Vitíligo

To diagnose vitiligo, your doctor will probably look at your skin, examine you to rule out other illnesses, ask some questions and do some tests.

Some questions your doctor might ask are:

• Do any of your family members have vitiligo?
• Do you or any of your family members have any autoimmune diseases?
• Did you have a rash, sunburn or other skin problem before the white patches appeared?
• Did you have something stressful happen or did you have a physical illness?
• Did your hair turn gray before age 35?
• Are you sensitive to the sun?

Tests might include:

• A biopsy, which means taking a small sample of your skin to be examined. Under a microscope, doctors can usually see a complete absence of melanocytes in the depigmented skin of a person with vitiligo.
• Blood tests to check for autoimmune diseases.
• An eye exam to check for uveitis, inflammation of part of the eye that sometimes occurs with vitiligo.

Vitiligo is not usually medically harmful, but the white patches can cause emotional distress. Most treatments for vitiligo are designed to help restore color to the white patches of skin. For some people, treatment helps make the skin color look more even, but many treatments can have unwanted side effects. Treatments can take a long time, and sometimes they don’t work.

Medical treatments can include:

• Medicines or medicated skin creams, such as corticosteroids, that may be able to return color to the white patches of skin. This is particularly effective in early stages of the disease.
• Light or laser treatments.
• A combination of ultraviolet light treatment and medicine known as psoralen photochemotherapy or psoralen and ultraviolet A (PUVA) therapy. This involves taking or applying the drug psoralen, which reacts with ultraviolet light to cause your skin to darken. With this type of therapy, it is very important to limit your exposure to sunlight.
• Depigmentation, or removing color from dark areas of the skin so they match the white patches. This may be recommended for people who have vitiligo on more than half of their bodies. Depigmentation tends to be permanent and will make you unusually sensitive to sunlight.
• Tattooing small areas of skin.
• Skin grafts, a type of surgery in which the doctor takes skin from one area of your body and attaches it to another. This surgery is sometimes used for people with small patches of vitiligo.
• Autologous melanocyte transplants, an experimental procedure in which melanocytes are grown in a laboratory dish and transplanted to the depigmented patches.

Diagnosing and treating vitiligo is a team effort involving you and perhaps several types of health care professionals. These may include:

• Dermatologists, who treat skin problems.
• Mental health professionals, who help people cope with difficulties in the home and workplace that may result from their medical conditions.