May 15, 2025 • 15 mins
Vitiligo: What is it? What causes it? How do we treat it? In this episode, we go over the history of Vitiligo, the different types of the condition, and how we diagnose it. Tune in to learn more!
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Resources:
Marmoladas: https://vimeo.com/641896772
Global Vitiligo Foundation: https://globalvitiligofoundation.org/
References:
https://pubmed.ncbi.nlm.nih.gov/17822509/
https://www.mayoclinic.org/diseases-conditions/vitiligo/symptoms-causes/syc-20355912
https://www.mayoclinic.org/diseases-conditions/vitiligo/diagnosis-treatment/drc-20355916
https://cdn.bad.org.uk/uploads/2022/01/29200045/Vitiligo.pdf
https://my.clevelandclinic.org/health/diseases/12419-vitiligo
https://vrfoundation.org/vitiligo_history
https://vrfoundation.org/famous
https://www.cosmopolitan.com/style-beauty/beauty/a40458553/winnie-harlow-vitiligo-skincare/
https://cayskin.com/pages/winnie-harlow
https://www.myvitiligoteam.com/resources/how-winnie-harlow-learned-to-embrace-her-vitiligo
https://www.nhs.uk/conditions/vitiligo/
https://medlineplus.gov/genetics/condition/vitiligo/
*This podcast is for entertainment purposes only. If you suspect you have a medical condition, please seek out an opinion of a medical professional.*
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Your five-year-old son, Zack, came home excited from school.
(00:03):
He hands you a painting he had done in class.
When you catch a glimpse at his hand,
on it, there was a little patch
that is much lighter than the rest.
You asked him if he had paint on his hand,
wondering what that patch was.
He shrugged, telling you, "It's been there a while."
Concerned, you decide to book him a doctor's appointment.
(00:30):
(upbeat music)
Hello and Welcome to Anatomy Of Illness.
Today's episode is about vitiligo.
Before we get into the condition,
we are going to start with the history.
So why we know vitiligo exists.
We begin in ancient Egypt,
between 3000 BC and 1550 BC.
This is with the Eber's papyrus.
(00:52):
In this papyrus, they differentiated
between leprosy and vitiligo.
Leprosy being called a pale swelling, unlike vitiligo.
The attempts at treating vitiligo in ancient Egypt
would be similar with that of the ancient Indians.
The ancient Indians would refer to vitiligo
as Sveta Kustha or white leprosy.
In ancient India, there was much stigma
surrounding vitiligo.
(01:12):
It was considered unmarriageable
if a woman had this disease.
It was also thought to be caused if you had,
in a past life, insulted a religious teacher,
according to Hindu texts.
This would cause you to have it in your next life.
The ancient Indians would use plants
containing the compound psoralen on the affected skin,
then would expose it to the sun
in an attempt to treat the discolored skin.
(01:33):
This would be in 1400 BC.
Going back to pre-Hindu Vedic myth,
the deity representing the sun, known as Bhagavatam,
developed vitiligo after his illegitimate child
gazed upon him.
Now we move to ancient Japan in 1200 BC.
This would also have its own description of vitiligo
in the Japanese Shinto prayers in the Amarakosa.
(01:56):
Now we move on to Herodotus,
who lived between 484 to 425 BC.
He was a Greek historian who did not take too nicely
to those who had vitiligo.
He claimed the foreigners had sinned against the sun
and they must leave the country.
Now we move to Celsus in the first century AD.
(02:16):
This is when he would publish his book, "De medicina."
This is where the term vitiligo would be attributed to.
There is a suggestion it comes
from one of three Latin words.
These are vitelius, which was a Latin term
used to describe the white flesh of the calves,
vitium, which means blemish,
or vitulum, meaning small blemish.
(02:36):
Now we move on to the Middle Ages.
During the Middle Ages, there would be minimal progress
or mention of vitiligo.
This in part may have been due to those with vitiligo
being mistaken for those who had Hansen's disease,
which at the time was known as leprosy.
Those who were considered to be lepers
were often chased out of towns,
which may have happened to those with vitiligo.
As we all know, the Middle Ages was not well known
(02:59):
for medical progress.
After this period, we would meet Andreas Vesalius
around the year 1533.
He would highlight that the skin
actually was more than one layer.
He claimed that there were actually two.
Several decades later, we would have the work
of Jean Riolan the Younger.
This was between the years of 1580 to 1657.
(03:20):
Now Riolan the Younger would take the skin
of a darker subject.
He would separate it into two layers.
These would be the darker upper layer.
This is what he called to be the horny layer, personally.
I would not have called it that.
And the lower white layer, which was described as snow,
which we now know to be the dermis.
Now we are going to discuss
(03:41):
the 16th century physician, Mercuralius.
So he would attempt to define the pathogenesis of vitiligo.
He would do this in his book, "De Morbus Cutaneis."
Now this would be the first treaty
specifically about skin diseases
that was written in Latin,
as the title means diseases of the skin.
His explanation for the cause of these skin diseases
was that the white patches were fed by phlegm or mucus blood
(04:04):
as a form of nourishment,
rather than just regular old blood.
He believed that vitiligo may be associated
with altered sensations.
And he was the first to attempt to distinguish this condition
from others that caused hypopigmentation
or loss of pigmentation.
Now we move into the 17th century
and away from Europe for a little bit.
We are taking a short stroll over to Korea.
(04:26):
I hear it's nice this time of year.
The turn in Korea towards vitiligo
and other hypopigmentation disorders were vastly different.
The medical textbook, Downy Bogum from the Yi dynasty
would describe all of these conditions as one disorder
and attempt to treat them that way.
The Yi dynasty also had a high ranking government official
by the name of Chang Meyong Song,
(04:46):
who based on a portrait of him,
had vitiligo type depigmentation on the face and neck.
So there was no purposeful hiding of the condition.
It was actually shown in his portrait quite prominently.
They never actually attempted to cover it up
with the portrait.
This points to it being more socially accepted
at the time in Korea than in Europe,
as he was quite high up in the government as well.
(05:08):
In the 18th century, we would have the French physician,
Claude Nicolas Le Cat.
He would publish about the ethnic differences
in skin pigmentation.
He would, in his publication, accurately detail
in the several cases of vitiligo he saw.
He would describe them as starting in small areas,
then progressing symmetrically over the hands and face.
He would also describe cases of where people
(05:29):
who had lost pigment due to burns from boiling water.
With the next centuries, we would have a better understanding
of the cells affected and the potential causes of vitiligo.
If you have been enjoying this episode,
make sure to share it with a friend as it helps us grow.
What is vitiligo?
Vitiligo is a medical condition that causes your skin
to lose its pigment.
These areas of lost pigment either become lighter
(05:50):
than your natural skin tone or turn white.
When it comes to these areas of missing pigment,
depending on the size, it will depend on their name.
So for areas of skin missing pigment
less than one centimeter wide, these are called macules.
For areas larger than one centimeter wide,
they are called patches.
But what actually causes the loss of pigment in vitiligo?
The loss of pigment is caused by the immune system
(06:12):
attacking the melanocytes in the area of the pigment loss.
This is why it is considered to be an autoimmune condition.
Melanocytes are colour producing cells
as they produce the pigment melanin.
So who does vitiligo affect?
Normally vitiligo macules, and patches,
which again are the areas of lost pigment,
become evident before the age of 30.
(06:32):
However, it can be developed at any age.
Vitiligo also affects all races and sexes equally.
However, having an autoimmune condition
can predispose people to developing vitiligo.
This occurs in about 15 to 25% of cases.
Examples of these conditions include Addison's disease,
which we covered in episode 14,
anemia, diabetes, which we covered in episode 26,
(06:55):
psoriasis, lupus, which we explored in episode 35,
thyroid disease, and rheumatoid arthritis,
which we went over in episode 43.
These are just some of the autoimmune conditions
that also occur with vitiligo.
There are also some other circumstances
that relate to an increased risk of developing vitiligo.
These include a family history.
So having a close relative with the condition
(07:15):
increases your risk of developing it in the future,
triggering events.
So this could be stress, severe sunburns,
or skin traumas like chemicals.
There have also been more than 30 different genes
found to have an influence over vitiligo
and increase the risk of causing vitiligo,
which is why it can be seen in families.
Due to the high number of genes,
the inheritance pattern is complex.
It is believed that it is a combination
(07:36):
of both genes and environmental factors
as to why someone would have vitiligo.
Vitiligo is not contagious,
so you cannot catch it from someone else.
How do we diagnose vitiligo?
When it comes to vitiligo,
the diagnostic process generally involves examining the skin.
This can be with a special lamp called a Woods lamp.
This is a UV lamp.
This test is done in a dark room.
To be able to see what is going on as vitiligo patches
(07:59):
can be easier to distinguish under UV lights,
or in some cases when a Woods lamp isn't available,
just looking at the skin normally.
The doctor may also request a skin biopsy
and blood test to rule out any other conditions
that may mimic,
or to see if you've got any autoimmune conditions
that may be contributing to colour loss,
as these both have to do with inflammation
and immune reactions.
(08:20):
We'll get right into the symptoms and presentation
right after this little break.
(upbeat music)
If you have been enjoying this episode,
you should support us on Buy Me a Coffee.
It helps us to continue the podcast.
(08:41):
What symptoms might you have if you had vitiligo?
The symptoms that are often seen with vitiligo include,
patchy loss of skin colour.
These patches first occurring around the hands, face, feet,
forearms, and various bodily openings,
as well as the genitals.
Loss of colour in the tissues that line the nose and mouth.
These are the mucous membranes.
Vitiligo also causes premature whitening
(09:01):
or graying of the hair.
This can be the scalp hair,
so the hair on top of your head, eyebrows, eyelashes,
or even the beard hair.
What should a doctor be aware of
when it comes to vitiligo?
Doctors should be aware of the different types of vitiligo.
These are, universal.
This type affects almost all skin surfaces in the body.
So the patches of discolouration
will appear almost anywhere.
Generalised.
This type is the most common form.
(09:23):
It causes discoloured patches to occur somewhat symmetrically
on corresponding body parts.
So the discolouration on say both arms
will be similar in this type.
Segmental.
This form only occurs on one side or one part of the body.
It normally occurs at a younger age,
progressing for only like one or two years
before it stops progressing.
Focal or localised vitiligo.
(09:43):
This occurs on only one or a few areas of the body.
Acrofacial vitiligo.
This type occurs on the hands, face,
and the various bodily openings
like the eyes, nose, and ears.
When it comes to vitiligo,
in most cases, the pigment loss spreads
and eventually involves a majority of the skin.
In some cases, the patches of discolouration
do stop forming without treatment.
(10:04):
Also occasionally, the skin does get some colour back.
When it comes to vitiligo,
some people may have vision issues and hearing loss.
How do we treat vitiligo?
When it comes to vitiligo,
no medications can actually stop the process of vitiligo.
But some medications,
either with or without the use of light therapy,
may be able to restore the pigment in the skin.
These medications that may help
include medications that control inflammation.
(10:26):
These are things like corticosteroid creams,
pills, and injections.
Creams are used in the case of mild and early stages.
It is applied to the skin
where the discolouration has occurred.
It may take several months to see any differences.
When it comes to the use
of corticosteroid pills and injections,
these are used for the cases that are more severe,
so the vitiligo is progressing more rapidly.
(10:47):
Medications that control the immune system,
these are things like calcineurin inhibitor ointments.
These can be effective for small areas of depigmentation
and discolouration in places like the face.
However, they are not used often
due to potential side effects.
There are also therapies that can be used
and may be helpful for those with vitiligo.
(11:07):
These include light therapy.
This is phototherapy that uses
narrow band ultraviolet B, so UVB.
This can slow or stop the progression of active vitiligo.
It may be more effective in combination with medications.
However, due to risks, this should be done carefully.
This therapy will need to be done
two to three times a week for one to three months
before any sort of effect is seen,
(11:28):
with up to six months or even longer
before the full effect is seen.
Combination, psoralen, and light therapy.
This psoralen, which is a plant-derived substance,
which is taken orally or applied to the affected skin,
is combined with light therapy,
which is used after you've taken the psoralen.
Previously, ultraviolet A, or UVA, light was used,
(11:48):
but this is difficult to use,
so many places use UVB light.
Depigmentation.
This is a permanent removal of the pigmentation
from the remaining unaffected areas of the skin.
This is offered to people with widespread vitiligo
who have had no success with treatment to restore colour.
This treatment gradually lightens the skin
so it blends in with the affected areas.
(12:09):
This is by using a depigmentation agent
once or twice a day for nine months,
but sometimes longer is needed.
This, again, is only used in widespread vitiligo,
so vitiligo occurring all over the body.
And once a pigment is gone,
using a depigmentation agent, it's gone.
You don't get it back.
There are also surgical interventions
that are offered for those who have stable disease,
so it isn't spreading,
(12:29):
but the medical and light therapies haven't worked.
These surgical options include skin grafting.
In this procedure, doctors take little sections
of the healthy pigmented skin,
so the parts that are not affected by vitiligo,
and transfer these patches
to the areas that have been affected.
This procedure may be used
if there are only small patches of discolouration.
As this is a surgical procedure, this does come with risks,
(12:52):
and it does not guarantee an even skin tone.
Blister grafting.
This procedure uses blisters
created through suction normally.
This is done on the pigmented skin.
These blister tops are transplanted to the discoloured skin.
The creation of the blisters may induce more vitiligo
in some people, as this is trauma to the skin,
and this can be a trigger for some.
(13:12):
Cellular suspension transplant.
This takes some of the tissue from the pigmented skin.
This is then put into a solution.
The cells from the solution
are then transplanted onto the affected area.
The repigmentation of this area takes about four weeks.
Are there any famous people with vitiligo?
Yes, there are several famous people with vitiligo,
one of these being Winnie Harlow, the Canadian top model.
(13:33):
Harlow is a very successful model.
She's had vitiligo since the age of four.
Both interestingly and unfortunately,
due to an issue on the set of a photo shoot back in 2018,
she ended up severely sunburned
and also needed medical care due to this.
This led to her starting her own line of skincare, Cay Skin.
She also spends her time advocating
and raising awareness of vitiligo,
(13:55):
even having a TED Talk discussing the stigma
that comes with being different,
although everyone is different.
If you would like to check out a film, there is Marmoladas.
Now, this is an artistic short documentary in German
with English subtitles.
The name means the marbled ones.
This short film talks about how the four women in it
have experienced vitiligo,
changing their view on their condition
(14:15):
from a disfiguring disease
to something more beautiful and decorative.
There is also the documentary More Than Our Skin.
It explores the effects of vitiligo
through the lives of five women with the condition.
This one does cover some pretty heavy topics,
so it is definitely not for small children.
If you would like to check out a foundation,
there is the Global Vitiligo Foundation.
They aim to improve the lives of those with vitiligo
(14:36):
through clinical care, education,
community support groups, and research.
They hold events throughout the year,
including World Vitiligo Day and scientific symposiums,
which increase the knowledge surrounding the condition.
If you want to check out the sources,
social media links, or any other links,
you can head to anatomyofillness.com.
If you enjoyed this episode and would like to hear more,
subscribe to be notified about our latest episodes.
If you want to join our community,
you can join us on Discord or Instagram.
(14:58):
Otherwise, stick around for the next episode.
(upbeat music)
Did you know the skin has its own microbiome?
Yes, it is actually home to more than 1,000 species
(15:20):
of bacteria, as well as many species of fungi and viruses.
They do all serve a purpose.
They help the immune system recognize potential invaders.
They also help to control inflammation and control infection.
Your five-year-old son, Zack, came home excited from school.
(00:03):
He hands you a painting he had done in class.
When you catch a glimpse at his hand,
on it, there was a little patch
that is much lighter than the rest.
You asked him if he had paint on his hand,
wondering what that patch was.
He shrugged, telling you, "It's been there a while."
Concerned, you decide to book him a doctor's appointment.
(00:30):
(upbeat music)
Hello and Welcome to Anatomy Of Illness.
Today's episode is about vitiligo.
Before we get into the condition,
we are going to start with the history.
So why we know vitiligo exists.
We begin in ancient Egypt,
between 3000 BC and 1550 BC.
This is with the Eber's papyrus.
(00:52):
In this papyrus, they differentiated
between leprosy and vitiligo.
Leprosy being called a pale swelling, unlike vitiligo.
The attempts at treating vitiligo in ancient Egypt
would be similar with that of the ancient Indians.
The ancient Indians would refer to vitiligo
as Sveta Kustha or white leprosy.
In ancient India, there was much stigma
surrounding vitiligo.
(01:12):
It was considered unmarriageable
if a woman had this disease.
It was also thought to be caused if you had,
in a past life, insulted a religious teacher,
according to Hindu texts.
This would cause you to have it in your next life.
The ancient Indians would use plants
containing the compound psoralen on the affected skin,
then would expose it to the sun
in an attempt to treat the discolored skin.
(01:33):
This would be in 1400 BC.
Going back to pre-Hindu Vedic myth,
the deity representing the sun, known as Bhagavatam,
developed vitiligo after his illegitimate child
gazed upon him.
Now we move to ancient Japan in 1200 BC.
This would also have its own description of vitiligo
in the Japanese Shinto prayers in the Amarakosa.
(01:56):
Now we move on to Herodotus,
who lived between 484 to 425 BC.
He was a Greek historian who did not take too nicely
to those who had vitiligo.
He claimed the foreigners had sinned against the sun
and they must leave the country.
Now we move to Celsus in the first century AD.
(02:16):
This is when he would publish his book, "De medicina."
This is where the term vitiligo would be attributed to.
There is a suggestion it comes
from one of three Latin words.
These are vitelius, which was a Latin term
used to describe the white flesh of the calves,
vitium, which means blemish,
or vitulum, meaning small blemish.
(02:36):
Now we move on to the Middle Ages.
During the Middle Ages, there would be minimal progress
or mention of vitiligo.
This in part may have been due to those with vitiligo
being mistaken for those who had Hansen's disease,
which at the time was known as leprosy.
Those who were considered to be lepers
were often chased out of towns,
which may have happened to those with vitiligo.
As we all know, the Middle Ages was not well known
(02:59):
for medical progress.
After this period, we would meet Andreas Vesalius
around the year 1533.
He would highlight that the skin
actually was more than one layer.
He claimed that there were actually two.
Several decades later, we would have the work
of Jean Riolan the Younger.
This was between the years of 1580 to 1657.
(03:20):
Now Riolan the Younger would take the skin
of a darker subject.
He would separate it into two layers.
These would be the darker upper layer.
This is what he called to be the horny layer, personally.
I would not have called it that.
And the lower white layer, which was described as snow,
which we now know to be the dermis.
Now we are going to discuss
(03:41):
the 16th century physician, Mercuralius.
So he would attempt to define the pathogenesis of vitiligo.
He would do this in his book, "De Morbus Cutaneis."
Now this would be the first treaty
specifically about skin diseases
that was written in Latin,
as the title means diseases of the skin.
His explanation for the cause of these skin diseases
was that the white patches were fed by phlegm or mucus blood
(04:04):
as a form of nourishment,
rather than just regular old blood.
He believed that vitiligo may be associated
with altered sensations.
And he was the first to attempt to distinguish this condition
from others that caused hypopigmentation
or loss of pigmentation.
Now we move into the 17th century
and away from Europe for a little bit.
We are taking a short stroll over to Korea.
(04:26):
I hear it's nice this time of year.
The turn in Korea towards vitiligo
and other hypopigmentation disorders were vastly different.
The medical textbook, Downy Bogum from the Yi dynasty
would describe all of these conditions as one disorder
and attempt to treat them that way.
The Yi dynasty also had a high ranking government official
by the name of Chang Meyong Song,
(04:46):
who based on a portrait of him,
had vitiligo type depigmentation on the face and neck.
So there was no purposeful hiding of the condition.
It was actually shown in his portrait quite prominently.
They never actually attempted to cover it up
with the portrait.
This points to it being more socially accepted
at the time in Korea than in Europe,
as he was quite high up in the government as well.
(05:08):
In the 18th century, we would have the French physician,
Claude Nicolas Le Cat.
He would publish about the ethnic differences
in skin pigmentation.
He would, in his publication, accurately detail
in the several cases of vitiligo he saw.
He would describe them as starting in small areas,
then progressing symmetrically over the hands and face.
He would also describe cases of where people
(05:29):
who had lost pigment due to burns from boiling water.
With the next centuries, we would have a better understanding
of the cells affected and the potential causes of vitiligo.
If you have been enjoying this episode,
make sure to share it with a friend as it helps us grow.
What is vitiligo?
Vitiligo is a medical condition that causes your skin
to lose its pigment.
These areas of lost pigment either become lighter
(05:50):
than your natural skin tone or turn white.
When it comes to these areas of missing pigment,
depending on the size, it will depend on their name.
So for areas of skin missing pigment
less than one centimeter wide, these are called macules.
For areas larger than one centimeter wide,
they are called patches.
But what actually causes the loss of pigment in vitiligo?
The loss of pigment is caused by the immune system
(06:12):
attacking the melanocytes in the area of the pigment loss.
This is why it is considered to be an autoimmune condition.
Melanocytes are colour producing cells
as they produce the pigment melanin.
So who does vitiligo affect?
Normally vitiligo macules, and patches,
which again are the areas of lost pigment,
become evident before the age of 30.
(06:32):
However, it can be developed at any age.
Vitiligo also affects all races and sexes equally.
However, having an autoimmune condition
can predispose people to developing vitiligo.
This occurs in about 15 to 25% of cases.
Examples of these conditions include Addison's disease,
which we covered in episode 14,
anemia, diabetes, which we covered in episode 26,
(06:55):
psoriasis, lupus, which we explored in episode 35,
thyroid disease, and rheumatoid arthritis,
which we went over in episode 43.
These are just some of the autoimmune conditions
that also occur with vitiligo.
There are also some other circumstances
that relate to an increased risk of developing vitiligo.
These include a family history.
So having a close relative with the condition
(07:15):
increases your risk of developing it in the future,
triggering events.
So this could be stress, severe sunburns,
or skin traumas like chemicals.
There have also been more than 30 different genes
found to have an influence over vitiligo
and increase the risk of causing vitiligo,
which is why it can be seen in families.
Due to the high number of genes,
the inheritance pattern is complex.
It is believed that it is a combination
(07:36):
of both genes and environmental factors
as to why someone would have vitiligo.
Vitiligo is not contagious,
so you cannot catch it from someone else.
How do we diagnose vitiligo?
When it comes to vitiligo,
the diagnostic process generally involves examining the skin.
This can be with a special lamp called a Woods lamp.
This is a UV lamp.
This test is done in a dark room.
To be able to see what is going on as vitiligo patches
(07:59):
can be easier to distinguish under UV lights,
or in some cases when a Woods lamp isn't available,
just looking at the skin normally.
The doctor may also request a skin biopsy
and blood test to rule out any other conditions
that may mimic,
or to see if you've got any autoimmune conditions
that may be contributing to colour loss,
as these both have to do with inflammation
and immune reactions.
(08:20):
We'll get right into the symptoms and presentation
right after this little break.
(upbeat music)
If you have been enjoying this episode,
you should support us on Buy Me a Coffee.
It helps us to continue the podcast.
(08:41):
What symptoms might you have if you had vitiligo?
The symptoms that are often seen with vitiligo include,
patchy loss of skin colour.
These patches first occurring around the hands, face, feet,
forearms, and various bodily openings,
as well as the genitals.
Loss of colour in the tissues that line the nose and mouth.
These are the mucous membranes.
Vitiligo also causes premature whitening
(09:01):
or graying of the hair.
This can be the scalp hair,
so the hair on top of your head, eyebrows, eyelashes,
or even the beard hair.
What should a doctor be aware of
when it comes to vitiligo?
Doctors should be aware of the different types of vitiligo.
These are, universal.
This type affects almost all skin surfaces in the body.
So the patches of discolouration
will appear almost anywhere.
Generalised.
This type is the most common form.
(09:23):
It causes discoloured patches to occur somewhat symmetrically
on corresponding body parts.
So the discolouration on say both arms
will be similar in this type.
Segmental.
This form only occurs on one side or one part of the body.
It normally occurs at a younger age,
progressing for only like one or two years
before it stops progressing.
Focal or localised vitiligo.
(09:43):
This occurs on only one or a few areas of the body.
Acrofacial vitiligo.
This type occurs on the hands, face,
and the various bodily openings
like the eyes, nose, and ears.
When it comes to vitiligo,
in most cases, the pigment loss spreads
and eventually involves a majority of the skin.
In some cases, the patches of discolouration
do stop forming without treatment.
(10:04):
Also occasionally, the skin does get some colour back.
When it comes to vitiligo,
some people may have vision issues and hearing loss.
How do we treat vitiligo?
When it comes to vitiligo,
no medications can actually stop the process of vitiligo.
But some medications,
either with or without the use of light therapy,
may be able to restore the pigment in the skin.
These medications that may help
include medications that control inflammation.
(10:26):
These are things like corticosteroid creams,
pills, and injections.
Creams are used in the case of mild and early stages.
It is applied to the skin
where the discolouration has occurred.
It may take several months to see any differences.
When it comes to the use
of corticosteroid pills and injections,
these are used for the cases that are more severe,
so the vitiligo is progressing more rapidly.
(10:47):
Medications that control the immune system,
these are things like calcineurin inhibitor ointments.
These can be effective for small areas of depigmentation
and discolouration in places like the face.
However, they are not used often
due to potential side effects.
There are also therapies that can be used
and may be helpful for those with vitiligo.
(11:07):
These include light therapy.
This is phototherapy that uses
narrow band ultraviolet B, so UVB.
This can slow or stop the progression of active vitiligo.
It may be more effective in combination with medications.
However, due to risks, this should be done carefully.
This therapy will need to be done
two to three times a week for one to three months
before any sort of effect is seen,
(11:28):
with up to six months or even longer
before the full effect is seen.
Combination, psoralen, and light therapy.
This psoralen, which is a plant-derived substance,
which is taken orally or applied to the affected skin,
is combined with light therapy,
which is used after you've taken the psoralen.
Previously, ultraviolet A, or UVA, light was used,
(11:48):
but this is difficult to use,
so many places use UVB light.
Depigmentation.
This is a permanent removal of the pigmentation
from the remaining unaffected areas of the skin.
This is offered to people with widespread vitiligo
who have had no success with treatment to restore colour.
This treatment gradually lightens the skin
so it blends in with the affected areas.
(12:09):
This is by using a depigmentation agent
once or twice a day for nine months,
but sometimes longer is needed.
This, again, is only used in widespread vitiligo,
so vitiligo occurring all over the body.
And once a pigment is gone,
using a depigmentation agent, it's gone.
You don't get it back.
There are also surgical interventions
that are offered for those who have stable disease,
so it isn't spreading,
(12:29):
but the medical and light therapies haven't worked.
These surgical options include skin grafting.
In this procedure, doctors take little sections
of the healthy pigmented skin,
so the parts that are not affected by vitiligo,
and transfer these patches
to the areas that have been affected.
This procedure may be used
if there are only small patches of discolouration.
As this is a surgical procedure, this does come with risks,
(12:52):
and it does not guarantee an even skin tone.
Blister grafting.
This procedure uses blisters
created through suction normally.
This is done on the pigmented skin.
These blister tops are transplanted to the discoloured skin.
The creation of the blisters may induce more vitiligo
in some people, as this is trauma to the skin,
and this can be a trigger for some.
(13:12):
Cellular suspension transplant.
This takes some of the tissue from the pigmented skin.
This is then put into a solution.
The cells from the solution
are then transplanted onto the affected area.
The repigmentation of this area takes about four weeks.
Are there any famous people with vitiligo?
Yes, there are several famous people with vitiligo,
one of these being Winnie Harlow, the Canadian top model.
(13:33):
Harlow is a very successful model.
She's had vitiligo since the age of four.
Both interestingly and unfortunately,
due to an issue on the set of a photo shoot back in 2018,
she ended up severely sunburned
and also needed medical care due to this.
This led to her starting her own line of skincare, Cay Skin.
She also spends her time advocating
and raising awareness of vitiligo,
(13:55):
even having a TED Talk discussing the stigma
that comes with being different,
although everyone is different.
If you would like to check out a film, there is Marmoladas.
Now, this is an artistic short documentary in German
with English subtitles.
The name means the marbled ones.
This short film talks about how the four women in it
have experienced vitiligo,
changing their view on their condition
(14:15):
from a disfiguring disease
to something more beautiful and decorative.
There is also the documentary More Than Our Skin.
It explores the effects of vitiligo
through the lives of five women with the condition.
This one does cover some pretty heavy topics,
so it is definitely not for small children.
If you would like to check out a foundation,
there is the Global Vitiligo Foundation.
They aim to improve the lives of those with vitiligo
(14:36):
through clinical care, education,
community support groups, and research.
They hold events throughout the year,
including World Vitiligo Day and scientific symposiums,
which increase the knowledge surrounding the condition.
If you want to check out the sources,
social media links, or any other links,
you can head to anatomyofillness.com.
If you enjoyed this episode and would like to hear more,
subscribe to be notified about our latest episodes.
If you want to join our community,
you can join us on Discord or Instagram.
(14:58):
Otherwise, stick around for the next episode.
(upbeat music)
Did you know the skin has its own microbiome?
Yes, it is actually home to more than 1,000 species
(15:20):
of bacteria, as well as many species of fungi and viruses.
They do all serve a purpose.
They help the immune system recognize potential invaders.
They also help to control inflammation and control infection.
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