Vitiligo

Information, treatment options, and support for people with vitiligo.

Vitiligo is a skin condition that affects as many as 6 million Americans — nearly 1 percent of our population. The Vitiligo Workgroup estimates that 70 million people across the world have the condition. Vitiligo is an autoimmune disorder. This means your own immune system destroys melanocytes — the skin cells that make pigment, or coloring.

The rare skin condition has gained an increasingly public face since celebrities like iconic singer Michael Jackson and model Winnie Harlow went public with their diagnoses. The condition typically develops in childhood but can occur at any age. While vitiligo may be more noticeable in those with dark skin tones, it can affect people of all ethnic backgrounds. It’s also emotionally stigmatizing for those who have it.

Symptoms of vitiligo

This condition causes loss of pigmentation, creating irregular white patches of skin and discolored hair. Despite ongoing research, there is no clear cause of vitiligo. Certain physical illnesses and stress have been linked to vitiligo, and also having your hair turn gray before age 35. Research suggests it may be genetic. Vitiligo is not contagious.

Skin and hair discoloration is difficult to cover up. Many people who have it tell us they feel isolated and judged, which can affect their personal and professional lives. Support groups can provide a sense of community and acceptance for people with vitiligo.

Support for people with vitiligo

We are proud to sponsor V Strong, the Southeast Michigan Vitiligo Support Group. The group welcomes anyone in the community who is interested in learning more about vitiligo or wants support and understanding.

Other support organizations include Vitiligo Support International and the National Vitiligo Foundation. The groups provide support for people who have lived for years with vitiligo and those who are newly diagnosed.

How we diagnose vitiligo

First, we take your personal and family history of vitiligo. Then we ask about skin trauma you’ve experienced on the affected areas, including rashes or sunburn.

Next, we perform a physical exam of the affected areas and take a small sample of skin for biopsy. Often, the biopsy will show total absence of pigment-producing cells. If the skin cells are inflamed, you may have a different skin condition. Your doctor also may recommend a blood test to confirm the diagnosis.

We offer these treatments:

Treatment for vitiligo

There currently is no cure for vitiligo, but treatment is available. Every patient responds differently to treatment. Most options work better if they’re started right away, rather than waiting to seek treatment. However, many insurance plans do not cover vitiligo treatments.

Light therapy

Ultraviolet light therapy is the preferred treatment for widespread vitiligo. About 80 percent of patients get a response with this treatment. About half of these patients will keep the new color.

We use these types of ultraviolet light therapy:

• Excimer laser: A form of ultraviolet B laser phototherapy that can be used on vitiligo that covers less than 10 percent of the body.
• Narrowband ultraviolet B: We expose the skin to UVB light two to three times a week. Responses typically occur after 20 to 30 treatments. Unlike PUVA, with which medication (psoralen) is taken orally or applied to the skin, UVB treatment is strictly a light therapy.
• PUVA: Oral or topical medication (psoralen) followed by controlled exposure to ultraviolet A light.

Medications

Topical steroids may be used for limited areas or in combination with other treatments, but they may be ineffective or impractical for widespread vitiligo. Protopic (tacrolimus), and Elidel (pimecrolimus) may help the pigment cells make color.

Bleaching creams for depigmentation

Special prescription bleaching creams are an option for extensive loss of pigment or if you don’t respond to other treatments. These creams will bleach any remaining pigment and result in the permanent loss of skin pigment. Talk with your doctor before trying this option.

Gingko biloba

Ginkgo biloba is an herbal medication that may have an effect on generalized vitiligo. There is no strong evidence that vitamins, herbal supplements, homeopathic treatments, or dietary changes affect vitiligo. Talk to your doctor if you’re interested in trying any of these options.

Surgery

Our dermatology surgeons can transfer intact skin or individual cells from unaffected areas of the body to areas affected by vitiligo.

One effective surgery is melanocyte keratinocyte transplant procedure (MKTP). We were the first health system in the country to treat vitiligo with this surgery. Iltefat Hamzavi, M.D., explains the long-term benefits of MKTP:

Other vitiligo surgeries include:

• Cultured melanocyte transplantation
• Punch grafts
• Split thickness grafts
• Suction blister grafts

MKTP for burn scars

Skin grafts sometimes are used to treat burns. When these grafts heal, the skin can become discolored. MKTP also can be an effective treatment for patients with skin discoloration from burn scars.

The MKTP process is the same to treat a burn as it is to treat vitiligo. Most burn patients will qualify for the procedure. The only qualifications are that the scar is at least a year old or well-healed, and that the patient has no open sores.