Appearance of white spots on the skin might worry quite a few people. A sudden emergence of lighter spots on the face, hands, neck, and other body parts makes one anxious and scares them as they think that they suffer from vitiligo. However, dermatologists claim that all white spots cannot be considered as the signs of vitiligo. There are many factors and causes that make the skin look lighter.
One of the most widespread reasons for white spots on the skin is indeed vitiligo. It is a lifelong autoimmune condition that is characterised by the damage of pigment-producing cells (melanocytes) by the immune system of the organism. Due to the death of these cells, well-demarcated white spots appear on the skin. Vitiligo can occur in people of any age, sex, and skin colour.
According to dermatologists, vitiligo spots are sharply demarcated and milky-white. These spots are symmetrically distributed and usually appear in such areas as face, hands, feet, eyes area, mouth area, elbows, knees, and genital area. In some patients, hair growing in the area with spots turns white. They do not create scaling on the skin.
However, there are other skin diseases that can be accompanied by white or light spots, for example, pityriasis versicolor. It is a fungal infection that usually occurs in tropical climates, like India. It develops due to the growth of yeast that usually lives on the skin.
Unlike the symptoms of vitiligo, fungal infection is characterised by the appearance of multiple light or dark patches with fine scales. These spots appear on the skin of the chest, back, shoulders, neck, and upper arms. Patients can experience mild itching. It is important to note that this disease is treatable with the help of antifungal agents and does not lead to irreversible pigment loss.
Besides these diseases, there are many other causes of lighter spots on the skin, including post-inflammatory hypopigmentation, pityriasis alba, nutritional deficiency, certain drugs, chemicals, or rare genetic disorders.
Many skin diseases that are accompanied by light patches on the skin can look very similar. It means that patients should not try to diagnose their condition without the consultation of specialists. Self-medicating, especially with the help of OTC creams (steroid combination preparations) might worsen their state.
Therefore, if you have noticed new white spots on your skin that spread, change fast or appear persistently, you should consult dermatologists as soon as possible. Clinical examination and some auxiliary methods (for example, Wood’s lamp examination and, rarely, skin biopsy) will help your doctor determine the correct cause of your condition.
Stress connect
Many patients with vitiligo wonder whether stress can trigger or aggravate their condition. It should be noted that stress is not a reason for the appearance of vitiligo. However, there is a lot of information proving that stress can have a significant impact on the development and aggravation of the disease.
Scientists suppose that psychological stress can negatively influence the immune system and cause the increase of oxidative stress that contributes to the death of pigment-producing cells. Many patients reported the onset of vitiligo after such stressful events as the loss of close ones, relationship issues, exam pressure, or job stress.
Patients who have vitiligo suffer emotionally because of societal prejudice and cosmetic reasons. Therefore, doctors emphasise that the treatment of vitiligo should include not only medical therapy but also counselling and stress management.
There are many ways to treat this disease, including topical medications, phototherapy, oral agents in certain cases, and surgical interventions if the disease is stable. Early diagnosis of the condition and timely intervention can improve the results of treatment.
The first steps
Try not to panic. Not all white spots mean vitiligo as some causes are temporary and can be treated easily.
Do not use any OTC steroids without the consultation of your doctor because this therapy can worsen the situation.
Consult a dermatologist if you notice that patches are spreading, changing fast, or remaining for a few weeks.
Protect your skin from intensive sun exposure and use sunscreen and special clothes because depigmented skin is more sensitive to sunlight.
If you are diagnosed with vitiligo, you should start treatment quickly to reduce the speed of its development and achieve better repigmentation.
Do not forget that white spots are not contagious and people with vitiligo can live a healthy life.
White patches on the skin should never be ignored, but neither should they automatically be assumed to be vitiligo. While some causes are temporary and easily treatable, others require long-term management. Seeking an early dermatological evaluation remains the best way to obtain an accurate diagnosis, begin appropriate treatment, and address concerns before the condition progresses.
by Dr Sooriya S, senior consultant, Dermatology, SRM Global Hospital, Chennai