BENGALURU: Vitiligo is an acquired disorder of depigmentation characterised by white macules and patches on various parts of the body reflecting selective melanocyte destruction. Although it is not a painful condition, there is a lot of stigma associated due to the cosmetic disfigurement. The condition tends to affects the quality of life and patients often suffer from low self esteem. They are at times subjected to social neglect, which in turn makes them to isolate themselves from the society.
There is a misconception that the disease can spread by contact. However, vitiligo is non-contagious. Another myth is with regard to dietary habits. For instance, people used to implicate sour food, fish, white food, and consider them to be the reason for vitiligo. However, there is no scientific evidence to support this belief. In fact, people belonging to different races, religions and socioeconomic groups with different dietary habits do not show any significant variation in predisposition towards the disease.
Another myth that surrounds the condition is the belief that vitiligo and leprosy are the same. Kilasa or external kushta (vitiligo) and leprosy were described together in Ayurveda and were believed to have a similar etiology. The suffix ‘Kushta’ was used for all skin diseases in Ayurveda. However, it became synonymous with leprosy later. Similarly, white spots were described in the old testament under the Hebrew word ‘Zora at’ which was translated as ‘lepra’ in the Greek and English bible leading to confusion between vitiligo and leprosy.
The exact cause of vitiligo is unknown. Multiple theories have been proposed including hypothesis based on genetic, autoimmune, neural, biochemical, autocytotoxic phenomenon and antioxidant deficiency theory. Stress, focus of infection and impaired melanocyte migration may also contribute to the pathogenesis.
The course of the disease is unpredictable and uncertain; however, it generally shows a tendency towards slow progression. There is no ideal treatment in the absence of a clear understanding of the etiopathogenesis. Some of the preventive measures that one could take to protect oneself are:
■ Adopt a nutritious diet – Consuming a nutritious diet enriched with adequate proteins, vitamin B-complex, vitamin E and minerals such as copper, zinc as well as iron is advised. These nutrients can be obtained from egg, green leafy vegetables, dairy products, nuts, beans, lentils and poultry. A diet rich in antioxidants such as fruits, vegetables, nuts and seeds can also be helpful.
■ Avoid excessive stress–Too much stress, anxiety and mental pressure can worsen the condition.
■ Avoid soap and detergent with harsh chemicals – Minimising the usage of soaps and detergents containing phenolic compounds is advisable. Also avoid direct contact or exposure to rubber goods and chemical agents known to be harmful to melanisation.
Vitiligo can be treated through various treatment options like phototherapy, surgical treatment, cosmetic camouflaging and bleaching. However, it is not always successful and there can be frequent recurrences and spread throughout the lifespan.
(The writer is a consultant dermatologist, Narayana Multispeciality Hospital, Whitefield)