|SSM Cardinal Glennon Children's Medical Center|
Whether fair, dark, or any shade in between, most kids have skin that is generally the same color all over their body. But this isn't the case for those with vitiligo.
Vitiligo is a loss of skin pigment, or color, that causes white spots or patches to appear on the skin. No one knows exactly why this happens, but we do know it affects people of both sexes and all races. In the United States alone, an estimated 1 to 2 million people have the condition, and more than half of them are kids and teens.
The good news is that vitiligo — upsetting as it can be to those who are living with it — isn't medically dangerous. It's not a form of skin cancer, it's not an infection like MRSA, and it's definitely not contagious. In fact, most kids who have it are every bit as healthy as everyone else.
Vitiligo is a skin disorder that affects the melanocytes, cells deep within the epidermis (the outermost layer of the skin) whose function is to produce melanin. Melanin is the pigment that gives skin its color and helps protect it from the sun.
Our skin color is determined not by how many melanocytes we have (we're all born with a similar amount), but rather by how active they are. Dark-skinned people have cells that naturally produce a lot of melanin, while light-skinned people produce much less.
Sometimes, though, skin cells suddenly stop producing melanin. At first, this might cause a spot, called a macule, whose color is much lighter than the skin around it. But in time these light patches may spread and grow to cover a larger portion of the body. Sometimes the spread happens quickly, and then remains stable for a number of years; other times it happens slowly, over a longer period of time.
Dermatologists label the types of vitiligo according to the amount and location of the patches:
Although vitiligo can occur anywhere on the body, it's more likely to happen in:
Although kids of all races are affected equally, spots tend to be more visible on those with darker skin.
Sometimes kids with vitiligo have other symptoms, such as premature graying of the hair or a loss of pigment on the lips, since pigment cells are found in these places, too.
Theories vary on what causes vitiligo. Some experts think it is an autoimmune disorder (in which the immune system mistakenly attacks healthy melanocytes). Others think it is a genetic condition, since over 30% of affected kids have a family member who also has it.
What is known is that the risk of developing vitiligo increases in kids with a family or personal history of thyroid disease, diabetes, and certain conditions like alopecia (an autoimmune disease that causes hair loss). And vitiligo is never contagious — kids can't "catch" it from someone else.
A dermatologist can usually make a diagnosis of vitiligo just by looking for the telltale white patches on the skin. On kids with very fair skin, a special tool called a Woods lamp might be used. This lamp uses ultraviolet light in a dark room to illuminate areas of affected skin that would otherwise be hard to see with the naked eye.
The doctor will also ask lots of questions about your child's medical history, including whether anyone in the family has had skin conditions or autoimmune problems in the past; whether your child recently has had a rash or sunburn; or whether he or she has had any other illnesses or been under stress. A blood test may be done to check for thyroid problems and diabetes, as these can increase the risk of vitiligo.
Very rarely, the doctor may perform a biopsy (where a small piece of the affected skin is removed to be analyzed in the lab). A biopsy lets the doctor check for pigment cells in the skin. If there aren't any, this can confirm a case of vitiligo.
There is no "cure" for vitiligo. Some patches will resolve without treatment, but for those that don't, treatments are available to help to even out your child's skin tone. You can try some at home; others require treatment by a doctor. Just remember that results can vary — what works for one person may not work for another, and no treatment is likely to be 100% effective at making the spots disappear.
Here are ways you can help:
Researchers are also looking into a new procedure called a melanocyte transplant. It works by removing a sample of normally pigmented skin and using it to grow new melanocytes in the lab. These can then be transplanted back into the depigmented skin to return some of the missing color.
When deciding which, if any, treatment plan to try, be wary of quick-fix "miracle" remedies you might see advertised. If it seems too good to be true, it probably is. Always work with your child's doctor to help you decide what's best for your son or daughter.
Dealing With the Emotional Impact
If your child has vitiligo, you know that even though it isn't dangerous to his or her physical health, it can still be a big deal. Any condition that makes kids look different from their peers can be emotionally tough, especially during the preteen and teen years when everyone's trying so hard to fit in.
Some kids are naturally more resilient and do just fine against these challenges. But others need a bit more help. As a parent you can do a lot to arm your child with confidence and self-esteem. Here are a few tips:
Finally, get emotional support if your child needs it — especially if you see any signs of withdrawal, depression, or anxiety. Counselors, therapists, and vitiligo support groups can help.
Reviewed by: Patrice Hyde, MD