How Vitiligo Works | HowStuffWorks

Publish date: 2023-05-22

Skin, the body's largest organ, is also perhaps the most noticeable of all a person's features. Its characteristics -- thickness, number of hair follicles, color and sensitivity -- vary depending on what part of the body it covers, and they help create the first impression we make on others. But skin also performs some vital body functions, such as helping to regulate temperature and storing fat, vitamin D and water [source: University of Maryland Medical Center]. Additionally, the way skin looks can give clues as to the health and well-being of the body it covers.

Sometimes, however, even when the body underneath may be fine, the color or condition of skin can change. Imagine, for example, that your skin stopped evenly producing melanin, the pigment that gives it its color. Your skin's new blotchy, discolored appearance might alter the way you look at yourself -- and probably the way others look at you, too. Case in point: Michael Jackson. The rumors that the late pop star had bleached his skin in order to look lighter began because he reportedly had vitiligo (pronounced vit-i-LI-go), a condition that inhibits the skin's normal melanin production. Jackson's famous one-gloved look was, some say, an early attempt to mask the symptoms of vitiligo [source: CNN].

Skin pigment resides in the epidermis, the thin outer segment of the three layers that make up this versatile, protective organ. The epidermis itself is made up of three sub-layers, and this is where vitiligo does its work. Melanin doesn't even reach the middle layer of skin, called the dermis, and this condition doesn't appear to affect any other organs or areas of the body.

Vitiligo changes the face a person shows to the world. Many consider Michael Jackson's story one extreme example of the effects of this rare skin disease. But what exactly causes vitiligo? Why does it happen, and can we do anything to halt or reverse its damage? Read on to find out.

Contents
  • Vitiligo Causes
  • Is Vitiligo Contagious?
  • Vitiligo Treatments
  • Vitiligo Diet

    • Vitiligo Causes

    Skin gets its color from melanin in its uppermost layer, or epidermis. That melanin is produced by cells called melanocytes. If melanocytes are destroyed or fail to function properly, the body cannot produce melanin, and the skin loses its color. This anomaly does not happen overnight, nor does it happen evenly throughout the body. Vitiligo can occur in three different forms:

    Because lightening of the skin is more noticeable in people with darker complexions, Michael Jackson's case was obvious both to him and to the public. But vitiligo can affect people of any skin tone. Between 0.5 to 1 percent of the world's population has the condition, which affects people of all races and both sexes equally [source: National Vitiligo Foundation]. Symptoms are most likely to begin when a person is in his 20s. The most common starting points for the telltale white patches are above the eyes or on the neck, armpits, elbows, genitalia, hands or knees. Less common signs of vitiligo are premature graying of scalp hair and loss of color in the mucous membranes or retinas [source: American Vitiligo Research Foundation].

    While doctors do not know why some people get vitiligo, they theorize that it is an autoimmune disease, a disorder in which the body attacks its own healthy tissue for unknown reasons. Heredity plays a role, although many people with vitiligo do not have a family member with the condition. Doctors believe a combination of genetic, immunologic, neurogenic and environmental factors are at play in many cases [source: American Skin Association]. Some people first report seeing the white patches after severe sunburn (one more reason to always protect your skin by wearing sunscreen), while others believe their vitiligo was triggered by emotional trauma. But is this condition contagious? Read on to find out if you can "catch" vitiligo from someone.

    Diagnosing Vitiligo

    Seeing a white spot on your skin does not necessarily mean you have vitiligo. A visit to a primary care physician or dermatologist can determine if the spot is caused by vitiligo or by another disease or condition. The doctor will most likely try to eliminate other causes for the loss of pigmentation. He may also use a Wood's light, a handheld ultraviolet light, to reveal all of the affected spots.

    Is Vitiligo Contagious?

    As you learned on the previous page, vitiligo appears because the body can no longer produce melanin. It is not caused by a germ or virus that can be transmitted from one person to the next, so the condition isn't contagious. In fact, vitiligo patients may feel isolated and alone simply because of their looks. Avoiding them out of fear that you may catch the disease could add to their pain [source: National Vitiligo Foundation].

    Lee Thomas, an Emmy Award-winning African-American television news anchor, understands the isolation and pain associated with having vitiligo. He first noticed white spots on his scalp more than a decade ago. Thomas said he hid his condition for as long as he could -- about four years -- because he feared other people's reactions to his appearance.

    "And not only did I wonder if I saw a monster, I wondered did other people see a monster when they saw me, especially when kids cry when they see your face," Thomas said in an interview on the ABC news program 20/20 [source: 20/20]. Thomas went on to say that people would not shake his hand, and if they did, they would sneak away to wipe their hands as soon as they could.

    Those fears are not necessary. Touching with someone who has vitiligo will not put you at any risk. And there is hope for those who have it. Read on to learn about treatments for the condition.

    Revealing Himself

    When TV anchor Lee Thomas' hands turned white, he knew it was time to tell his boss about his vitiligo. Instead of firing him or relegating him to an off-camera job, management encouraged Thomas to share his story on air. After a fellow patient asked him to do so, Thomas cleaned the makeup off of his face and talked honestly about his trials. He has since written a book called "Turning White," and he continues to make appearances to discuss vitiligo and assure the public that contact with those who have the condition won't cause it to spread [source: 20/20].

    Vitiligo Treatments

    Currently, there is no cure for vitiligo, but there are treatments for the disease. Depending on the severity of the condition and your original skin color, you may opt for no treatment at all if you have vitiligo. But you must be extremely cautious about sun exposure or wear makeup that evens the skin tone. Others may choose medical or surgical treatments. These treatments either attempt to restore skin to its original color or -- as doctors reportedly recommended for Jackson -- eliminate all pigmentation.

    One of the most effective treatments for adding pigment back into the skin is Psoralen photochemotherapy, also called psoralen and ultraviolet A (PUVA) therapy, but this method can be risky. During treatment, a patient consumes or topically applies psoralen, which reacts when exposed to ultraviolet light. The downsides of PUVA are that it's time consuming and can also cause blistering or dark patches [source: National Institute of Arthritis and Musculoskeletal and Skin Diseases]. Narrow and ultraviolet B (UVB) therapy is an alternative to PUVA that does not require psoralen, but researchers are still trying to figure out how effective it actually is.

    Corticosteroid cream can be effective for people who have large areas of color loss, but it takes up to three months to work and can cause thinning of the skin. Immunomodulators work best, especially on the face, for people with small areas of depigmentation. These creams may have fewer side effects, but they are sometimes associated with increased risk of lymphoma and skin cancer [source: Mayo Clinic].

    If more than half the vitiligo patient's body has lost pigment, removing pigment from the rest may be the best option. This is done by spreading medicine on the darker areas of skin until it lightens. The result is permanent and will leave the patient extremely sensitive to sun exposure.

    Surgical remedies also have their advantages and disadvantages. Autologous or blister skin grafting may be used if the light-colored patches are small. In these procedures, doctors remove tiny bits of healthy skin and place them where pigment needs to be restored. Autologous grafting may cause scarring or uneven color, if it works at all. Blister grafting is less likely to cause scarring, but the treated area still may not look normal, and there's no guarantee that this method will work, either. Finally, doctors may choose to implant pigment under the skin, like a tattoo. This works best around the lips, especially if a vitiligo patient had dark skin to begin with [source: Mayo Clinic].

    Can those with vitiligo eat their way to evenly toned skin? Read the next page to find out.

    Experimental Treatments

    Doctors are experimenting with growing melanocytes in a lab and transplanting them onto whitened areas. They are also looking into a compound found in black pepper called piperine. This compound, especially when used in combination with UV light, has restored pigment to the skin of mice [source: Mayo Clinic].

    Vitiligo Diet

    There is no recommended "vitiligo diet," but a healthy diet that supports the immune system is a good choice, since doctors theorize that vitiligo may be an autoimmune disease. Foods to avoid include blueberries and pears, because they contain hydroquinone, a natural depigmenting agent. Some vitiligo patients have also found that the spice turmeric makes their condition worse [source: Vitiligo Support International].

    There are also some vitamins and minerals a person with vitiligo may need to add to their diet. Research has found that vitiligo patients are often deficient in vitamin B12, copper, folic acid and zinc. But before taking any vitamin supplements, you can also try to boost levels of these vitamins by eating foods that are rich in them. For example, vitamin B12 can be found in fish, shellfish, meat and dairy products. Leafy green vegetables such as spinach, as well as fruits, dried beans and peas are good sources of folate (the natural form of folic acid). Since healthy diets are naturally rich in copper and zinc, supplements may be necessary only if a patient is deficient in these minerals [source: National Institutes of Health Office of Dietary Supplements].

    Natural supplements such as ginkgo biloba may also help slow the spread of depigmentation. If vitiligo patients choose to go this route, experts typically recommend taking three 40-millgram doses of a standardized extract each day. Additionally, a few studies suggest that combining the natural amino acid L-phenylalanine with ultraviolet light exposure may cause repigmentation of vitiligo spots. Another supplement that may help is khellin, an extract of the fruit of the Mediterranean plant khella. [source: University of Michigan Health System].

    Remember, while vitiligo cannot be cured, patients can live a long, healthy life with the condition, especially if they learn how to understand and cope with it. For much more information on this topic, read on to the following page.

    A Healthy Mind, Too

    It's just as important to maintain mental health as it is to maintain physical health. Vitiligo is a disease that is obvious to those around you, and it can affect the way you feel about yourself. Joining a support group or forum online might be able to help you get through some of the tougher moments. Groups like The National Vitiligo Foundation offer tools to help you find support near you. Check out the Vitiligo Support Forum for more information [source: Vitiligo Forum].

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