Around one in every 100 people worldwide has vitiligo – a chronic, autoimmune skin condition that causes the skin to appear lighter in patches.
The number of people affected by vitiligo makes it one of the most common skin disorders. Several studies also suggest that many cases still remain undiagnosed, meaning the true number of people living with vitiligo may even be higher.
Yet despite how common vitiligo is, many misconceptions still surround the condition. People who have the condition still face stigma, intrusive questions and may experience lower wellbeing as a result.
What causes vitiligo?
The human skin has two layers. The outer epidermis (which we can all see) and the inner dermis (which lies underneath the epidermis).
Skin colour is primarily determined by melanin, a pigment produced by specialised cells known as melanocytes that are found within the epidermis. All humans have melanocytes, but the amount and type of melanin the skin produces varies naturally between people and populations. Melanin also contributes to hair and eye colour.
Vitiligo occurs when a person’s immune system mistakenly thinks their melanocytes are dangerous to the body. This causes the immune system to target these cells and destroy them, leading to a loss of pigment.
Vitiligo is initially triggered by either a person’s genetics or certain environmental factors, such as stress, severe sunburn and exposure to melanocytotoxic chemicals, which are found in some cosmetics and households items. These factors either trigger an immune response or cause damage to melanocytes. As melanocytes disappear, affected areas of skin lose pigment and become lighter or completely white.
Vitiligo can affect people of all ethnic backgrounds, ages and skin types. However, it’s often more noticeable in people with darker skin tones.
Vitiligo may appear anywhere on the body. Commonly affected areas include the face, hands, arms, eyes and mouth. Hair growing from affected skin may also lose colour.
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Vitiligo can develop gradually or rapidly. While some people develop only a few small patches, others may develop more widespread de-pigmentation over time. Most commonly, patches appear on both sides of the body and spread over time (non-segmental vitiligo). But in rarer cases, patches only appear on one side of the body (segmental vitiligo).
Some people may also notice mild itching, tingling or burning, especially as new patches appear. The affected skin can also be more sensitive to sunlight due to reduced melanin.
Because vitiligo is linked to a dysfunctional immune system, people with the condition may be slightly more likely to develop other autoimmune conditions, such as thyroid disease and type 1 diabetes.
Currently, there are several treatment options for vitiligo. These aim to control disease progression and improve long-term skin appearance.
A misunderstood condition
Despite the fact that vitiligo affects so many people globally, misconceptions and stigma about the condition still persist.
Studies have found that some people continue to wrongly believe vitiligo is contagious, linked to poor hygiene or socially undesirable. This highlights ongoing gaps in public education.
Many people with vitiligo have to endure staring, judgment, intrusive comments and insensitive questions about their appearance – sometimes daily.
Model Winnie Harlow, who has vitiligo and has been candid about her experience with the condition, shared in a recent interview that as a child, parents told their children not to play with her because they might “catch her skin”. Harlow also experienced bullying throughout her school years.
Numerous reports have also highlighted experiences of anxiety, depression, social exclusion and even low self-esteem in people with vitiligo.
Skin colour plays a major role in the development of someone’s identity and affects feelings of integration, acceptance and belonging. Visible changes in pigmentation experienced by people with vitiligo also exposes them to societal or social stigmatisation, social exclusion, loss of employment opportunities or even intrusive questions.
Societal perception needs to be corrected because at its core, vitiligo is a condition rooted in cellular biology and immune dysfunction. Knowing this is crucial because it significantly affects how society responds to those affected with visible medical conditions such as vitiligo.
Benedicta Quaye does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
