Having a skin with different color patches (vitiligo) is devastating and stressful as far as trying to eliminate them is concerned much as dermatologists say with the right medication, the condition can be cured.

What is it vitiligo?

Francoise Gahongayire, a dermatologist at King Faisal Hospital, Kigali, says vitiligo is a condition where by one develops white patches on their skin. It’s an autoimmune disease which most of the time is genetic and can appear on any area of the body.

According to her, vitiligo is caused by the loss of pigment in the skin known as melanin. This pigment is the one that is responsible for giving the skin its characteristic colour.

"This comes about because of the destruction of the pigment-forming cells called melanocytes. Although vitiligo affects all races equally, it is more noticeable in dark-skinned people,” she says.

Similarly, Rachna Pande, an internal medicine specialist, says vitiligo is a condition where white patches appear on the skin, giving one a discoloured look.

"It can occur at any age or any part of the body. Africans are said to be more vulnerable to this condition. In some, few patches or a single patch appears and remains for life. In others, it progresses from the affected body part and new patches appear in different parts, giving an ungainly look to the face and limbs,” she says.

Pande points out that the exact cause of vitiligo is not known.

"It is said to be an autoimmune disorder, where the body’s immune system fails to recognize its own antigen proteins. It also tends to run in families and is hereditary. Excess exposure to sunlight has been cited as one of the causes, but not substantiated by scientific studies,” Pande says.

How it comes about

According to Pande, anyone at any age can develop the condition, but it’s more common in people who are in their twenties. However, she adds that this is more noticeable in people with dark skin.

"People with certain autoimmune diseases (such as hyperthyroidism) are more likely to get vitiligo than people who don’t have any autoimmune diseases. Children whose parents have the disorder are more likely to develop vitiligo,” she says.

Protais Kanimba, a dermatologist based in Butare, Southern Province, says some people may inherit the condition, but they don’t necessarily know whom they inherited it from.

How to treat it

According to medics, diagnosis is by clinical examination and a skin biopsy to exclude other causes of white depigmented patches like psoriasis and leprosy.

To treat the condition, Kanimba says one should be in a position to know its symptoms. He adds that the mode of treatment also varies, noting that there is no prevention to the disease since it is hereditary. Visiting a dermatologist, he says, is the only sure way one can find out the treatment options for the skin condition.

"The most common signs of the condition include rapid pigment loss on several areas of the skin. The initial appearance of the white patches can be followed by a stable period without any progression of the condition,” Kanimba says.

He notes that treatment can also be by tablets and ointments, which boost melanocyte production, but are not very successful in most cases. Derm abrasion, cosmetic use to make the patches look darker or surrounding skin areas lighter are other options.

Patients are advised to use a sun screen regularly over the affected part while moving out in sun.

Francis Kazungu, a general practitioner in Kigali, says the hair of people with this condition turns gray early. However, one can still make their skin become even by removing the white patches through trying out different treatments.

"It is always good to seek treatment from a dermatologist. This is because treatment varies according to the individual. For instance, certain treatments may not be right for everyone, and they come with side effects,” he says.

Kazungu says in most cases, the treatment is mainly aimed at restoring the colour in areas where the condition has been affected.

This, however, can be treated through surgical, medical and other protective ways that will help cover the areas affected.

"There are creams that are prescribed for the patient, basically for applying over the affected areas. There are also those that are swallowed as well as combination of medicine and ultraviolet light,” says Kazungu.

For surgical procedures, Gahongayire says the doctor can take skin from one area of the patient’s body and cover another area (skin graft from a person’s own tissue). The process is more effective in patients with small patches.

On the other hand, she notes that one can use make-up to cover the areas affected. This is better for people with less vitiligo on their face. Sunscreens are also good especially for those patients with patches on their eyelids.

She adds that counselling and support should be given to the patient.

"This helps them to accept the condition and live with it in cases where the patches keep multiplying or don’t go away completely. Patients should also know that if the condition is inherited and there is nothing that can be done to prevent it, they should not blame themselves,” Gahongayire says.

Pande similarly says people suffering from the condition are more susceptible to sun burn and skin cancers.

"This happens due to depletion of skin pigment producing cells. They also suffer from inflation inside the eyes. They often suffer from depression; therefore, counselling is crucial for them to cope with the condition,” she says.