Vitiligo a Skin Disease That Causes Serious Psychological Distress to Sufferers

Everyone has seen people with more or less extensive white patches on their faces or arms. This skin depigmenting disease is called vitiligo. Although it is not life-threatening, it is very visible and often makes the sufferer’s social or love life difficult. Existing treatments can help to reduce it, but never to get rid of it. This is why psychologists are brought in to help them cope and live better.

Vitiligo. Image Courtesy of James Heilman, MD

The effects of vitiligo

Vitiligo is characterized by skin depigmentation and more precisely, it is the destruction of the cells that give the skin its pigmentation. Vitiligo is an autoimmune disease caused by an immune dysfunction that attacks the cells responsible for pigmentation, the melanocytes, for no good reason. It is not hereditary and has no life-threatening consequences.

Vitiligo occurs in less than 1% of the population and can affect both women and men in adulthood or childhood. The affected areas and their distribution vary from person to person. The face, hands, feet, and genitals are often affected. Friction areas such as the elbows and knees are also usually affected.

Negative effects on social life

For many patients, vitiligo is embarrassing. It puts them at a great disadvantage socially because it is visible and prominent. This is especially true for dark-skinned people. It is more prominent in Indians than in white Europeans for example. The condition is associated with many serious conditions, although in fact it is not contagious and has nothing to do with leprosy. It is neither psychosomatic nor psychological. And parents who still feel guilty have nothing to do with their children’s illness.

The fact is that these bright patches are complex and sometimes cause a sense of shame, a loss of self-confidence, a feeling of being too visible, too different. Stigma can even cause difficulties in social life or relationships.

Psychological effect

The high visibility of vitiligo symptoms is sometimes stigmatizing, leading to a change in body image. And the sight of others is often difficult to bear. People’s psychological distress can manifest as increased anxiety or depression, which requires regular psychotherapeutic help.

Patients try to hide the stigma of vitiligo by trying to improve or reduce skin depigmentation through make-up techniques that allow them to “mask their depigmented skin areas. The practice has to be adapted depending on the place or person being treated.

No cure so far!

While there are treatments that can re-pigment the skin, they cannot cure the disease. Vitiligo can therefore recur, either in the same places or in other places. Corticosteroids may sometimes be recommended as an adjunct to topical anti-inflammatory treatment. They can only be administered in small doses so as not to negatively affect health.
Ultraviolet light can also be used to pigment the most problematic patches. Everything is decided on a case-by-case basis, depending on the patients, their needs, and the location of the patches.

On the positive side, thanks to public figures such as model Winnie Harlow, much has been made public about the disease. By showing her vitiligo in a natural way, she has raised public awareness of the disease and helped sufferers feel more confident.