Special aspects of Vitiligo

Vitiligo is a disorder of the skin pigmentation characterized by well-defined, ivory white macular lesion. It affects 1% of the population worldwide. Both sexes are equally affected. In 10-20% of people, vitiligo goes on its own. However, in majority of the patient the condition tends to worsen with time.

Vitiligo is often confused with leprosy by common people due to the apparent discolouration of the skin. This disorder often carries a social stigma which can lead to self-isolation, discrimination and low self-esteem. This ultimately has a serious psychological consequences such as depression and negative self-image. People with vitiligo (leucoderma) often find a hard time in getting a suitable match for marriage also. The stigma attached to vitiligo is more intense in developing countries than the developed world.

There is a popular belief among the public that vitiligo is a contagious disease. This sort of belief are more common among the less educated people. Here, I would like to say that vitiligo does not spread through physical contact or sharing of food, washrooms or clothing. It does not harm the body also. As such vitiligo can be considered as an innocuous disease.

The usual treatment include steroids (both topical and systemic), calcineurin inhibitors, ultraviolet therapy and surgery in stable vitiligo. Apart from therapy, patients require a lot of social and emotional support. There are various support groups available who offer support to each other. Family members, friends and peers also play a very important role in providing support to these patients. Meeting people with similar life experiences can have a wonderful emotional healing effect. They can relate to your daily life struggles and can provide you the much needed emotional support. It would eventually help you embrace your skin condition and develop self-love.

There is a scarcity of high quality studies that have looked into the efficacy of psychological intervention in the management of patients with vitiligo. Papadopoulos L et al in his small randomized trial noted a significant improvement in the quality of life, self-esteem and perceived body image in adult patient with vitiligo who received cognitive behavioural therapy in addition to conventional treatment. They also noted a change in the course of the disease itself. Some of the behavioural treatment include:

•  Acceptance of the condition: In chronic illness like vitiligo, self-hatred/guilt would be detrimental. There is no reason to feel ashamed about this entity. As mentioned before it is an innocuous condition and not contagious. So self-acceptance of the disease is important so that one doesn’t get an inferiority complex. You can’t expect society to treat you as normal if you yourself hate these white spots.
•  Getting involved in  stress busters– Stress buster techniques like Yoga, meditation, prayers, running, jogging, gym workout, cycling, swimming etc can help you relieve stress and come in terms with the fact that vitiligo is going to stay with you for the rest of your life.

To sum up, accept vitiligo as very part of you. It is just a harmless, non-communicable skin condition that doesn’t stop you from fulfilling all your personal and professional goals.

 

 

Dr. Ranjeeta Sapam, MD
Professor and Head, Department of Dermatology, JNIMS