Can we use creams for Vitiligo?
- What is Vitiligo: Non-contagious, harmless skin disease ("white spot disease"). Mostly affects young people under the age of 20. Sometimes accompanied by autoimmune diseases such as neurodermatitis, Hashimoto's thyroiditis or type 1 diabetes mellitus.
- Symptoms: sporadic or extensive white (depigmented) skin spots everywhere on the body or only in certain areas (face, hands, feet). Sometimes the hair growing on the affected areas of the skin also turns white. Sometimes itching when new spots appear.
- Causes: Not fully known. Probably an autoimmune disease. Risk factors: genetic predisposition, stress, sunburn, skin irritation.
- Treatment: Medicines (cortisone, calcipotriol etc.), light therapy (phototherapy), PUVA (psoralen plus light therapy), bleaching, transplantation of pigment cells (melanocytes). Relief prevention through stress avoidance and intensive sun protection.
- Possible complications: Greatly increased risk of skin cancer in depigmented areas.
- Forecast: Not curable, but easily treatable. Without treatment, Vitiligo progresses. Once stains have occurred, they usually remain permanent. They rarely resolve on their own.
Vitiligo: description and causes
Vitiligo (White spot disease) is a harmless, non-contagious skin disease. It is based on one Pigment disorder. The disease is characterized by white patches of skin either all over the body or limited to the face, hands and feet. They usually arise in batches.
In Germany, around one percent of the population suffers from white spot disease. There are no differences between women and men. It is noticeable that the disease occurs predominantly before the age of 20. Also is a familial accumulation Noticeable: In 30 percent of the patients, another family member suffers from Vitiligo. In addition, Vitiligo sufferers develop other autoimmune diseases such as autoimmune thyroid inflammation (Hashimoto's thyroiditis), neurodermatitis or type 1 diabetes mellitus.
Vitiligo: Different types
Vertiligo mainly affects young people. Depending on when the white spot disease first appears, a distinction is made between two different types:
- The rarer one Type 1 vitiligo begins before puberty. Many of those affected also suffer from neurodermatitis. In addition, the young patients usually have many birthmarks (halo nevi) and gray hair in places.
- The Type 2 vitiligo begins after puberty. It accounts for about 85 percent of all white spot disease cases. In contrast to Vitiligo type 1, type 2 is not accompanied by increased birthmarks, neurodermatitis or gray hair.
The white spot disease can also be classified according to the extent of the white spots:
- In the local vitiligo only a few white spots appear.
- In the generalized vitiligo several parts of the body are mostly affected over a large area. One of the sub-forms of generalized vitiligo is Vitiligo vulgaris, the most common form of white spot disease. In doing so, large white spots are formed in various places. Usually the respective sides of the body are affected in parallel (non-segmental vitiligo). If, on the other hand, the white spots are limited to one side, one speaks of one segmental vitiligo. The Vitiligo acrofacialis is limited to the face, hands and feet. In the Vitiligo generalis after all, more than 80 percent of the body's skin is pigmentless.
The white spot disease rarely spreads to mucous membranes and scalp hair.
How exactly and why Vitiligo develops has not yet been conclusively clarified. However, medical professionals suspect that it is a Autoimmune disease acts: The immune system acts against the body's own structures due to a malfunction. In the case of white spot disease, these are the pigment cells (melanocytes) in the skin. The melanocytes produce the pigment melanin and release it to the surrounding skin cells. The more melanin there is in the skin, the darker it is.
Melanin formation does not occur due to the destruction of melanocytes in Vitiligo patients. This is how the typical pigment-free white skin spots are created.
Vitiligo: Risk Factors and Triggers
The risk for white spot disease seems genetically conditioned to be. Familial clusters suggest this connection. The most important trigger for acute relapses is considered stress: Both physical (such as an infection) and psychological stress can promote the development of further white spots. Also Sunburns and local skin irritationAs they occur in the context of psoriasis, for example, can trigger vitiligo.
As a Vitiligo patient, there are a number of things you can do yourself. In particular, you should Reduce stress, as this can trigger new relapses. Due to the increased risk of skin cancer, you should also direct the affected areas of skin Exposure to sunlight protect and use sunscreens with a particularly high sun protection factor.
With strong covering cosmetics like camouflage make-up, you can effectively conceal the annoying light spots.
Many of those affected suffer mentally from their illness. Then it can help to exchange ideas with other Vitiligo patients, for example in one support group. They also offer psychological support Psychologists for example as part of talk therapy.
In addition, you can have your Vitiligo medically treated with special medication and phototherapy.
Vitiligo: drug therapy
Since Vitiligo is believed to be an autoimmune disease, drugs that suppress the immune system are used to treat it. These so-called immunosuppressants are intended to prevent or at least weaken the immune system's attack on the pigment cells. About Glucocorticoids (cortisone) and Calcipotriol. Both active ingredients can be applied to the skin as a cream. In certain cases, the doctor may also use the immunosuppressant Tacrolimus (as an ointment).
Vitiligo: phototherapy and PUVA
Alternatively or additionally, you can undergo phototherapy. This allows good results in Vitiligo therapy to be achieved: The white skin spots are targeted with UV-B light irradiated at a certain wavelength. This is supposed to stimulate the growth of the pigment cells.
A combination of phototherapy and the active ingredient psoralen (PUVA = psoralen plus UV-A light) is even more effective: the patient first receives psoralen (as a tablet, cream or bath additive), which makes the skin more sensitive to light. Then the skin areas affected by Vitiligo are irradiated with UV-A light.
Other methods of vitiligo treatment
In the case of a very pronounced, generalized vitiligo, this can bleaching the last treatment option for the skin: the unaffected areas of the skin are chemically bleached to match their color to that of the white spots. But be careful: the result is not always uniform. It is also permanent and cannot be reversed.
Also one Melanocyte transplantation is one way of treating Vitiligo. The doctor removes healthy pigment cells from the patient, multiplies them in the test tube and transplantes them into the affected areas of the skin. Discuss with your doctor whether this treatment method would be possible for you.
From a naturopathic point of view, experts recommend Gingko extract for the treatment of white spot disease. Studies have shown that it promotes skin repigmentation in some patients.
This is typical for white spot disease Whitening (depigmentation) The skin: In more or less numerous places there are spots that are only weakly or not at all pigmented (white). They are a few millimeters to centimeters in size, round or oval. Their edges are irregular, but stand out sharply from the surrounding skin. The white spots can also merge and so-called herd form.
The white patches of skin can in principle appear on all parts of the body, from the face above Fingers and wrists, Elbow, Forearms and Kneel up to the genitals. Also the Mucous membranes can be affected as well as eyes and Inner ear.
In some patients they lose too hairthat grow on the pigment spots, their color. The emergence of a new stain is avoided in some patients itching accompanied.
Vitiligo: examinations and diagnosis
If you think you have white spot disease, your best bet is to find one Dermatologist on. He will first ask you in detail about your Medical history (Anamnese). Possible questions are, for example:
- When did you first notice the skin changes?
- Where are the spots located and how big are they?
- Are other family members sick?
- Do you have any other illnesses (diabetes mellitus, neurodermatitis, etc.)?
- Do you regularly take medication?
- Did you suffer from severe sunburn or other skin conditions or irritations prior to the onset of the disease?
Vitiligo: Physical Exam
After the anamnesis discussion, the doctor will examine you: he will examine the skin all over your body. Ideally, he photographs the affected areas of the skin in order to be able to understand the course of the disease later.
The doctor also looks at the white patches of skin with the help of a special UV lamp, the so-called Wood light (Wavelength: 364 nm). In this light, the Vitiligo spots glow white-yellow.
To confirm the diagnosis, healthy areas of skin can be mechanically irritated with a wooden stick. If it is actually the white spot disease, new pigment spots appear on the irritated area. This effect is under the name "Koebner phenomenon" known.
Vitiligo: further investigation
If vitiligo is suspected, this is usually also the case blood tested for specific antibodies (such as total IgE, antinuclear antibodies = ANA). The thyroid values are also determined because the white spot disease is often associated with an inflammation of the thyroid gland (Hashimoto's thyroiditis). The doctor also takes a closer look at the sugar levels - diabetes is another possible concomitant disease with vitiligo.
If the laboratory values show abnormalities, further investigations are carried out for clarification.
The various examinations are not only used to diagnose Vitiligo. They also help rule out other conditions that can cause similar skin changes. These so-called differential diagnoses in white spot disease include other pigment disorders and skin diseases such as certain types of birthmarks (nevus depigmentosus, nevus anaemicus), piebaldism, hypomelanosis guttata and pityriasis versicolor alba.
Vitiligo: disease course and prognosis
White spot disease is a chronic disease that continues to progress if left untreated. Once stains have occurred, they usually remain permanent. Only rarely do they regress on their own. Further relapses can be prevented by consistent treatment of the Vitiligo. A cure is currently not possible.
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