhile the hair follicle pore gradually closed, and the skin texture also gradually disappear, and skin surface gradually become more smooth. Therefore, the earlier the treatment for vitiligo patients will have greater possibility to recover.

Who is Prone to Vitiligo？

Vitiligo affects 0.5-2% of the population, and occurs in all races and all social levels. Vitiligo can affect people of all ages, but often starts between the ages of 10 and 30 years. Vitiligo generally affects both men and women equally.

Vitiligo can happen anywhere on the body, but it's more likely to develop in some of these areas:

• skin that's exposed to the sun, such as the face or hands,
• skin that has folds, such as the elbows, knees, or groin,
• skin around the eyes, nostrils, belly button, and genital areas.

In addition, some people will notice white patches appearing inside their mouth and may have premature greying of the scalp hair, eyelashes, eyebrows or beard.

Can Chemicals Cause Vitiligo?

Yes, certain chemicals can, indeed, induce or worsen vitiligo. Most commonly they include phenols, such as 4-tertiary-butyl phenol (4-TBP, found in adhesives) or 4-tertiary-butyl catechol (4-TBC, found in rubber and other products).

There are a number of commercial products that have been reported to induce vitiligo, and most of them contain phenols. A study was performed by a group in India to identify products that cause vitiligo, and below is a list of suspicious products that they identified, which includes permanent hair dyes, some detergents, and other ornamental dyes sometimes used on the skin. The problem is, exactly which products do this, and what chemicals are directly responsible, is not yet clear, and it is impossible to avoid all suspicious products. Also, it is unlikely that every chemical has this effect on every patient with vitiligo, so some products may be harmful for some patients but not others.

• Rubber gloves
• Lubricating and motor oils
• Detergents
• Printing inks
• Hair dye
• Deodorant/perfume
• Detergent/cleanser
• Adhesive "bindi"
• Rubber sandal
• Black socks/shoes
• Eyeliner 
• Lip liner 
• Rubber condom 
• Lipstick 
• Fur toys
• Toothpaste
• Insecticide 
• Alta (decorative color on feet) 
• Amulet string. 

Is There A Special Diet for Vitiligo?

We have specifically looked into claims that some food supplements or special diet may ease symptoms of vitiligo, or completely reverse it, and found no firm scientific evidence to support this theory.

• Common vitamin deficiencies in people with autoimmune conditions like vitiligo include folic acid, B-12, copper and zinc. However, vitiligo is not caused by a vitamin deficiency and therefore cannot be cured by vitamins alone. Vitamins can have an opposite effect: an excessive intake of Vitamin C can worsen vitiligo.
• While certain chemicals can induce or worsen vitiligo, it is not caused by a toxin that can be removed from your system with 'detox' or 'cleansing.' Contrary to many beliefs, gluten-free diet has no effect on vitiligo and isn't very healthy, either.
• Extracts of Gingko Biloba and Polipodium Leukotomas can be used as an adjunct treatment for vitiligo, but should not be considered as it's replacement.

What's Better: Laser or Phototherapy?

In a recent controlled study researchers assessed effect and safety of different laser and phototherapy treatments, such as excimer laser/light, narrowband UVB, UVA and PUVA.

No significant difference was found between 308-nm excimer laser and its cheaper alternative NB-UVB in the treatment of vitiligo. Laser may produce slightly faster re-pigmentation compared to UVB, while UVA and PUVA are not recommended due to potential side effects.

Take note that leukotrichia (depigmented or white hairs inside the vitiligous area) are often correlated with lower efficacy of phototherapy treatments because of of a deficient melanocyte reservoir.

Why There Is No Drug for Vitiligo Yet?

Despite the dearth of medications available to treat psoriasis - a disease with similar prevalence numbers and impact on quality of life - vitiligo has no known cure or specific treatments. Few therapies can reduce or stop vitiligo symptoms for prolonged periods of time, but no single treatment works for everyone. Worse, not all of these medicines have been approved in all countries.

Since the average cost of single drug development reached $5.5 billion in late 2013, Big Pharma have little interest in developing drugs for "neglected diseases", including vitiligo.

While efficient vitiligo treatments would clearly be in demand if available, there is little public demand for the development of such treatments. This paradox arises from the non-life-threatening nature of vitiligo and widespread awareness of it's perceived incurable nature, thus lowering the expressed demand for treatment development.

Which Tests That The Vitiligo Patients Better Do?

The scientific test is very important index to know about the pathogenesis, diagnoses this disease, and know about the illness well, and make an accurate therapeutic regimen. Vitiligo patients have some relevant test items. For example: skin CT test, this is imageological examination, Doctor Will examine the subcutaneous tissue, and the melancytes condition with the help of the equipment. Wood lamp examination can examine the hidden white patches, and it has a significant effect to diagnose this disease and distinguish with other skin disease.

Immunity test usually have a close relationship with the vitiligo, and immunity test help patient to know about the patient's auto-antibodies condition. Such as the immunity function, it greatly helps doctor to make a treatment plan.

Microelement examination, the lack of the microelement will cause the onset of vitiligo. These tests are necessary before the treatment, it provides a scientific base to establish therapeutic regimen and ensure patients getting a good therapeutic effect.

How Long Does It Take to Treat Vitiligo?

The therapeutic effects would be different according to the vitiligo types.

Based on our experience, some of the patients should saw some initial effects at the first 10 to 15 days, but the ideal result would be seen after three to six months, and the skin grafting surgery effect would be faster, the new skin would be survived take 7 days.

Newly appeared depigmented spots can be efficiently treated soon after onset, typically within the first 6-8 weeks of the appearance of white lesions. Unfortunately, new patients get trapped between physicians, dermatologists, insurance companies and their daily activities, and typically lose this best window of opportunity. Early treatment will produce better and longer lasting results, which is why medical care should be sought as soon as possible to stop the patches from spreading.

Learn more about different vitiligo treatments.

How Can I Cure Vitiligo?

According to the UM-D multi-dimensional system put forward if the vitiligo patients want to obtain the best treatment effects, they have to noted few important points.

1. Treatment methods and medical device in specialized hospital are much more than the small clinic, and the specialists are more experienced.

2. Etiological treatment is more scientific than the symptomatic treatment.

3. Combining internal and external treatment more safe than using the external treatment alone.

4. It would be more scientific to make a therapeutic regimen according your own vitiligo condition than generalized methods.

5. The therapeutic effects would be faster if combing multiple therapies instead of using the simple method.

Best Treatment?

Except the conventional external using cream, NB-UVB, laser therapy etc.

There are also some therapies that rare known by many patients, such as Traditional Chinese Medicine, Traditional Chinese Medicine fumigation, anti free radical treatment, and luminous energy therapy, biased potential energy therapy silicon, carbon light therapy, electronic acupuncture, medicine iontophoresis therapy all these can accelerate patient's recovery process.

The patients didn't get the satisfied treatment effects using some expectant treatment and their vitiligo are at stabilized condition. We also can choose the skin epidermis transplantation. The effect is quite good, and the treatment also is very fast.

Which Kind of Hospital is Best In Treating Vitiligo

Here are some suggestions for reference only

1. It has a certain level of hospital, such as the Grade-III A specialized Hospital which is the highest grade, and high level of specialized hospital treat a lot of complex vitiligo cases, this Grade-III A specialized hospital have more experience to treat this disease, and there are more large advanced medical equipment in hospital.

2. The bed amount would be more than 100 for the Grade-III A specialized hospital, because of there are more cases in the large scale specialist hospital, so they have more experience.

3. The hospital should be approved by the health ministry

Read about : Vitiligo Appointment And Medical Expenses