Skin turns pale or white when the body mistakenly destroys cells that produce pigment. The condition (called vitiligo) can happen to anyone, and most develop it before their 40th birthday. Sorry to say, but most patches will spread. “Over time new patches tend to arise gradually and over symmetric areas of the body,” explains Boston-based dermatologist Daniela Kroshinsky. “Some come up spontaneously, and others develop when skin is injured by a cut or sunburn. The longer the disease has been stable, however, the less likely it will spread in the future.”
Although the cause remains unknown, strong evidence points to a triad of genes that make people more susceptible to the physically harmless yet socially distressing and hard-to-treat condition. When patients are upset by their appearance, months-long use of topical lotions and carefully controlled exposure to laser rays or light boxes may help stop the immune system attack and coax cells to grow back and re-pigment the area, says Dr. Kroshinsky. Others opt to cover up faded areas with skin dyes, medical-grade cosmetics, and self-tanning creams.
Advances in surgical techniques hold promise for treating vitiligo, according to information presented at American Academy of Dermatology’s 70th Annual Meeting in March 2012 by Rebat M. Halder, MD, FAAD, professor and chair, department of dermatology, Howard University, Washington, D.C.
· What it is: Normal skin is transplanted to areas affected by vitiligo and begins producing pigment. Phototherapy is often used to boost pigment production in treated areas.
· Who is eligible: Patients with limited and extensive vitiligo that has been stable for at least six months.
· Success rate: 80 to 90 percent in most patients.
· Availability: Uncommon in the United States, this outpatient procedure is widely available in South America, Europe, Southeast Asia, India and China.
· What it is: Cells (melanocytes and keratinocytes) found in the top layer of skin are obtained surgically under local anesthesia and grown overnight in the lab. Then cells are placed or applied on the skin’s vitiligo patches. Phototherapy is often used to boost pigment production in treated areas.
· Who is eligible: Patients with limited vitiligo that has been stable for at least six months.
· Success rate: 95 percent in most patients.
· Availability: Few dermatologic centers in the U.S. are currently offering this specialized outpatient procedure, but Dr. Halder expects that it will be more available in the future.
“It is important for anyone who notices any unusual changes in the pigmentation of their skin to see a dermatologist, as vitiligo treatments are more successful the earlier they are started,” said Dr. Halder. “The newest surgical grafting techniques and transplant procedures hold a lot of promise for successfully treating vitiligo, and I think we’ll see more dermatologists offering these cutting-edge procedures in this country in the future.”
For more about vitiligo and to find a board-certified specialist contact the American Academy of Dermatology.