Navigating the stigma tied to vitiligo – ET HealthWorld


By Dr B S Chandrashekar

Diya was about the age of 16 when she was diagnosed with vitiligo. It started with a few small patches on the hands and arms. Before long, it was widespread. She reported experiencing emotional distress and a decrease in self-esteem since the onset of vitiligo. Diya described facing bias and discrimination from friends, colleagues, and even family members. People often made insensitive remarks and treated her differently, causing her to withdraw socially. She became self-conscious and would only wear clothes that would cover her patches. For the past few months, she has been receiving treatment for anxiety and depression. Diya’s case explains the significant impact of prejudice and discrimination on individuals with vitiligo.

What is vitiligo?

Vitiligo is a chronic autoimmune disorder that causes the skin to lose pigment or color. White or light areas called macules or patches appear on the skin. This happens when skin cells that produce melanin know as melanocytes, are attacked and destroyed causing the skin to rose color. Vitiligo typically begins on hands, forearms, feet, and face, but can develop on any part of the body, including mucous membranes (mouth, nose, genital and rectal areas), eyelids, and inner ears. More than 1 per cent of the global population suffers from vitiligo.

Vitiligo can develop at any age and does not depends on gender. Family history and genes play a crucial role in causing vitiligo as about 30 per cent of vitiligo cases are genetic. Certain autoimmune diseases, including addison’s disease, anemia, psoriasis, rheumatoid arthritis, thyroid disease, and type 1 diabetes can trigger vitiligo. Sometimes sunburn, emotional distress, or exposure to a chemical can also cause vitiligo.

Psychological cost

While vitiligo itself is not physically dangerous or harmful to one’s health, the psychological and emotional impact it can have on individuals remains significant1. Individuals with vitiligo often face societal stigma, hurtful remarks, and intrusive questions which can considerably impact their mental well-being. The psychosocial impact on education, marriage, and employment is particularly evident among young adults. Patients often lose certain employment opportunities because of the condition. The fear of judgment and rejection can lead to social withdrawal, anxiety, and depression, thereby negatively impacting patients’ quality of life. According to a recent study among 53 vitiligo patients, 30 of them had major depressive disorder and 36 patients had social phobia.

Treatment opportunities

Although there are numerous treatments for vitiligo, there is still no known cure for the condition. Treatment options include topical treatment with corticosteroids, phototherapy and systemic drugs. Phototherapy is one of the conventional treatments for vitiligo. It uses monochromatic light from an excimer laser or lamp that penetrates deeper into the skin and prevents melanocyte destruction. However, traditional phototherapy is not viable due to the lengthy treatment regimen. It requires 2-3 visits per week for at least a year to achieve visible benefits. Moreover, the cost of treatment and the availability of equipment and experienced physician may be challenging for patients who opt for this treatment. Today, advanced options like topical creams offer innovative solutions. Such treatments selectively filter solar radiation to provide narrow-band UVB to vitiligo lesions. They offer a more convenient home-based alternative to phototherapy.

Both traditional and modern treatments for vitiligo can have positive psychological effects such as hope, reinforcement, and reduced anxiety. Consulting a dermatologist is crucial in determining the most appropriate topical treatment plan to ensure its safe and effective use. However, it is important to address psychological well-being alongside managing the physical aspects of vitiligo to support patients throughout their journey.

Written by Dr B S Chandrashekar, Chief Dermatologist & Medical Director, CUTIS Academy of Cutaneous Sciences, Bengaluru

(DISCLAIMER: The views expressed are sole of the author and ETHealthworld does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person/organisation directly or indirectly)

  • Published On Jun 25, 2023 at 05:58 PM IST

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