Diagnosis of Vitiligo
To diagnose vitiligo, your doctor will ask about your family history and perform a thorough physical exam. The exam may include a close evaluation of your skin. Sometimes doctors use a Wood’s lamp, also known as a black light, which is an ultraviolet light that the doctor shines on your skin. If you have vitiligo, the light makes affected areas of your skin appear chalky and bright.
Other tests can include:
- Blood tests to check for other autoimmune diseases.
- An eye exam to check for uveitis, an inflammation of part of the eye that sometimes occurs with vitiligo.
- A skin biopsy, which means taking a small sample of your skin to be examined under a microscope. Doctors can examine the tissue for the missing melanocytes seen in the depigmented skin of a person with vitiligo.
Treatment of Vitiligo
Your doctor may prescribe a medication that focuses on stopping the immune system from destroying the melanocytes and improving the skin’s appearance. In most cases, the goals of your treatment are to:
- Slow or stop the disease from progressing.
- Encourage the regrowth of melanocytes.
- Restore color to the white patches of skin, which can help the skin color look more even.
It’s important to remember that treatments may take time, and not everyone responds. In addition, the results from treatments can vary from one part of the body to another, and new patches may appear in the meantime. Sometimes, doctors will recommend more than one treatment to get the best results.
Treatments can include:
- Medicines or medicated skin creams, such as corticosteroids or a calcineurin inhibitor, which may be able to return color to the white patches of skin.
- Use of light (phototherapy) to help return color to the skin. There are several different forms of light therapy. Doctors may use light boxes to treat large areas of vitiligo and use laser treatments on more localized areas.
- Depigmentation, or removing color from dark areas of the skin so they match the white patches. Doctors usually recommend this treatment for people who have vitiligo on more than half of their bodies. Depigmentation tends to be permanent and can take more than a year to complete. As with other treatments, it is very important to limit exposure to sunlight during and after treatment.
- Dermatologists may consider surgical techniques for long-standing segmental vitiligo or vitiligo of any type for which other treatments do not work. Surgery is typically not recommended when vitiligo is spreading or for people who scar easily or develop keloids, which are raised scars that grow larger than the wound that caused the scar.
Who Treats Vitiligo?
Health care providers who treat vitiligo include:
- Dermatologists, who specialize in diagnosing and treating disorders of the skin, hair, and nails.
- Primary care physicians, such as a family practitioner or internist.
- Other specialists, such as ophthalmologists (who treat eye problems) may also provide care.
Living With Vitiligo
Living with vitiligo can be hard. Some people with the disorder feel embarrassed, sad, ashamed, or upset about the changes in their appearance. Sometimes, this can lead to low self-esteem and depression. Seeking advice and help from a mental health professional can help you cope with the disorder and treat depression.
In addition to the treatments your doctor recommends, you can help manage the disease by:
- Protecting your skin from the sun. Use sunscreen and wear clothes to help protect your skin from sunburn and long-term damage.
- Wearing cosmetics, such as self-tanning lotions or dyes, to cover depigmented patches of skin. Talk to your doctor about which lotion or dye you should use.
- Finding a doctor who has experience treating people with vitiligo.
- Learning about the disorder and treatments to help you make decisions about care.
- Talking with other people who have vitiligo. Consider finding a vitiligo support group in your area or through an online community.
- Reaching out to family and friends for support.