White spot disease (vitiligo) is more than just a harmless cosmetic problem to live with. White spot disease is an acquired disorder of normal skin coloration. Striking white patches appear on different areas of the skin, with very different shapes. These light patches lack the pigment melanin, which gives the skin its particular hue. Melanin is formed by special cells of the skin (melanocytes) and is deposited in the middle layers of the skin as it were as a protective film against the damaging ultraviolet radiation.
Vitiligo and albinism
Vitiligo should not be confused with albinism, which is a completely different clinical picture. In this rare congenital disorder of regular melanin formation, the body pigment is absent throughout the organism.
The skin is uniformly whitish-pink, the hair is already completely white in children and the eyes appear red because the iris is also pigmentless. In the animal kingdom, this hereditary disorder is known, for example, as albinos in the famous white mice or rats.
Cause of white spots
White spot disease (vitiligo), on the other hand, is not directly inherited and does not usually affect the entire skin or all pigment-containing tissues. However, a certain inherited predisposition can still be assumed, as the disease occurs more frequently in some families. The causes of “white spots” are still being researched.
It is probably an immune reaction against the body’s own cells that produce melanin. This so-called autoimmune reaction causes these cells to become damaged and lose the ability to produce pigment, thus causing the colorless patches of skin. Hair in this area can also be white, but is not necessarily affected by the discoloration.
The immunological cause is supported, among other things, by the fact that vitiligo often occurs coupled with other diseases from this group, for example, with certain thyroid diseases, with gastric mucosal changes or with circular hair loss (alopecia areata), in which immunological processes are also involved.
Typical signs of white spot disease.
The disease is very easy to diagnose by eye because of the typical symptoms. The whitish skin spots vary in size, are sometimes bizarrely shaped, and the border may appear reddened or even more darkly discolored. The extremities, head and genital region are particularly frequently affected.
Vitiligo itself does not cause any symptoms, but it may lead to secondary complications. On the one hand, these can be psychological changes due to the disfigurement of the skin, leading to insecurity, social isolation and a reduced quality of life.
Vitiligo and the sun
More importantly, however, in white spot disease, these areas of skin are exposed to damaging UV light without protection when they occur on unclothed areas of skin. This can demonstrably lead to a higher risk of skin cancer if consistent photoprotection is not maintained.
How to treat white spot disease
It is not currently possible to treat the cause of the disease.
However, one can and must treat the symptoms and risks of this pigmentation disorder. For this purpose, cosmetic preparations for covering the white spots, which have not only an optical effect, can be considered, for example.
The administration of the provitamin beta-carotene is used therapeutically, as this results in an overall stimulation of skin pigmentation. However, this can also cause the white spots to become even more prominent.
Therapy by irradiation and plant extracts.
Targeted irradiation with ultraviolet light (PUVA) and phenylalanine can produce some success in fresh foci of white spot disease, as demonstrated in a comparative study over five years of treatment.
Various plant extracts (for example, from black mulberry) and tannins have also been recommended for the treatment of white spot disease, although their effect is most likely to be explained by a staining effect.
When exposed to sunlight, the pigmentless skin areas must be covered with a sunscreen with a high sun protection factor, otherwise sunburn easily develops in white spot disease sufferers.
