by Anne StClair

Created on: April 08, 2008   Last Updated: May 13, 2008

Vitiligo is a rare condition in which patches of skin lose their pigmentation. Another name for this condition is leukoderma, which simply means "white skin". Most people susceptible to the condition (about 1% of the population) begin to develop white patches on their skin before they reach the age of forty. The disease is not infectious or contagious, and the affected skin has a normal texture and is not inflamed.

The physical effects of vitiligo are cosmetic, and are much more obvious in people with darker skin. The psychological and social effects, however, can be serious, with patients developing low self-esteem, feeling self-conscious or embarrassed, having poor body image, and feeling they have a poor quality of life.

Vitiligo develops when the cells that produce the main skin pigment (melanin) that colors skin are destroyed or damaged and lose their ability to manufacture the pigment. The reason for the damage is not certain, but many believe it may be a form of autoimmunity, in which the body attacks its own cells.

The symptoms of vitiligo are the appearance of small patches or spots of white or pale skin, which may gradually increase in size, or may remain stable for some time. The patches are usually oval and roughly symmetrical, and are often found in similar locations on both sides of the body. The patches are more common on the hands, face, feet, neck, wrists, elbows, knees, and upper body, but they can also be found on the armpits, groin, genitals, around the navel and in the mucous membranes inside the mouth and nose. In rare cases parts of the retina may also lose pigmentation. Any hair growing on the de-pigmented skin is white.

The causes of vitiligo are uncertain, but it is sometimes hereditary, with around 30% of sufferers having a parent with the condition. It can be triggered in susceptible people by physical or emotional stress, skin injuries such as burns, exposure to chemicals such as phenol (a bleach), and by other conditions in which the skin becomes inflamed. It can also be induced by medications that adversely affect the melanocyte cells that produce the melanin pigment.

Vitiligo is more common in people with auto-immune diseases such as Hashimoto's thyroiditis and other thyroid conditions, pernicious anemia, lupus and alopecia areata. It is also more common in people with diabetes and Addison's disease.

Vitiligo is usually diagnosed by examination of the patches, but in fair-skinned people a lamp known as a "Wood's lamp" may be used to

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