Vitiligo – can you do something against the white spots?

As a child, Winnie Harlow was called a cow or a zebra. Because of the pigment disorder vitiligo, she is covered with white spots. Today she is an internationally successful model despite the skin disease. What is vitiligo and can anything be done about it?

When pigments are suddenly missing from certain areas of the skin and white patches appear, there is a great deal of uncertainty. What is behind it? Is it dangerous? The skin disease has actually become known primarily through the Canadian top model. Vitiligo, the medical term for the white spots, is one of the most common chronic skin diseases. Nevertheless, the white spot disease still puzzles experts. To date, it has not been possible to clarify what exactly causes vitiligo to develop. We asked dermatologist Dr. Christoph Liebich about this.

“In principle, the white spots can form on any part of the body. Often the disease starts on the face, hands or feet. Mucous membranes and hairy areas can also be affected,” explains Dr. Liebich. The light patches lack the pigment melanin, which gives the skin its individual hue. Melanin is produced by specialized skin cells, the melanocytes, and is deposited in the middle skin cells as a protective film against harmful UV radiation. Therefore, it is particularly important that the skin areas affected by vitiligo are not exposed to the sun without protection.

Causes of Vitiligo

“One of the suspected triggers is an autoimmune reaction against the body’s own cells that produce melanin. As a result, the cells are damaged, lose the ability to produce pigment, and thus cause the white spots,” says the dermatologist. The immunological cause is supported by the fact that vitiligo often occurs together with other diseases in which immunological processes are also involved, for example in certain thyroid gland diseases, gastric mucosa changes or circular hair loss.

Another cause is likely to be genetic, as about one-third of sufferers have affected family members. Extreme stress may also be a trigger. “The disease can occur at any age. In most cases, however, in my experience, it develops at a young age, in half of the sufferers before the age of 20,” emphasizes the skin specialist.

This helps against the pigment disorder

Vitiligo is not yet curable, but it can be treated. Doctors mainly use different light therapies (phototherapy). The irradiation is supposed to lead to the repigmentation of the white skin areas and is carried out over several months. Ointments with cortisone and other active ingredients are also available for therapy. In recent years, the following additional treatment options have proven successful: Using a laser with a special wavelength (Eximer laser), individual small areas can be treated very well, the healthy skin remains spared.

Pigment cell transplantation is also very promising. In this procedure, a 0.2 to 0.3 millimeter thin layer of skin is removed from a healthy area under local anesthesia. Pigment cells are immediately isolated from the piece of skin and prepared. At the same time, the doctor removes the top layer of skin from the areas to be treated using dermabrasion or an erbium-yag laser (both treatments are also used in aesthetic medicine). Following this, the processed pigment cells are applied and repigmentation takes place in the weeks that follow. “Unfortunately, there is no silver bullet when it comes to therapy. In almost all patients, different therapies should be combined,” recommends Dr. Liebich.

Photo: Desigual