Vitiligo & the stigma associated with it
Vitiligo
& the stigma associated with it
By Dr.Sravya C Tipirneni, Consultant - Dermatologist
& Cosmetologist, Columbia Asia Hospital, Whitefield (A unit of
Manipal Hospitals)
Vitiligo is a skin disorder in which
white patches appear resulting in the skin losing its original pigment. The
condition occurs when melanocytes, which are essentially skin cells that
produce melanin, are destroyed by the body’s immune system. Melanin provides
the necessary pigmentation of the skin.
The main factor associated with
vitiligo, is the stigma attached to it. Though not a life threatening or
contagious condition, there are still some prejudices attached to it. Many of
the vitiligo patients tend to develop low self-esteem as a result of the social
and emotional trauma that comes with such a condition and it is this issue
which we counsel more in the hospitals everyday than the condition itself.
Many cultures, across the world,
attach a strong social stigma to the disease. People tend to sit away from a
person impacted by vitiligo, thinking it’s contagious. In India it can go to
the extent of even hampering marriage prospects. Thankfully, an alternative
narrative is being built as well. Fashion shows, ads, art exhibitions etc are
featuring models with vitiligo, in a bid to drive away this wrongly perceived stigma.
How does vitiligo happen?
Vitiligo usually sets in with a few
small whitish or pale patches which may or may not spread in the first place
but causes more panic. In some cases, it spreads to all parts of the body within
few weeks or can take even a few months. There are numerous types in this spectrum.
Some affect only the hands and feet. Some only the tips and lips. Some are
random and scattered patches throughout the body, while some have extensive
involvement as well.
Though, in some, it may spread and
become larger over the course of time, it usually stays in the same place for
years for most of the patients. It is often seen that the location of smaller
macules moves over a period of time, as certain areas of the skin lose and
regain their pigments. Those suffering from larger patches become conscious
about their condition which can lead to anxiety.
How common is vitiligo?
Globally, vitiligo occurs in about
1% of the population and is rare among the very young or very old. It is seen
more often in people with darker skin, though it impacts all races. It is most
commonly seen in people aged 10 to 30 years.
Causes
The affected person’s immune system may develop
certain antibodies that destroy melanocytes. Also, certain factors that
may increase the chance of getting vitiligo may be inherited. Or else, a defect
in the melanocytes causes them to destroy themselves. These are the common
causes. Sometimes, Vitiligo may also be triggered by certain events, such as
physical or emotional stress. While, it can be said that Vitiligo is not
necessarily inherited, about 30% of affected people do have at least one close
relative who has the condition.
Symptoms
Whitish of pale patches of skin appear spontaneously
in different parts of the body. They are usually asymptomatic. Some might have
borders of differential colour gradation.
Problems associated with vitiligo
While vitiligo maybe termed as a cosmetic condition,
it can be often seen that people with vitiligo may end up suffering from a host
of issues. As they lack melanocytes, patches are more sensitive to sunlight
than the rest of the skin, so they will burn rather than tan. People with vitiligo may have
some abnormalities in their retinas and some variation of colour in their
irises but vision is usually not affected. Patients with vitiligo may be more
likely to get other autoimmune diseases such as diabetes, hypothyroidism
and pernicious anaemia.
But one of the key issues of people with vitiligo is
the embarrassment that they feel about their skin. As a result, they may suffer
from poor self-esteem. Later, this could turn into some form of depression.
This can turn into a psychological issue and if the person affected is
isolating himself, then the family should definitely seek medical help.
Treatment
Topical creams and ointments are available to take
care of immune reactions. They aid in reinstating the colour of the skin. To
check the disease progression, often oral medication is also recommended in
certain cases. Light treatment is carried out to re-pigment the skin in
suitable candidates. Those who don’t respond to light therapy can be treated
with surgical options.
Vitiligo management
Creating a uniform skin tone by
either restoring colour or eliminating the remaining colour is followed. The
former is termed as re-pigmentation and the latter de-pigmentation. Common
treatments include camouflage therapy, re-pigmentation therapy, light therapy
and surgery. Counselling is almost ways be recommended. Most importantly, they
need emotional support and social acceptance, from friends and family.
Education and awareness is key.
