The World Vitiligo Day on 25th June is a significant date in the vitiligo calendar because it marks the passing date of popstar Michael Jackson, the most famous man that lived with vitiligo and also the most criticised about his vitiligo. That day aims to generate knowledge of vitiligo and its appropriate care.
Vitiligo is a persistent or chronic autoimmune depigmenting skin disorder that results from a loss of melanocytes which results in very pale or pink skin. The pigment that gives our skin its normal color is denoted as melanin and is made by cells known as melanocytes. In patches of vitiligo the melanocytes are inactive but still present. The reason for this is not fully understood. It is not more than a skin disorder and not a nosogenic one.
It is common, affecting about 1% of the world’s population. It can start at any age after birth, but in more than half of the people affected it does so before 20 years of age. Umpteen factors have been involved in disease development, with a prominent role of the immune system and several other factors including autoimmune disorders, heredity, burn or accidental injury, stress, chronic or acute gastric disorders and impaired hepatic function such as jaundice etc.
Some chemicals like monobenzyl ether of hydroquinone-containing products and phenols (rhododenol) containing cream can hamper the pigment of the skin. For instance, this occurred in Japan when a product advertised as a skin-lightening cream caused widespread vitiligo across the product’s consumer base because of the use of rhododenol as an active ingredient.
There is no treatment discovered to cure vitiligo but several treatment options are available which can help repigmentation. Vitiligo with the face (except eyelids), chest, back, upper arms, legs, and patient in primary stage having a better chance of recovery.
The patient trying to get normal skin colour to return in the areas affected by vitiligo have many treatment options like topical treatments, steroid creams, Ultraviolet B light treatment, oral medicines and depigmentation and skin grafting etc.
Ultraviolet (UV) therapy is currently the best treatment option for people with ‘active’ vitiligo. Natural sunlight can help improve vitiligo, although in some parts of the country the climate does not allow for all the year round ‘natural UV’ therapy. Most dermatologists provide an artificial form of UV, in ‘light boxes’ which are specially designed to treat skin conditions, including psoriasis and eczema. UV therapy (including natural sunlight) has the effect of dampening down the immune system in the skin. It may also have the effect of ‘stimulating’ melanocytes to re-pigment the skin.
Understandably, the physicians reported that most patients get very tired of coming in for treatment week after week, for what appears to be a very gradual improvement. This treatment causes the normal skin to tan and therefore worsens the appearance of the vitiligo.
After repigmentation, vitiligo frequently recurs in the same area, research suggesting that vitiligo could involve the presence of resident memory T cell (TRM). Thyroid disease and other autoimmune conditions are more common in individuals with vitiligo.
In Bangladesh, sometimes the vitiligo patients are treated inhumanly, for instance, the patient may get divorced for vitiligo. It is high time to raise awareness that vitiligo is only a disorder of the skin and not a contagious disease.
The writer is a student of Pharmacy at Bangabandhu Sheikh Mujibur Rahman Science and Technology University.