How it manifests itself
- Clearly defined milky-white spots, often symmetrical
- Typical places: around the mouth and eyes, hands, elbows, knees, groin folds, friction areas
- Hair in the lesion may also become discolored
- The spots do not peel, do not itch or hurt
- The appearance of depigmentation at the site of injuries and burns (Köbner phenomenon)
- The skin in the outbreaks easily burns in the sun - there is no protection from melanin
Под лампой Вуда очаги витилиго светятся молочно-белым и становятся видны даже при небольшой депигментации — это помогает отличить их от других светлых пятен.
Causes and associated diseases
The leading one is the autoimmune theory: the immune system attacks melanocytes. There is a hereditary predisposition, and the onset can be triggered by stress, sunburn, injury, or contact with certain chemicals.
- Autoimmune thyroiditis and other thyroid diseases are the most common association and must be checked
- Diabetes mellitus type 1
- Alopecia areata
- Pernicious anemia, vitamin B12 deficiency
- Rheumatoid arthritis and other systemic diseases
What helps
The response to treatment depends on the location and duration. The face and neck respond best; hands and feet - worse. Fresh lesions recover much better than old ones, so there is no need to delay treatment.
- Topical glucocorticosteroids - for limited, fresh lesions
- Topical calcineurin inhibitors are the drug of choice for the face, eyelids and folds, can be used long-term
- Narrowband UVB phototherapy is the main method for common forms, in courses of several months
- Excimer laser - for limited lesions
- The combination of phototherapy with external medications is more effective than either method alone
- Surgical methods of melanocyte transplantation - with a stable process that does not respond to therapy
- With extensive lesions, depigmentation of the remaining areas is sometimes discussed
Pigment restoration is slow: the first signs appear after 2–3 months of treatment in the form of small pigment spots around the hair follicles. You shouldn't expect quick results.
Protection and daily life
- Sunscreen with a high factor is a must for hot spots: they lack natural protection and burn easily
- Sunburn causes new spots to appear
- Be careful with skin injuries, friction, tight clothing
- Decorative products and self-tanning are a safe way to even out your tone
- Check your thyroid gland once a year
- Psychological support: vitiligo has a significant impact on self-esteem, and it is okay to discuss this with your doctor