Vitiligo is an autoimmune disease and skin condition that appears as smooth white patches of skin. When vitiligo first develops, the patches typically appear on the hands, forearms, feet, and face. However, as it progresses, it can spread to cover larger areas.
What is an Autoimmune Disease?
An autoimmune disease occurs when the body mistakes healthy cells for unhealthy ones and begins attacking them as if they were harmful organisms such as bacteria or viruses. When the immune system attacks healthy cells, they become damaged and that leads to health problems.
The cause of vitiligo is not well understood, but experts believe that a genetic component may be at play. Read on to find out more about how genetics drive vitiligo development.
What’s the Difference Between Genetic and Hereditary Conditions?
“Genetic” and “hereditary” are terms often used interchangeably despite their having two different meanings. While hereditary conditions are passed down from generation to generation, genetic diseases can be developed with or without a hereditary component. Genetic conditions occur when there is a mutation in someone’s genes.
What are Genes?
A gene is a part of your DNA. Genes are passed down through families and contain the hereditary information needed for certain traits, such as eye and hair color.
A genetic mutation is a change in certain genes that occurs because of mistakes in the replicating (copying) of DNA. DNA copying occurs to help produce new cells. The new cells that are created learn their function based on the cell they were copied from. If a mutation occurs while the DNA is copying cells, it can lead to genetic mutations.
Vitiligo and Genetics
Research has shown that genetics plays a role in the development of vitiligo. Experts didn’t reach this conclusion until the 1950s, however, when two medical researchers reported on eight families with many members with vitiligo.
The condition is considered a “complex inheritance,” which means a genetic component is involved, however, it doesn’t follow the same rules of something being hereditary. This means that two or more abnormal genes are involved, whereas hereditary conditions develop because of only one abnormal gene.
Research shows that about 7% of people genetically linked to a person with vitiligo will also have the condition. Also, people with a genetic link to the disease will develop vitiligo earlier in life and the skin condition will be more widespread than people without a genetic cause.
Families with many members with vitiligo also have a higher incidence of autoimmune diseases, which means that genetics is an inherent risk factor for vitiligo and autoimmune diseases that are associated with the skin condition.
What Causes Vitiligo?
The patches of white skin that develop in vitiligo are caused by a lack of melanin, which is a pigment that gives skin its tone or color. Cells known as melanocytes produce melanin in the skin. A person with vitiligo lacks melanocytes in the affected patches of skin.
Although the exact cause of the lack of melanocytes isn’t clear, experts believe that the following conditions or situations may be factors in its development:
- Autoimmune diseases
- Having skin cancer or non-Hodgkin’s lymphoma, a type of cancer that affects an organ system made up of the lymph, lymphatic vessels, lymph nodes, and lymphoid tissues
- Neurochemicals (small molecules, such as dopamine and serotonin, that maintain brain activity) released onto the skin through defective nerve endings, causing toxicity to the outer layer of the skin and leading to vitiligo
How and When Does Vitiligo Start?
The reason behind the onset of vitiligo isn’t clear, and the condition can develop at any age. Researchers are not clear about what triggers the condition in some people and not others, nor are they able to pin down the average age of onset.
How Is Vitiligo Treated?
Since there is no cure for vitiligo, treatment focuses on the loss of melanocytes and the body’s autoimmune response.
This means that to address the white patches, damage to skin cells done by the immune system has to be stopped while the production of new melanin, or skin pigment, is stimulated. In some cases of severe vitiligo, lightening the pigment of surrounding skin can reduce the appearance of spots by making the skin around the patches the same color as the patches.
Treatment options include:
- Topical medications such as corticosteroids, which are anti-inflammatory drugs, are applied to the skin to add color to the affected area
- Light treatment, which uses a special kind of light or laser to restore lost color pigment in the skin
- PUVA light treatment (UVA, or ultraviolet A, light therapy) combined with Psoralen, which is a medication that enhances how much UVA light your skin can absorb
- Surgery that replaces the affected skin with unaffected skin from another part of your body
- Ginkgo biloba, an herb, to help bring back the skin pigment or stop the patches from spreading (more research is needed)
- Depigmentation, which is the process of removing all pigment from the skin so it is all one color
Is Treatment Always Necessary?
Although some people opt for treatment for cosmetic reasons, vitiligo doesn’t always require treatment. Very few people experience pain, itching, or symptoms in the patches of skin, and, for that reason, many people decide not to treat it at all.
A Word From Verywell
While vitiligo can cause some people to feel uncomfortable about the way their skin looks, it is not a dangerous condition. There’s not much a person can do about their genetics, either, so if you do happen to develop vitiligo because of genetics, you have two options: seek treatment or embrace your unique skin.
Many models with vitiligo have chosen to embrace their patches and see their skin as a striking characteristic as opposed to a flaw. Whether you seek treatment is up to you, but know that your skin is beautiful either way.
Frequently Asked Questions
How do you pronounce vitiligo?
The proper pronunciation of vitiligo is vih-tuh-LIE-go.
Does vitiligo hurt?
Vitiligo does not hurt. Even if the skin patches spread across large areas of skin, very few people experience painful or irritating symptoms that are often the case in other types of skin conditions. Burning, itching or pain are not likely to occur when a person has vitiligo.
Can you stop vitiligo from spreading?
There is no cure or prevention for vitiligo, and that means that you cannot stop the condition from spreading. In some cases, treatment can help to restore pigment to the patches of skin that have lost their color and prevent any further color loss. The best way to keep the condition from spreading is staying out of the sun, as exposure to the sun can further damage the skin causing further loss of color.
What age does vitiligo start?
Researchers have not been able to determine an average age of onset and a person can develop vitiligo at any age or at any point in their life. That being said, roughly 25% of people with the condition developed it before they reached the age of 10.