OUR CARIBBEAN SKIN SERIES / Vitiligo
Janine Mendes-Franco
Your skin is as individual as you are – Caribbean skin even more so, thanks to its beautiful diversity. Vitiligo, which is characterised by a gradual loss of skin pigmentation that typically occurs in sharply defined patches, equally affects people of all ages, races and genders, but it is more noticeable in people of colour.
Links to autoimmune diseases
The condition may first manifest itself in parts of the body that are exposed to the sun, but other areas are soon affected, getting larger, whiter and more pronounced. There is currently no cure, but as work continues into determining precisely what causes vitiligo, this may someday change. Doctors suspect a genetic predisposition, perhaps triggered by environmental factors, or an autoimmune disease link, whereby the immune system attacks the cells that create skin pigment. In most cases, the loss of pigmentation happens on both sides of the body. As with other autoimmune conditions, vitiligo can be brought on by stress or other types of trauma. We can usually diagnose the condition from a skin biopsy.
Social ostracisation
Sadly, vitiligo tends to attract a lot of social stigma, which is why having role models like Winnie Harlow is so important, as it helps people to understand the condition and hopefully, change their mindset. She advises young women to “make [their] own mould for what beauty is”.
Still, many patients – particularly younger ones – may grapple with self-esteem issues after diagnosis, including depression. We’ve therefore found that any treatment plan should ideally include psychological support. Public outreach at the national level would also be useful, as patients should not be made to suffer from greater societal ignorance or intolerance about the condition.
Other than the psychological distress and impact on quality of life – which are real issues – vitiligo is considered a benign condition, although patients are more easily prone to sunburn. In severe cases, it might contribute to vision problems and hearing loss, though these side effects are much less common.
Treatment options
The approach to treatment may differ depending on the patient’s age, as well as the extent and progression of the condition. Other than the regular sun protection advice, vitiligo treatment may involve a combination of topical creams, medications that control inflammation or regulate the immune system, and light-based therapy.
The hope is that future treatments may include drugs that stimulate the melanocytes, to either prevent loss of pigment or control the spread of vitiligo. While come people report results with alternative remedies, it’s important to let your doctor know what you’re taking, in case there are contraindications with some prescribed medicines.
If you notice lighter patches on your skin that you’re concerned about, have a family history of the disease, or feel that you may be at risk because of stress factors or underlying autoimmune conditions, just give us a call or schedule an appointment.