Live, enjoy and dare..... also with vitiligo!

General questions

What is vitiligo

Vitiligo is a skin condition that causes white spots to appear on the body. These areas lack pigment.

How does vitiligo develop?

Vitiligo is a skin condition that causes white spots to appear on the body. These areas lack pigment. The exact cause of vitiligo is still unknown. The most likely explanation is that vitiligo is an autoimmune disease.

What is an autoimmune disease?

An autoimmune disease is a disease that occurs because the immune system in our body behaves abnormally. Normally the immune system produces antibodies against outside invaders (pathogens). In an autoimmune disease, however, the system produces antibodies against part of the body.

Is vitiligo contagious?

No, it is not contagious. It is true that vitiligo runs in families. 30% of the vitiligo patients has someone in the family who also has vitiligo.

Are there different forms of vitiligo?

Yes, there are six forms of vitiligo. The most common form is vitiligo vulgaris (also called generalized vitiligo). This form usually occurs symmetrically or bilaterally across the body.

How many people in the Netherlands have vitiligo?

Approximately 1 to 2% of the world's population has vitiligo, regardless of race or gender. So in the Netherlands approximately 240,000 people have vitiligo.

Can vitiligo be cured?

Vitiligo is a chronic condition, the cause of which is not (yet) known and therefore cannot be cured. It is possible to counteract the loss of pigment and even regain pigment. However, the duration and success of treatment differ per treatment type and per person.
There are several forms of vitiligo, from a modest white spot to a complete disappearance of the pigment over the entire body.

How do I know my white spots are vitiligo?

To be sure whether or not the white spots are fungus, it is best to ask your GP for a referral to a dermatologist, who can use a Woods lamp or black light to determine whether or not it is vitiligo.

Make a diagnosis

My daughter, who is now 2 years old and 5 months old, was born with a white spot on her belly (diameter slightly larger than a piece of € 2, very irregular edge) and she has a very small spot on her chest. For several months now I have also noticed a few white spots on her arm. Could this be vitiligo?

A white spot does not always have to indicate vitiligo, it could be a Pityriasis versicolor (superficial fungal infection) or Pityriasis alba, another harmless, self-healing skin condition (mild form of atopic eczema).
We advise you to request a referral from your GP for a consultation with a dermatologist, who can provide a definitive answer (using Woodslamp).

Do areas of hair loss occur in vitiligo patients?

Hair loss is a broad concept, as there are many causes of hair loss. Alopecia areata is an autoimmune disease that manifests itself in bald spots. This condition can occur along with vitiligo. The male type of baldness is not often seen with vitiligo, although the whitening of the hair can make it seem as if there is less hair. In addition, there are other (autoimmune) conditions that may resemble vitiligo (lichen sclerosus and morphea) that can cause atrophy of the skin with hair loss. The skin also becomes whiter, but this does not concern vitiligo. Of course, bald spots can also occur in people with vitiligo, but this is not due to the vitiligo itself. The bald spot is therefore not the result of vitiligo.
It is worth noting:

  • It is conceivable that a person with vitiligo also has a skin condition with hair loss and that vitiligo is triggered in those same bald areas.
  • In addition to vitiligo, someone can also have another skin disease with hair loss without any connection between the two.
  • It is also worth mentioning that alopecia areata and vitiligo are autoimmune diseases that can occur in the same person.
But one must always bear in mind that there are also skin conditions such as lupus in which both hair loss and depigmentation occur in the same area.

How is vitamin D production on vitiligo skin where no pigmentation occurs?

Vitamin D production works better in skin with less pigment, which is why darker people are relatively more likely to have a vitamin D deficiency if they live in countries with less sun (such as in the Netherlands) and the nutrition center recommends taking supplements. With vitiligo skin it is easier to produce vitamin D, provided you do not apply high factor sunscreen, cover your skin with clothes or camouflage, because then the UV light will of course not reach your skin where the vitamin production takes place. Just by spending a few minutes a day outside (doesn't have to be in direct sun) with your face and the backs of your hands exposed, you can produce sufficient vitamin D with fair skin. The problem is that there is no clarity about what a good vitamin D level is. We do know when it is really too low and problems arise in bone development. Food can also be a source of vitamin D, in addition to natural supplements.

So in short: people with vitiligo actually have an easier build-up of vitamin D (especially if they also receive UVB light therapy), even if they originally have dark skin. Problems arise from extreme avoidance of the sun, covering the skin and applying high factor sunscreen every day.

Can the skin also become more pigmented with vitiligo? Or do I have something else?

No, dark spots are not part of vitiligo. However, it is possible that the spots that are still colored (pigmented) appear darker. That is why it is sometimes more difficult than you might think to see whether someone has developed darker or lighter spots. But if it is really just dark spots, this is not vitiligo. The only temporary exception is so-called “blue vitiligo”, a rare first stage of vitiligo. This causes temporary dark spots to occur due to the breakdown of the pigment-forming cells that precipitate the pigment in the deeper layer. However, this is only the case for a limited time because the epidermis quickly becomes whiter and then it will be clear that the skin becomes lighter and not darker.

Has there ever been research into whether people with vitiligo are highly sensitive or highly sensitive?

It is not entirely known what causes vitiligo. Apart from a genetic predisposition and a trigger (which could probably be many things and not one specific one, which always causes vitiligo to develop), no other causes are known. Being highly sensitive cannot be measured objectively and is therefore very difficult to find out whether this plays a role. Vitiligo is probably highly multifactorial, which means there are so many things that sometimes contribute a lot and sometimes a very little bit. So it cannot be ruled out, but it cannot be demonstrated either.

I feel tired very often and my vitiligo is spreading quickly. Is fatigue part of it?

Both the physical and psychological quality of life can be put under pressure as a result of the skin disease vitiligo. Consider: daily activities, mobility, vitality/energy, sleep deprivation, but also mood and emotions, body image, your self-image and of course your concerns about the skin disease. All this can lead to fatigue.

Can vitiligo only occur on the vulva or should I rather think of lichen sclerosus?

Lichen sclerosus is a skin condition in which the skin becomes less supple and whitish in color.
In most cases it occurs in women between the ages of 45 and 60, but it can also occur in adult men and children.

Vitiligo can certainly only occur on the vulva. In fact, the vulva is a preferred location for vitiligo.
The genital area is often the first part of the body to be affected by vitiligo in both men and women.
However, lichen sclerosus is included in the differential diagnosis (list of possible conditions).
The distinction is usually easy due to the structure/texture change (sclerosis) of the skin in longer-standing lichen sclerosus.
And shorter-lived lichen sclerosus is characterized by inflammation, flaking, rhagades, itching and pain.
However, sometimes it is difficult to distinguish and a skin biopsy is taken.

Pigment returns spontaneously. What could be the cause of this?

We often see that the pigment can return on its own. Even in people who were already more than 95% white.
Sunlight is certainly a triggering factor because sunlight stimulates the pigment cells. That is why we mainly see this phenomenon in places exposed to the sun.
It can happen suddenly while the pigment disappeared for years. This is most likely because the immune response against pigment cells has extinguished; so the vitiligo is stable. But that can also change again.
We already know a lot about how it happens, but little about why it happens.

One of my parents has vitiligo, will I get it now too?
Is the predisposition of vitiligo hereditary?

Vitiligo primarily has genetic components, which means that there must be a hereditary predisposition.
In 20 to 30 percent of patients, the disease also occurs in family members. The hereditary material in our cell nuclei contains a large number of codes for the predisposition of vitiligo.
The majority of these codes relate to the functioning of our immune system and some codes are related to the ability to produce melanin (skin pigment).