Vitiligo is an autoimmune condition, and what that means is that for some reason your own body's immune system decides that the pigment forming cells that give your skin color don't belong to you and they attack it, and they tend to do this in a very patchy and predictable way.
The first place we start to see vitiligo in most people is around the eyes, around the mouth, and then on areas of high friction, like the hands or even the elbows. So that's what causes it. We know the underlying cause, it's not a mystery. There is no cure for it that we know of, but there are ways to mask it. There are products like Dermablend that you can put on and you can match your own natural skin color to try to conceal it.
There are some treatments that we try as dermatologists to help with it. Sometimes using a product called a psoralen, which can be either by mouth or topical.
Applied to the skin, you let it incubate for a little while, and then go under ultraviolet light in a light box, can stimulate those pigment forming cells to come back to life and suppress the immune system in the skin in those areas to try to help the pigment come back. Sometimes this works, sometimes it doesn't.
When the vitiligo is extensive enough that it covers more of the body than not, so if it's very patchy, if there is a big contrast in skin color, we can use a topical cream called Benoquin to try to eliminate all the pigment forming cells.
And take away all the pigments. So sometimes we try to bring the pigment back and sometimes we try to take it all away. But in the meantime, trying to cover it may be the best thing. In rare cases it just fades out on its own.
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