Medical Edge Newspaper Column

Treatment Options For Loss Of Skin Pigmentation

May 8, 2006
DEAR MAYO CLINIC:
Can you tell me about vitiligo, a skin condition where white spots appear on the skin? Is there a cure? Can anything be done to restore pigment? -- Norridge, Ill.

ANSWER:
Vitiligo is a skin condition in which loss of pigment results in white patches on the skin.

Vitiligo affects about 2 percent of the population. The condition is not medically dangerous but it can be emotionally distressing. For people with dark skin, the areas of skin without pigment can be conspicuous. The patches can appear anywhere on the body, but usually first develop on the hands, feet, arms, face and lips. For people with fair skin, the spots might not be noticeable, especially if tanning is avoided.

We don't know what causes vitiligo, though it may be more common in people with autoimmune diseases or thyroid disorders. There may be a genetic link; about one-fifth of people with vitiligo have a relative with the condition.

Vitiligo often begins with rapid loss of pigment. The pigment loss may stop on its own and resume later. While the loss of pigment may stop, it's rare for pigment to return to the affected areas on its own.

There's no cure for vitiligo. Concealing the white spots with makeup or self-tanning products can help improve appearance. If this isn't satisfactory, there are several treatment options:

• Topical corticosteroids: These creams can help return pigment to small areas affected by vitiligo. It takes at least three months before you see results.

• Ultraviolet therapy: Controlled exposure to ultraviolet light one to three times a week for a year can help repigment the skin. Patients use the medication psoralen to make the skin sensitive to light. About half of patients see improvement with this treatment.

• Skin transplant: The doctor can transplant tiny pieces of the patient's normal skin to affected areas. This therapy is considered experimental.

• Depigmentation: If vitiligo affects a large portion of the body, medication can be used to fade the rest of the skin to more closely match the white patches.

If you or a family member has vitiligo, seek out a doctor who's knowledgeable about the condition to determine a treatment approach. And be extra cautious in the sun. People with vitiligo are at increased risk of sunburn and skin cancer.

-- Mark Davis, M.D., Dermatology, Mayo Clinic, Rochester, Minn.