What is Vitiligo and Whos At Risk?
People from any race can be diagnosed with vitiligo, but itâ€™s usually most noticeable among people with dark skin because of the contrast between the depigmented skin and the unaffected skin. (1)
Vitiligo affects between 0.2 percent and 1 percent of the population around the world. (4740779/' target='_blank' rel='noopener noreferrer' >3) It doesnâ€™t necessarily affect the skin only. Some people with vitiligo also lose coloring in their mouth, on their eyebrows or eyelashes, or in their hair. (4)
There Are 2 Different Types of Vitiligo and 3 Subtypes
Doctors typically categorize vitiligo as one of the following two types: (4)
- Nonsegmental vitiligo (also known as bilateral vitiligo, vitiligo vulgaris, and generalized vitiligo) This is the most common type of vitiligo and results in white patches appearing on both sides of the body. Usually it starts near the hands, around the eyes or mouth, on the feet, or in an area of the body where the skin rubs together frequently. (5) With nonsegmental vitiligo, color loss comes in spurts over the course of oneâ€™s life, spreading and becoming more noticeable as time goes on.
- Segmental vitiligo (also known as unilateral vitiligo) This type of vitiligo usually starts when a person is young. It generally progresses for a year or so before it stops. Segmental vitiligo appears in one area (or segment, hence the name) of the body, such as on one arm or one leg. In about 50 percent of cases, itâ€™s accompanied by color changes in the hair, eyebrows, or eyelashes. Segmental vitiligo is less common than nonsegmental vitiligo and affects about 1 in 10 vitiligo patients. (5)
Doctors use the following subtypes to describe how much pigment loss appears on the body: (4)
- Localized The vitiligo appears in just one or a couple of spots on the body.
- Generalized The patches of color loss appear in many areas of the body.
- Universal Most of the original skin color is gone. Note: This is very rare.
Vitiligo Is the Result of Certain Skin Cells Dying Suddenly and Unexpectedly
Melanocytes are cells found in the skin that produce melanin and are responsible for giving the skin its color. (4,6) When these cells die, the skin loses its color â€” which by definition is vitiligo. Researchers still donâ€™t know for sure what causes these cells to die. (4)
Itâ€™s suspected that problems with the nervous system lead to segmental vitiligo, while other types are thought be the result of an autoimmune disease that results in the body destroying its melanocyte cells. (4) In these latter cases (the more common type), Dr. Skotnicki says, â€œyour body is attacking the cells that make pigment.â€
For other autoimmune diseases, the mechanisms that cause those conditions to develop are more clearly understood. In the case of vitiligo, there is still no definitive explanation for why the melanocytes die, and therefore many sources stop short of concluding the skin condition is an autoimmune disorder. Still, that is the most widely accepted theory (especially for nonsegmental vitiligo).
Vitiligo Is Thought to Be an Autoimmune Disease and Is Linked to Other Autoimmune Conditions
Autoimmune diseases occur when the bodyâ€™s immune system mistakenly attacks healthy cells. (7) In vitiligo, the theory is that the body attacks its own melanocyte cells, resulting in a loss of color in the skin. (4)
So Who Gets Vitiligo? And Is It Always Hereditary?
The combination of a certain genetic makeup and an environmental trigger is thought to set off an autoimmune response within the body in which the body attacks its melanocytes, resulting in depigmented patches on the skin. (8)
Because there is a genetic component to the disorder, having family members with vitiligo increases the chances that youâ€™ll develop it too. Thatâ€™s not to say everyone with vitiligo can point to a close relative with it, but about 20 to 30 percent of vitiligo patients can, Rodrigues says. (5) Where the vitiligo occurs on the body and how it progresses, however, doesnâ€™t seem to be passed on from one family member to the next. (9)
For people with vitiligo, triggering events can also cause the condition to spread. For instance, â€œif someone gets an intense sunburn, they can develop vitiligo in the areas where the sunburn occurred if they already have vitiligo,â€ Skotnicki says.
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