The 25th of June is World Vitiligo Day, celebrating the lives of people who suffer from vitiligo.
This year’s theme, ‘Vitiligo: Looking into the Future’, places emphasis on advancing knowledge and treatment of this lifelong condition.
Over the years, its purpose has broadened from simply raising awareness of vitiligo to including recognition of the bullying, social neglect, psychological trauma and disability of nearly 100 million people affected by vitiligo.
The Vitiligo Research Foundation (VRF) is currently running a petition to have the 25th of June recognised by the United Nations as World Vitiligo Day. You can help by signing the petition to the UN Secretary-General. Visit www.25June.org and add your name to the 500 000+ who have already signed.
A brief history
The first World Vitiligo Day was held in 2011 and has since become an annual, global event. The campaign was born from the determination of non-profit organisations VR Foundation (USA) and VITSAF (Nigeria), and their supporters across the world, to bring this skin disease into the public eye, and to shine a light on challenges faced by those suffering from vitiligo.
About Vitiligo
Pronounced vit-ill-EYE-go, the condition is a complex and generally unpredictable skin disease. Vitiligo causes the skin to lighten in patches across the face and body. It is a poorly understood, non-communicable, immune-mediated skin disease that affects one in every hundred people to some degree. Vitiligo can be treated temporarily — for up to 3-5 years — with varying degrees of success on different parts of the body, but there is no cure yet.
It can strike anyone at any age, but the condition normally develops before 20 – meaning many children are living with vitiligo. The burden of vitiligo falls particularly hard on developing countries, due to misdiagnosis of the disease, little or no access to effective treatments, and widespread stigmatization and discrimination.
The total number of people suffering from vitiligo is estimated at around 100 million people worldwide. However, the actual number may be much higher because vitiligo is a very underreported disease.
Diagnosis
The health care provider will ask about the person’s medical history and examine their skin, possibly with a special lamp. The evaluation might also include a skin biopsy and blood tests.
Treatment
The choice of treatment depends age, how much skin is involved and where, how quickly the disease is progressing, and how it’s affecting the person’s life.
Medications and light-based therapies are available to help restore skin colour or even out skin tone, though results vary and are unpredictable. However, some treatments have serious side effects.
Medications
No drug can stop the process of vitiligo — the loss of pigment cells (melanocytes). But some drugs, used alone, in combination or with light therapy, can help restore some colour.
Therapies
Light therapy - Phototherapy with narrow band ultraviolet B (UVB) has been shown to stop or slow the progression of active vitiligo.
Combining psoralen and light therapy - This treatment combines a plant-derived substance called psoralen with light therapy (photochemotherapy) to return colour to the light patches.
Removing the remaining colour (depigmentation) - This therapy may be an option if vitiligo is widespread and other treatments haven’t worked. A depigmenting agent is applied to unaffected areas of skin. This gradually lightens the skin so that it blends with the discoloured areas.
Side effects can include redness, swelling, itching and very dry skin. Depigmentation is permanent.
Surgery
If light therapy and medications haven’t worked, some people with stable disease may be candidates for surgery. The following techniques are intended to even out skin tone by restoring colour:
Skin grafting - In this procedure, the doctor transfers very small sections of healthy, pigmented skin to areas that have lost pigment. This procedure is sometimes used if there are small patches of vitiligo.
Possible risks include infection, scarring, a cobblestone appearance, spotty color and failure of the area to recolor.
Blister grafting - In this procedure, the doctor creates blisters on the pigmented skin, usually with suction, and then transplants the tops of the blisters to discoloured skin.
Possible risks include scarring, a cobblestone appearance and failure of the area to recolor. And the skin damage caused by suctioning may trigger another patch of vitiligo.
Cellular suspension transplant - In this procedure, the doctor takes some tissue on the pigmented skin, puts the cells into a solution and then transplants them onto the prepared affected area. The results of this repigmentation procedure start showing up within four weeks.
Possible risks include scarring, infection and uneven skin tone.
Potential future treatments
Treatments being studied include a drug to stimulate color-producing cells (melanocytes). Called afamelanotide, this potential treatment is implanted under the skin to promote the growth of melanocytes.
A drug that helps control melanocytes (Prostaglandin E2) is being tested as a way to restore skin colour in people with vitiligo that isn’t widespread or spreading. It’s applied to the skin as a gel.
- Adapted from The Mayo Clinic and Vitiligo Research Foundation