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Loss Of Pigmentation On Skin

Vitiligo Can Affect Your Quality Of Life

What causes skin pigmentation and how to get rid of it?

Vitiligo can change your appearance, which leaves some people feeling:

  • Self-conscious

  • Embarrassed

  • Frustrated

If vitiligo affects the way you feel about yourself, youre not alone. In talking with their patients, dermatologists have learned that vitiligo often changes how people feel about themselves.

Many patients want to hide vitiligo. One woman confided that she wanted to wear a short-sleeved dress to a wedding but didnt. She was too worried about what others would think when they saw the light patches on her skin.

If vitiligo affects the way you feel about yourself and life, tell your dermatologist. With help, many people feel better. Help can range from treatment that may restore lost skin color to learning how to get natural-looking results from camouflage makeup. For some patients, joining a support group or seeing a psychologist helps build their self-confidence.

Learning more about this disease can also be helpful. Some people say it helps them feel more in control. To learn why some people get vitiligo, go to Vitiligo: Causes.

Related AAD resources

ImagesImage 1: Used with permission of the American Academy of Dermatology National Library of & & Dermatologic Teaching Slides.

Image 6: Used with permission of the Journal of the American Academy of Dermatology. J Am & Acad Dermatol. 2016 74:1178-84.

Image 7: Used with permission of the Journal of the American Academy of Dermatology. J Am & Acad Dermatol. 2017 77:17-29.

The Physical Exam And Woods Lamp

The Woods lamp is a UVA light that looks dark purple, and its used by holding it close to the skin with all the lights in the room turned out. Its the same light used for highlighting fluorescent colors in the dark, like midnight bowling, fluorescent mini golf, and clubs in the 70s. So be careful when going to one of these places that uses a black light if you have vitiligo, because your spots will glow! Maybe youll think this is cool, and want to find one. . .

When a patient has vitiligo, the Woods light makes all of the white spots fluoresce bright white, making them clearly visible in contrast to the normal skin color, even if the normal skin is very pale. It has something to do with proteins in the skin absorbing UVA light and then emitting a longer wavelength thats in the visible spectrum, so your eyes can better see it. Its an incredibly useful tool for a dermatologist and vitiligo specialist, because very few other diseases turn the skin white like this. So, when the spots glow under Woods lamp, it narrows down the possibilities by a lot. Combined with other pieces of information gathered by talking with the patient, we can usually diagnose vitiligo without a skin biopsy.

Why People With Vitiligo Are Joining The Body Positive Movement

While some people with vitiligo seek treatment to cover up or repigment their skin, others choose to embrace the condition however it shows up. Ash Soto falls into that camp. The twentysomething from Orlando, Florida, documents her experience with vitiligo on her , which is over 150,000 followers strong.

Soto was diagnosed with vitiligo at age 12 after she saw a white spot on her neck and then noticed another one appear within a few months. I remember being really scared and confused, she says.

Soto admits she was teased at school for the way her skin looked and says her vitiligo hurt her self-esteem and made her feel insecure. By her late teens, however, she had decided to embrace her skin and use it as a canvas for art, which she shares photos of on Instagram. Her photos are accompanied by inspirational captions that promote a love-yourself mentality.

The body positive movement is all about self-acceptance, so its been a natural fit for people who want to embrace their vitiligo. Some well-known people have been open about their vitiligo including the model Winnie Harlow, the ballet dancer Michaela DePrince, Breanne Rice from The Bachelor, and actor Jon Hamm and this has helped bring vitiligo into the spotlight, notes the Vitiligo Society. With this raised awareness, people may become more accepting of those living with the condition.

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How Is Vitiligo Diagnosed

A dermatologist can usually tell if someone has vitiligo just by looking for the telltale white patches. On people with fair skin, a special tool called a Woods lamp might be used. This lamp uses ultraviolet light in a dark room to illuminate areas of damaged skin that would otherwise be hard to see with the naked eye.

Your doctor will ask about your medical history, and probably also ask you about:

  • any skin conditions you or anyone in your family has had
  • past immune problems you or anyone in your family has had
  • any recent rashes or sunburns
  • whether you’ve been ill or under stress recently

The doctor also may do a blood test to check for thyroid problems and diabetes, since they can increase the risk of vitiligo.

Very occasionally a doctor may do a biopsy removing a small piece of the affected area to check whether there are pigment cells in the skin. If the biopsy shows there are no pigment cells, this may confirm a case of vitiligo.

Treatment And Medication Options For Vitiligo

Vitiligo Facts: Skin Pigment Loss and Possible Treatments

There is not currently a cure for vitiligo, says Michele Green, MD, a dermatologist in private practice in New York City. But a growing variety of treatment options can minimize the appearance of white skin spots.

Nondrug and nonsurgical therapies include:

  • Makeup and self-tanners, which can cover up white patches and hair dye to bring color back to graying or white hair
  • Light therapy, specifically narrowband UVB, according to Dr. Haughton

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Who Is Likely To Get It

Up to 2% of the population and an estimated 2 to 5 million Americans have the condition. It doesn’t matter if you’re a man or a woman.

In most cases, it develops early in life, between ages 10 and 30. It will almost always show up before age 40.

Vitiligo may run in families. You’re more likely to get it when someone else in your family has it, too, or when people in your family get gray hair prematurely.

Autoimmune diseases, such as autoimmune thyroid disease or type 1 diabetes, can also raise your odds.

How Is Vitiligo Treated

There is no cure for vitiligo. The goal of medical treatment is to create a uniform skin tone by either restoring color or eliminating the remaining color . Common treatments include camouflage therapy, repigmentation therapy, light therapy and surgery. Counseling may also be recommended.

Camouflage therapy:

  • Using sunscreen with an SPF of 30 or higher. Also, the sunscreen should shield ultraviolet B light and ultraviolet A light . Use of sunscreens minimizes tanning, thereby limiting the contrast between affected and normal skin.
  • Makeups help camouflage depigmented areas. One well-known brand is Dermablend┬«.
  • Hair dyes if vitiligo affects the hair.
  • Depigmentation therapy with the drug monobenzone can be used if the disease is extensive. This medication is applied to pigmented patches of skin and will turn them white to match the areas of vitiligo.

Repigmentation therapy:

  • Corticosteroids can be taken orally or topically . Results may take up to 3 months. The doctor will monitor the patient for any side effects, which can include skin thinning or striae if used for a prolonged period.
  • Topical vitamin D analogs.
  • Topical immunomodulators such as calcineurin inhibitors.

Light therapy:

Surgery:

Counseling:

  • Vitiligo can cause psychological distress and has the ability to affect a persons outlook and social interactions. If this happens, your caregiver may suggest that you find a counselor or attend a support group.

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Vitiligo And Pityriasis Alba

Two of the most common skin disorders associated with pigment loss have causes that are not completely understood 5. Vitiligo typically occurs during the first 3 decades of life and is characterized by smooth, white patches of skin. Pityriasis alba, which is most often observed in young children, may first appear as a red scaly rash, typically on the face and arms. The rash often resolves spontaneously but leaves dry, white patches as it heals. These patches eventually disappear, causing no permanent pigment loss.

  • Two of the most common skin disorders associated with pigment loss have causes that are not completely understood 5.
  • Vitiligo typically occurs during the first 3 decades of life and is characterized by smooth, white patches of skin.

Vitiligo Causes And Risk Factors

Scalp micropigmentation is a nonsurgical hair loss treatment

The skin doesn’t have its characteristic color because it has lost its melanin. For some reason, the pigment-forming cells known as melanocytes have been destroyed.

We don’t know why this happens. It might be an autoimmune condition, where your body’s defenses turn on your own cells instead of attacking invading germs.

Although vitiligo affects all races equally, it’s more noticeable in dark-skinned people.

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Other Causes And Follow

Inadequate intake of copper or selenium can cause generalized pigment loss, usually beginning on the face and sometimes also affecting the hair. This may occur in a person receiving long-term intravenous feeding or in instances of severely insufficient nutrient intake.

If you notice any pigment loss, see your doctor to help identify the cause and determine the most appropriate next steps. The pigment loss may be simply a part of a normal process, such as wound healing, but it may represent something more sinister, such as a melanoma changing from dark brown to flesh color.

  • Inadequate intake of copper or selenium can cause generalized pigment loss, usually beginning on the face and sometimes also affecting the hair.
  • The pigment loss may be simply a part of a normal process, such as wound healing, but it may represent something more sinister, such as a melanoma changing from dark brown to flesh color.

Chemical Exposure And Topical Medicines

Exposure to certain chemicals can cause skin color changes. For example, an antioxidant used in rubber manufacturing — monobenzyl ether of hydroquinone — was one of the first chemicals noted to be associated with occupation-related pigment loss. Certain compounds used in antioxidants or germicidal disinfectants can also produce pigment loss. Likewise, some medicines applied to the skin, such as corticosteroids and tretinoin, have the potential to produce lighter areas.

  • Exposure to certain chemicals can cause skin color changes.
  • For example, an antioxidant used in rubber manufacturing — monobenzyl ether of hydroquinone — was one of the first chemicals noted to be associated with occupation-related pigment loss.

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Medical Treatment For Skin Pigmentation

The treatment you do depends on the cause of your hyperpigmentation. If it is due to other health issues, treating the underlying problem may help to reduce pigmentation. Consult a doctor who can recommend better treatment options available.

  • Intense pulsed light treatment
  • Topical creams

Preventing unwanted skin darkening is the first step to avoiding hyperpigmentation in the future. You need to take good care of your skin and limit sun exposure. Here are some tips you can follow to prevent skin pigmentation.

Some tips to prevent skin pigmentation

Use Sun Protection Everyday

Exposure to UV rays triggers sun spots, age spots, dark patches, and hyperpigmentation. Never forget to apply sunscreen lotion on all exposed areas. Excessive sun exposure activates the melanin production system, and a good sunscreen helps prevent that.

Apply Anti-Inflammatory Skin Care Products

Whether its acne or dermatitis, skin inflammation often leaves behind marks that are tough to erase later and eventually make your skin look dark and pigmented. Let your skin heal by using anti-inflammatory skincare products.

Eat healthy food

A healthy and balanced diet keeps your skin and body healthy. Your body can use the vitamins and nutrients derived from the diet to trigger faster healing.

Almost all of us have some form of hyperpigmentation. These natural ways will help minimize their appearance and any future damage. If you have ignored those spots all these days, its time you tried out these remedies.

How Does Vitiligo Progress

Vitiligo: Causes and Treatment of Skin Pigment Loss

Vitiligo usually begins with a few small white patches that may gradually spread over the body over the course of several months. Vitiligo typically begins on the hands, forearms, feet, and face but can develop on any part of the body, including the mucous membranes , the eyes, and inner ears.

Sometimes the larger patches continue to widen and spread, but usually they stay in the same place for years. The location of smaller macules shifts and changes over time, as certain areas of skin lose and regain their pigments. Vitiligo varies in the amount of skin affected, with some patients experiencing few depigmented areas and others with widespread loss of skin color.

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What Are The Different Types Of Skin Pigment Disorders

Pigment disorder Treatment
Albinism This is a rare, inherited disorder. It reduces the amount of melanin pigment in the skin, hair, and eyes. People with albinism have white hair, pale skin, and blue eyes. Their eyes may seem red in different lighting conditions. Many also have vision problems. There is no cure for albinism. People with this condition should avoid sun damage to the skin and eyes by wearing sunscreen, hats, and sunglasses.
Melasma Dark brown to gray-brown, symmetric patches of pigment on the face. During pregnancy, this is called the mask of pregnancy. Sun exposure, hormones, and birth control pills are thought to cause melasma. Sunscreens and avoiding sun exposure can prevent melasma from becoming worse. Other treatment may include prescription creams containing hydroquinone and tretinoin to lighten the patches.

Pigment Loss After Skin Damage

An injury to the skin, from simply picking a blemish or a significant burn, may cause enough damage to form a white scar . If the damage is enough to partially, or completely, destroy melanocytes in the area, a scar with decreased pigmentation may result, says Lortscher. To prevent further injury, fight the urge to touch your wounds and let them heal.

Best Treatment Option: There are several topical prescriptions that possibly help with re-pigmentation of white scars, but Dr. Lortscher does not expect them to have highly noticeable improvement. Care for wounds during the healing process with a scar treatment or oil to help repair the skin, conceal with a tailored product or aim to lighten your overall skin tone to decrease contrast.

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Favorite Camp For Kids With Vitiligo

This weeklong camp from the American Academy of Dermatology is open to children between ages 8 and 16 who have a chronic skin condition, such as vitiligo, alopecia, or psoriasis. All fees for camp, including transportation, are covered by the AAD. A dermatologist’s referral is needed to attend.

AAD Camp Discovery takes place in five locations each summer and gives children the opportunity to swim, fish, horseback ride, and have fun. A dermatologist is on site to ensure each childs health needs are met.

With additional reporting by Sari Harrar.

What Causes An Itchy Scalp

UV technology reverses pigmentation loss from vitiligo

If you are looking for a treatment for your itchy scalp, then it is first important to identify the cause behind the itch.

Do you know the body undergoes a complex process before generating an itch? It takes mere seconds for you to feel something. But the process behind it is quite lengthy.

The body generates the sensation of itching in response to a stimulus, which is an irritant. For example, you may experience an itch after an insect bite. Certain fabrics, too, may cause itching as an allergic reaction.

The irritant is identified by neurons, cells in the nervous system serving as message transmitters. Information about the irritant is transmitted to the spinal cord. A protein called NPPB is produced in response to the message.

The NPPB protein releases another protein gastrin-releasing peptide or GRP receptor. The function of the GRP receptor is to transmit the sensation of itch through the spinal cord. The itching sensation then gets delivered at the site of irritation. The result human beings feel the itch and scratch it for relief.

Here are some reasons why the scalp may feel itchy:

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Hypopigmented Spots That Are Not Vitiligo

If the spots are not truly white, but hypopigmented and not depigmented , then they are NOT vitiligo and could be any number of different diseases and conditions. Ill list a few of the most common ones here. Both IGH and nevus depigmentosus can also be hypopigmented instead of depigmented. They look similar and are located on the same areas of the body. Nevus anemicus is a common birthmark that looks lighter than surrounding skin, although it is actually not different in pigment at all. It is due to a lower blood supply to that area of skin, so it is less pink than surrounding skin and thus looks lighter. It actually disappears completely for a few seconds when you apply pressure to the area because the surrounding blood in the vessels is pressed out. It reappears once the blood rushes back into it. Individuals with tuberous sclerosis can have light areas of skin called ash leaf spots, but they usually have other more cleare signs of this condition as well. Occasionally, darker skin from melasma can make it look like the normal skin is lighter, and thus could look a little like vitiligo.

Melasma

Tinea versicolor causes lighter spots on the chest and back, get scaly if scratched with a fingernail, and are caused by a common fungus that isnt dangerous. Its easily treated with an antifungal therapy.

Tinea versicolor

Progressive macular hypomelanosis looks a lot like tinea versicolor but without the scale, most commonly affecting the chest and back.

Pityriasis albaMorphea

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