The skin gets its color from the pigment melanin. Specialised cells called melanocytes produce melanin. Any loss or damage to these cells can cause whitish (hypo-pigmented) patches on skin. Hypopigmented patches have partial loss of melanin and they are not complete white. Depigmented patches have completely lost their melanin so they appear white. Vitiligo is one of the most common reason of white patches on skin. It affects about 1-2% of the population wordwide. The patients develop white patch (or patches) on the skin which may or may not spread progressively.
Though vitiligo is not harmful, many misconceptions and social stigma surround this disease, especially in Indian population as the white patches prominently stand out on darker skin complexions. Some patients, due to lack of proper knowledge and existing stigma and myths around this disease, may feel embarrassed and fail to go to a dermatologist. As a result, they deprive themselves of proper treatment and their disease keep on growing.
In this post, we would debunk common myths around vitiligo with actual facts.
Myth: All white patches are vitiligo
Fact: No, all white patches are not vitiligo. There are many conditions when the white patches appear on skin. These include:
Fungal infections: some fungal infections can cause hypopigmented patches that are scaly in nature
Post inflammatory Hypopigmentation: patches appear on site of previous inflammation
Chemical leukoderma: white patches may appear on exposure to some chemicals
Congenital leukoderma: white patches appear since birth in some people. In Albinism, there is complete loss of melanin since birth, and the patients are born with depigmented skin, including depigmented hair and iris.
Leprosy: vitiligo patches are most commonly confused with leprosy. This misconception is one of the main reason of social stigma associated with vitiligo.
Myth: Vitiligo is contagious
Fact: No, vitiligo is not contagious as it is not an infection. Therefore, it cannot spread from one person to another via touch, saliva, blood, inhalation, sexual intercourse or sharing of personal items (drinking bottle, towels). Vitiligo is rather an immune disorder in which there is a destruction of melanocytes, the pigment-forming cells. As a result, white depigmented patches develop over skin.
Myth: Vitiligo is similar to leprosy
Fact:No, vitiligo is not at all similar to leprosy. Leprosy is an infection caused by bacteria while vitiligo is an immune disorder. In vitiligo patches, there is depigmentation or complete absence of melanin, while in leprosy there are hypopigmented patches with sensory loss. In leprosy, there is associated nerve involvement that may cause sensory or motor loss and deformities in affected area, while vitiligo patches have proper sensory activity.
Myth: Vitiligo is related to albinism
Fact: No, vitiligo is not related to albinism. Albinism is a genetic disorder, the patients born with this have no melanin. These patients have white skin all over, including hair, iris and eyebrows, since birth.
On the other hand, vitiligo patients have normal skin at birth. Later in life they develop abnormal immune response towards melanocytes causing their destruction. Vitiligo patients gradually develop patches of white skin, most commonly at about 10 to 20 years of age.
Myth: Vitiligo is caused by eating wrong food items
Fact: In India, the common belief is eating sour foods as sour yoghurt, sour pickles or citrus fruits might cause vitiligo. And simultaneous consumption of milk and food should also be avoided as it may to aggravate the disease. But, there is no scientific data to support these beliefs. On contrary, studies have shown antioxidants as folic acid, ascorbic acid, lipoic acid and vitamin B12 increase effectiveness of phototherapy in vitiligo.
Though, there is no evidence that any diet may aggravate vitiligo, but physical injury & emotional stress are known triggers of vitiligo.
Myth: Vitiligo patients are deficient in mental and physical abilities
Fact: Not at all. Vitiligo is not a systemic disease, it is only limited to skin and does not affect any other body organ or system or intelligence.
Myth: Children of parents with vitiligo ultimately develop this disease
Fact: Not true. Of patients with generalized vitiligo, only 15-20% have one or more affected first-degree relative. This leaves 80-85% of cases which occur without any family history.
Myth: Vitiligo can not be cured
Fact: No, vitiligo can be cured. Treatment of vitiligo is difficult and slow, and at least 70% patients show good response with optimal treatment. Medical science has provided us with multiple options to treat vitiligo that include immunomodulater drugs and phototherapy with ultraviolet A and B light. Surgical techniques involve grafting of normal skin with melanocytes on depigmented patch of vitiligo. Latest technique includes transfer of melanocytes from normal skin to vitiligo patch.
Myth: Vitiligo is dangerous
Fact: No, vitiligo is a cosmetic problem. It is not dangerous or life threatening problem. Though, most patients have psychological impact, excessive anxiety and depression too. These patients should be properly counselled and reassured. They should be told all therapeutic options and also camouflage techniques.
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