Times of India
19 May 2010

When sudden white patches start showing on the skin, the reactions may be varied–curiosity, fear, depression and even diffidence. In medical parlance, the condition is called vitiligo (pronounced vitill–eye–go). However, it is neither an infection nor is it contagious, says Dr D S Krupa Shankar, professor and head of department of dermatology, Manipal Hospital.

In line with a decision taken by the Indian Association of Dermatologists, Venereologists and Leprologists in 2006, May 19 is observed as Vitiligo Day. The day is set aside to create awareness about the facilities available to treat vitiligo and eliminate stigma attached to the disease. It’s a condition affecting up to 1–2% of the population.

Vitiligo refers to white patches that many people develop. These may appear in localized areas as one or two small patches or may involve one or multiple regions of the body. However, not all white patches are vitiligo, they could also result from a variety of other skin diseases.

What causes vitiligo?
Vitiligo is an auto–immune disease which may or may not be associated with various underlying medical conditions such as diabetes, thyroid problems, etc. Your dermatologist will be able to guide you on various tests that you need to undergo to determine the underlying medical conditions, if any, associated with the patches.

Is it hereditary? A child born to a person having vitiligo has 5% chances of developing the same disease in his/her lifetime. This is not very high as compared to a child born to a non–vitiligo person, which is 1–2%. What is the course of vitiligo? The course is rather unpredictable. Most often it shows a tendency to slow progression.

What are outcomes of treatment?
About 25% of children with vitiligo regain colour without treatment. In adults, areas of skin in the head and neck regions and hairy areas regain skin colour faster than fingertips, toes and skin directly over bones and lips.

Available treatments?
If no underlying disease is found, vitiligo can be left untreated. However, depending on the type of vitiligo and extent of the white spots, various medical and surgical treatments are available. The goal is to restore the skin’s colour. This could also take years.

Does vitiligo surgeries have complications?
You can develop graft rejection, scarring/darkening of donor site, polka dot appearance, etc. However, most patients have good to excellent results. It depends on various factors such as the type, size, site and stability of vitiligo lesions, age and colour of the patient.

Other than surgeries, what are the treatment options available?
The use of cover–up creams is a good option. These are thick pastes that are spread over the affected areas and blended with the surrounding skin. These cover–ups stay on for 6 to 8 hours and have to be cleansed at the end of the day. They are non–toxic and do not wear off easily with water or sweat. Brown matte lipstick, buffed with talc after application, is another practical cover–up.

(Dr D S Krupa Shankar is head of department of dermatology, Manipal Hospital. He’s also the president of Bangalore Dermatological Society)