What is vitiligo?
It is classically considered to be a silent pigmentary disorder with few or no symptoms. With no pigment, the skin is extremely susceptible to burning. Prior studies have demonstrated that one-third of vitiligo patients report skin symptoms (e.g. pruritus, burning), which may be specifically associated with early-onset disease. Some vitiligo patients report abdominal cramping associated with their disease. An estimated 45 million people worldwide suffer vitiligo; at least one in 100 British adults is affected. It affects white skins as much as black and Asian ones, and men as much as women, with the average age of onset at just 20 years old.
What can trigger vitiligo?
Vitiligo is the loss of skin pigmentation caused by autoimmune destruction of melanocytes[1]. Multiple pathogenic factors for vitiligo have been described. Several studies have found a high prevalence of antecedent psychological stressors in vitiligo patients, suggesting that specific stressors may trigger and/or exacerbate vitiligo.
Potential mechanisms for stress-triggered vitiligo include increased catecholamines and neuropeptides, which have been found in vitiligo patients[2]. However, the complex relationship between stressors and subsequent vitiligo is not well defined. Both emotional and physical stress can trigger the white patches that mark the skin disease vitiligo.
Vitiligo is a complex disease that involves both faulty genes and environmental factors. It is likely that pigment-producing cells called melanocytes are more susceptible to damaging chemicals produced during emotional stress. Psychological stressors (e.g. loss of a loved one) that occur within 2 years prior to vitiligo onset should be considered as potential disease triggers. Psychological stressors have been associated with symptoms of abdominal cramping and itching/burning in vitiligo patients but not disease extent or distribution.
How can vitiligo be treated?
Despite a large number of sufferers, there is no particularly effective treatment for vitiligo other than steroid creams that dampen the condition for some people, through a mechanism which is not properly understood. However, long-term use of steroids can itself do further damage, such as skin thinning or stretching. The alternative is regular exposure to specific wavelengths of ultraviolet light, which may occasionally stimulate some re-pigmentation, but has to be done every other day.
A new drug called Scenesse [3], currently at the trial stage, may bring new hope. It is based on a compound called afamelanotide, which mimics the effect of melanocyte-stimulating hormone, which is involved in the production of melanocytes — the skin's pigment cells.
Read more on Vitiligo here: https://www.human.com.sg/vitiligo-treatment-in-singapore
References:
1. Vitiligo: MedlinePlus Medical Encyclopedia. Medlineplus.gov. Published 2016. Accessed December 26, 2019.
2. Harris JE. Answer to what causes vitiligo? University of Massachusetts Medical School.Published January 16, 2016. Accessed December 26, 2019.
3. Office of the Commissioner. FDA approves first treatment to increase pain-free light exposure in patients with a rare disorder. U.S. Food and Drug Administration. Published 2019. Accessed December 26, 2019.
