By Awa Sowe
Vitiligo is a chronic (long-lasting) autoimmune disorder that causes patches of skin to lose pigment or color. This happens when melanocytes skin cells that make pigment are attacked and destroyed, causing the skin to turn a milky-white color. In vitiligo, the white patches usually appear symmetrically on parts of the body such as on both hands or both knees. Sometimes, there can be a rapid loss of color or pigment and even cover a large area.
The loss of pigment results in irregular pale patches of skin. The precise cause of vitiligo is complex and not fully understood. There is some evidence suggesting it is caused by a combination of auto-immune, genetic, and environmental factors.
According to the World Health Organization (WHO) skin diseases are among the most common of all human health afflictions and affect almost 900 million people in the world.
Many global cultures and societies place a profound significance on appearance, esthetics, and pigmentation. Any condition that affects appearance may be fraught with loss of privilege, opportunities, and often upward societal mobility. However, in the Gambia, there is a huge misconception around Vitiligo with some associating it with black magic and people often marginalized and stigmatized by society. Some people even resort to traditional medicine to find a cure and in some cases come out more terrible.
Dr Ebrima Cham, said that Vitiligo affects all races and sexes equally. It’s more visible in people with darker skin tones. Although vitiligo can develop in anyone at any age, macules or patches usually become apparent before age 30.
He added that , A person with vitiligomight be at a higher risk of developing vitiligo if He/She have certain autoimmune conditions like, Addison’s disease, Anemia, Diabetes (Type 1), Lupus, Psoriasis, Rheumatoid arthritis and Thyroid disease.
Drchamadded the skin disorder usually starts with a few small white macules or patches that may gradually spread over your body. Vitiligo typically begins on your hands, forearms, feet and face, but can develop on any part of your body, including your mucous membranes (the moist lining of your mouth, nose, genital and rectal areas), your eyes and inner ears.
“Sometimes, larger patches continue to widen and spread, but they usually stay in the same place for years. The location of smaller macules shifts and changes over time, as certain areas of skin lose and regain their pigment”. He noted
The amount of affected skin varies for each person diagnosed with vitiligo. Some people experience a few depigmented areas, while others have a widespread loss of skin color. He went on to explained that Types of vitiligo include, generalized, which is the most common type of vitiligo that causes macules to appear in various places on your body.
He mentioned that, signs and symptoms of vitiligo, includes patches of skin or mucous membranes that lose color. These can appear white or lighter than your natural skin tone. Patches of hair on your body turn silver, gray or white.Symptoms can be mild and only affect a small area of your body or severe and affect a large area of your skin. Some people with vitiligo experience itchy skin before depigmentation starts.Symptoms of vitiligo can appear anywhere on the skin of the body.
“The most common places to have symptoms of vitiligo include on the Hands Feet, Arms, Face, Mucous membranes (inside of your mouth, lips and nose) and Genitals”, he posited
On the causes, lack of pigment in your skin (melanin) causes vitiligo. The reason why this happens is unknown. According to him, research suggests vitiligo could be the result of an autoimmune condition, as the immune system mistakes healthy cells (melanocytes) as foreign invaders like bacteria that can cause harm to your body, which makes the immune system overreact and develop antibodies to destroy your melanocytes.
Furthermore, he mentioned that genetic changes, genetic mutation or a change to the body’s DNA can affect how your melanocytes function. ‘There are over 30 genes that can increase your risk of developing vitiligo”. He explained
The amount of pigment your melanocyte cells produce may change if you experience frequent emotional stress or physical stress on your body, especially after an injury. Moreover he highlighted that Environmental factors like ultraviolet radiation and toxic chemical exposure can affect how the melanocyte cells function.
Additionally, research is ongoing to learn more about the causes of vitiligo, studies indicate that about 30% of vitiligo cases are genetic. Dr Cham added that, this means that the condition is hereditary and you could potentially inherit vitiligo from your biological family. Several possible genetic mutations affect how melanocyte cells function. If a genetic mutation targets the cells that give your skin pigment, you’ll experience symptoms of vitiligo.
He added that, there is no specific medication to stop vitiligo from affecting your skin but there are certain drugs and creams that can slow the speed of pigmentation loss, help melanocytes regrow or bring color back to your skin.
“Vitiligo isn’t painful. However, you can get painful sunburns on lighter patches of skin affected by vitiligo. It’s important to protect yourself against the sun with measures like using sunscreen, staying out of the sun during the hours that it is strongest and wearing protective clothing”.
The skin expert, said that Although vitiligo is mainly a cosmetic condition, vitiligo may cause, sensitive skin, macules and patches lack melanocytes, so your skin can be more sensitive to sunlight than the rest of your skin. This can cause the skin to quickly burn instead of tanning.
Moreover , Drcham mentioned that , the disorder can also cause eye abnormalities and people with vitiligo may have some abnormalities in their retinas (the inner layer of the eye that contains light-sensitive cells) and some variation of color in their irises (the colored part of your eye)
Melanocytes are also present in the cochlea found in the inner ear. He added that in some cases of vitiligo, immune cells attack cochlear melanocytes, causing hearing loss. It is estimated that between 12% and 38% of people with vitiligo have some hearing loss.
“People with vitiligo may be more likely to get other autoimmune conditions that affect how their body’s immune system functions. Common autoimmune conditions include hypothyroidism, diabetes and anemia.”.he said
In conclusion, he added that people affected by vitiligo undergo some Emotional challenges they feel embarrassed about the way their skin looks. Some people diagnosed with vitiligo develop low self-esteem and this could cause anxiety or depression and make someone want to isolate his/herself, avoid social situations.
He advised that, if such happens, vitiligo patients should talk to a healthcare provider, a mental health professional, family and friends.
Mariama Kaba , 34 years old shared her vitiligo story that at 24, she was first diagnosed with vitiligo. She added that she remembered falling ill whiles she was pregnant with her first child and a white patch appeared right after.
“We visited the doctor, and he just gave us some creams to apply. My Dad thought there was something else to this and we tried all kinds of medications”she noted
She mentioned that her family did not allow her to go out in the sun at all, People used to give her blank stares in public, she was discriminated, people would not sit next to her because she have a disgusting skin and all of this shattered her confidence.
“I used to cry and ask myself, why me? Why did I have to go through this? My dad used to tell me every night before sleeping that I should not care about outer beauty because when I become successful in life no one is going to care about my looks”, she explained
My family supported me throughout and never made me feel different. She added that this is why I am so strong and confident today. A little love is all we need.“When I was 26 the white pigmentation naturally spread all over my body”.
“Over the years, I realized that focusing on yourself and ignoring other people’s opinions is the key to growth. It’s never that easy to accept yourself the way you are, but once you do it, there is no stopping. You don’t need anyone’s validation in this world, just be yourself”. She concluded
