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 (vih-tih-LY-go) 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
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:
focal vitiligo happens when there are just a few spots in a single
generalized vitiligo is associated with many spots all over the
body that tend to be symmetrical (they affect the right and left sides of the body
like a mirror image). This is the most common form of the condition.
segmental vitiligo is characterized by spots only on one side
of the body and usually nowhere else. This type of vitiligo is relatively uncommon.
Although vitiligo can appear anywhere on the body, it's more likely to happen in:
areas that are exposed to the sun, such as the face or hands
skin that has folds, such as the elbows, knees, or groin
skin around orifices (body openings), such as the eyes, nostrils, belly button,
and genital area
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
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 usually can 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 do 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 the biopsy shows there
are no pigment cells, this may confirm a case of vitiligo.
There is no "cure" for vitiligo. Some patches will clear up without treatment.
For those that don't, treatments can help to even out the 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 to help if your child has vitiligo:
Sunscreen. One of the most important things your child can do
is wear sunscreen
every day to protect against skin cancer. And because vitiligo spots can't tan (they
have no melanin), they may burn and scar. Getting a tan on the rest of the body will
only highlight white patches even more, especially if a child has light skin.
Cosmetics. Different kinds of over-the-counter concealers are
available. Ask your doctor for recommendations and try different brands until you
find the one that works best for your child.
Corticosteroid creams. Corticosteroids are a type of medication
which, when applied to white patches very early in the disease, may help to "repigment"
the skin. They reduce the inflammation that causes a loss of pigment so that
pigmented cells can return to the skin. Some non-steroidal creams also produce a similar
Photochemotherapy with ultraviolet A (also known as PUVA). PUVA
has two steps: first, a medicine called psoralen is either applied to the white patches
of skin or taken orally; then, the skin is exposed to ultraviolet light, sometimes
from the sun but usually from an artificial source, like a UVA lamp. This turns the
affected skin pink, which in time tends to fade to a more natural (often slightly
darker) color. There are side effects, which may include severe sunburn and skin blistering.
Other side effects may be more serious, so talk to your doctor about the risks involved.
Narrow-band ultraviolet B (UVB) therapy. This treatment is more
widely used than PUVA. It's similar to PUVA, except that the ultraviolet light used
is UVB instead of UVA. Also, no psoralen is required beforehand, which eliminates
some of the side effects.
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 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:
Don't focus on the vitiligo or put pressure on your child to cover it up. He or
she needs to know your love and acceptance are unconditional.
Remind your child of all the things at which he or she excels —
and how they have nothing to do with skin color.
Teach your child to be comfortable explaining what vitiligo is —
and isn't — to other kids. Once the mystery is taken away,
most kids will stop staring and asking questions.
Encourage your child to say yes to play dates, pool parties, trips, and any
other experiences he or she might be tempted to pass on because of the vitiligo.
Urge your son or daughter to volunteer
or get involved in the community. Giving back makes kids feel powerful.
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.