WHAT IS VITILIGO?

Vitiligo is a skin disorder in which the skin starts losing its color and white patch starts to appear on the skin. If the white area is less than 5mm in size, it is called a macule and if bigger than 5mm, it is called a patch. It may be limited to some area or spread throughout the body. The affected area if has hair may turn the hair white as well.

WHY IS IT CAUSED?

Melanocytes are the cells that produce melanin, that is to say color/pigmentation in the skin. For some unknown reason, the affected person’s body activates its defense system and starts attacking the melanocyte. As the melanocytes are destroyed, this specific area loses its pigment and results in white spots on the skin.

HOW DOES VITILIGO PROGRESS?

It generally begins with one or more white patches on the skin that can spread to other parts of the body over months to years. It may affect any body part, but it is believed that areas exposed to the sun are more likely to be affected first such as hands, feet, face, forearms. The tissue inside the nose or mouth, eyelids and the inner ear may get affected too.

Large patches may appear to remain the same for years and may progress further into the future if not addressed. The smaller area may appear to change shape and size over time.

IS IT CONTAGIOUS?

No. Nor does it threaten life.

IS IT PAINFUL?

No, vitiligo is not painful. Melanin, which is absent if the affected tissue, plays a significant role in protecting against sun damage. It also helps protect from UV rays. Therefore, it is advised to protect the affected area from the direct sunlight.

DIAGNOSIS

If you see a dermatologist, the doctor would probably be able to diagnose you by having a look. A few blood work ups and skin biopsy may eb advised in some cases.

TREATMENT

There is no definite cure for vitiligo but there are several treatment options available and the extent of their result may vary person to person.

• Medications: Application of corticosteroid cream may help in the early stages. Corticosteroids injection pills or injections may be prescribed if the disease seems to be progressing rapidly. Dicaris (levamisole): Use of levamisole to be a simple, safe, and fairly effective remedy for controlling the activity of the disease process in vitiligo patients who have limited and slow-spreading disease. Some patients develop spontaneous repigmentation as well. To achieve a faster rate of repigmentation, levamisole can be combined with other treatment methods such as topical corticosteroids.

• Physiotherapy/Phototherapy: This is a second line and a common therapy for vitiligo. Focused UV light when exposed under supervision of a clinician may help increase the number of melanocytes and prevents new white patches to occur. Light therapy when combined with psoralen application has been proven to be more effective.

• Camouflage: Makeup can be used to camouflage affected areas. Use of sunscreen with high SPF will help protect the skin from harmful UV rays and also minimizes tanning resulting in a lesser contrast between affected and unaffected area.

• Depigmentation: In cases of widely spread vitiligo, depigmentation of the unaffected area may be done to reduce the contrast between affected and unaffected area.

• Surgery: Skin grafting may be done.

MY PERSONAL EXPERIENCE WITH DICARIS

My vitiligo started with macule over my great toe which was noticed in early stages and treatment was started right away. My treatment included a lot of hit and trials including homeopathic, allopathic and ayurvedic. My doctors were changed as felt appropriate by my parents. My vitiligo spreaded very slowly over the years and was only limited to my foot.

The last doctor that I saw prescribed me dicaris. As I was really young then I don’t remember the dosage. Dicaris was already prescribed to me 2-3 times before but only to be taken over weekend once. This doctor advised my mother to give it to me in a particular pattern over some months. It worked like a miracle for me. My patches stopped spreading pretty soon. It has been more than ten years and I do not need any treatment anymore.

I am not qualified enough to prescribe this medicine. But I hope sharing my experience would help you to have a conversation with your doctor.

LIVING WITH VITILIGO

Vitiligo may not be life threatening or contagious, but it can be devastating and life altering for some people. The person may develop anxiety, low self esteem, antisocial behavior and lack of self confidence. People suffering from vitiligo are often subjected to unkind remarks and may lead to bullying in teen years. In many societies, physical appearance still play an important role.

As important it is for society to distigmatise vitiligo, it is important for the patients to take ownership of their health and accept it. It’s true that we all care about how we look and also, how others see us. There is more to a person that the looks. It is important to focus on their skills and achievements. It is easier said than done. It is important to accept ourselves, let go of the stress, reaching out to others, do activities that make you happy. Also, in this era, we have some amazing support groups on social media. Knowledge is power. More you know about your disorder, more you’ll feel equipped to deal with it. While vitiligo may not be curable, but it is usually treatable.

Here are links to some of the support groups available:

https://www.myvitiligoteam.com/

https://rarediseases.org/organizations/vitiligo-support-international/

https://vitiligosociety.org/