White spot disease (vitiligo) is more than just a harmless cosmetic problem you have to live with. White spot disease is an acquired disorder of normal skin coloration. In various areas of the skin, striking white spots appear that are very different. These bright spots lack the pigment melanin, which gives the skin that particular hue. Melanin is formed by special cells of the skin (melanocytes) and deposits in the middle skin layers as a protective film against the damaging ultraviolet radiation.
Vitiligo and albinism
Vitiligo must 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, since the iris is also without pigment. In the animal kingdom, this inherited disorder is known, for example, as albinos in the famous white mice or rats.
Cause of white spots
The white spot disease (vitiligo), however, is not inherited directly and usually does not affect the entire skin or all pigmented tissue. However, a certain inherited condition is to be assumed, because the disease is common in some families. The causes of the "white spots" are still being researched.
Presumably it is an immune reaction against the body's own cells that produce the melanin. This so-called autoimmune reaction damages these cells, losing the ability to produce dyes and thus causing the colorless skin sections. Hair in this area can also be white, but are not necessarily affected by the discoloration.
One of the reasons for the immunological cause is that vitiligo often occurs in combination with other diseases in this group, for example in certain thyroid disorders, in gastric mucosal changes or in circular hair loss (alopecia areata), in which immunological processes are also involved.
Typical signs of white spot disease
The disease is easily diagnosed by visual inspection because of the typical symptoms. The whitish skin patches vary in size, sometimes bizarrely shaped, the edge may appear red, or even darker discolored. The extremities, the head and the genital region are particularly common.
Although the vitiligo itself causes no complaints, but it may lead to complications. On the one hand, this can be psychological changes due to the blemishing of the skin, which lead to insecurity, social isolation and reduced quality of life.
Vitiligo and sun
Even more important in the case of white spot disease, however, is that these skin areas are exposed to the harmful UV light without protection when they occur on unclothed areas of the skin. This can demonstrably lead to a higher risk of skin cancer, if not consistent sunscreen is maintained.
How to treat the white spot disease
The treatment of the cause of the disease is currently not possible.
However, one can and must treat the symptoms and risks of this pigmentation disorder. For example, cosmetic preparations for covering the white spots are considered, which not only have an optical effect.
The administration of the provitamin beta-carotene is used therapeutically, as this leads to an overall stimulation of the skin pigmentation. But this can also cause the white areas to stand out even more clearly.
Therapy by radiation and plant extracts
Targeted irradiation with ultraviolet light (PUVA) and phenylalanine can bring certain benefits to fresh spots of white spot disease, as shown in a comparative study over five years of treatment.
Also, various plant extracts (for example black mulberry) and tannins have been recommended for the treatment of white spot disease, but their effect is most likely explained by a coloring effect.
When exposed to sunlight, the non-pigmented skin areas must be covered with a sunscreen with a high SPF, otherwise a sunburn may easily occur in those affected by the white spot disease.