Understanding The Symptoms Of Vitiligo

November 28, 2023

Vitiligo is a skin disease where an individual loses skin pigment or color in blotches. For individuals affected by vitiligo, the pigmentation loss is not predictable and can occur on any body part covered by skin. Skin color comes from cells that produce melanin. With vitiligo, skin cells that make melanin stop working or begin to die off. Individuals of all skin types can be affected by vitiligo, but it is more apparent and noticeable in those with darker skin. Vitiligo does not pose life-threatening health risks and cannot be spread to others. Most individuals with vitiligo first experience symptoms before reaching their second decade of life. Predicting the behavior or progression of vitiligo can be a challenge. Vitiligo may be caused by a genetic mutation, skin cancer, sunburn, industrial chemicals, or the immune system attacking melanocytes.

Loss Of Skin Color In Patches

The hallmark symptom of vitiligo is the loss of pigment on the skin that causes an individual to develop milky-white colored blotches on one or more regions of their skin. This form of depigmentation most often originates in regions where the skin has been frequently exposed to the rays of the sun, including the lips, face, arms, hands, and feet. Three different types of depigmentation occur in vitiligo patients. Focal depigmentation occurs when one or a few areas of the skin on the body are affected. Segmental depigmentation is characterized by the loss of skin color that occurs on just one side of an individual's body. Generalized depigmentation occurs when the loss of skin pigment occurs in widespread fashion across the entire body. Most discolored patches that develop in vitiligo are symmetrical. Discoloration of the skin from vitiligo occurs evenly among both genders and is most likely to manifest between the second and third decade of a patient's life.

Premature Gray Hair

Premature gray hair is a term used to describe when a Caucasian individual develops graying of the hair before twenty years old, and when an African American individual develops graying of the hair before thirty years old. Human hair has color to it because of a pigment called melanin, which is produced by special cells referred to as melanocytes. An individual affected by vitiligo has melanocytes that are overly sensitive to oxidative stress. Oxidative stress is when the level of free radicals and the level of antioxidants in an individual's body become unbalanced. Free radicals are molecules characterized by an uneven number of electrons, which allow it to react with other molecules too easily. These highly reactive molecules cause damage to the melanocytes responsible for supplying the pigmentation to the hair. The melanocytes die prematurely due to oxidative stress, which produces the premature gray hair that occurs in vitiligo patients.

Loss Of Color In The Retina

Eye choroid is a term used to describe a structure in an individual's eye that is abundantly vascularized. This structure provides the outer part of an individual's retina with blood flow. The eye choroid contains a choriocapillaris layer that borders the Bruch's membrane, Haller's layer, Sattler's layer, retinal pigment epithelium, and suprachoroidal layer. Patches of melanocytes and all of these layers that make up the choroid sit within an elastic and collagenous stroma. Melanocytes in the choroid are responsible for producing melanin to protect an individual's eye from the intraocular light reflections. The color that displays in an individual's iris is produced by the melanin in the uveal tract of their eye. Vitiligo in an individual can destroy pigment cells or melanocytes located in an individual's ciliary body, choroid, meninges, retinal pigment epithelium, and iris. When the melanocytes are destroyed in these parts of an individual's eye, they can experience a loss of color in their retina.

Color Loss In Mucous Membranes

A mucous membrane, which is comprised of ectodermal tissues, is the cell layer that covers the interior of multiple body organs and orifices. Mucous membranes can secrete or contain a substance referred to as mucus, a thick fluid that protects the tissues on the inside of an individual's body from foreign pathogens, dirt, and other harmful substances. There are numerous different mucous membranes in an individual's body, including those in the digestive system, respiratory system, and reproductive system. Melanocytes populate the tissues that make up an individual's mucous membranes the same way they populate the tissues that make up their skin. Therefore, the same mechanism that causes depigmentation in the skin tissues can also cause depigmentation in the vitiligo patient's mucous membranes.

Progression Of Discoloration

An individual who experiences skin, mucous membrane, and retina discoloration may notice the discoloration starts to progress as their condition progresses. In individuals affected by vitiligo, the discoloration of their skin usually begins with a few relatively small white patches that tend to slowly and gradually spread around their bodies. Most vitiligo patients experience their first symptoms when certain events like physical or emotional stress trigger the onset of their disease. The small patches can become wider and continuously spread in some patients while they stay in the same size for several years in others. The location of the depigmented macules on an individual's skin can change and shift over time. Certain parts of an affected individual's skin lose their pigment and then regain it. The amount of skin ultimately affected is varied. Some patients only ever develop a few macules, while others experience widespread loss of the color in their skin.

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