The appearance of white spots on the skin can bother many people. The sudden appearance of lighter spots on the face, hands, neck and other parts of the body makes a person anxious and scared as they think they are suffering from vitiligo. However, dermatologists claim that all white spots cannot be considered signs of vitiligo. There are many factors and causes that make skin look lighter.
One of the most widespread reasons for white spots on the skin is really vitiligo. It is a lifelong autoimmune condition characterized by damage to pigment-producing cells (melanocytes) by the body’s immune system. Due to the death of these cells, well-demarcated white spots appear on the skin. Vitiligo can occur in people of any age, gender and skin color.
According to dermatologists, vitiligo spots are sharply demarcated and milky white. These spots are symmetrically distributed and usually appear in areas such as the face, hands, feet, eye area, mouth area, elbows, knees and genital area. In some patients, the hair growing in the patchy area turns white. They do not create scales on the skin.
However, there are other skin diseases that can be accompanied by white or light spots, for example, pityriasis versicolor. It is a fungal infection that usually occurs in tropical climates, such as India. It develops due to the growth of yeast that usually lives on the skin.
Unlike the symptoms of vitiligo, the fungal infection is characterized by the appearance of numerous light or dark spots with fine scales. These spots appear on the skin of the chest, back, shoulders, neck and arms. Patients may experience mild itching. It is important to note that this disease is treated with the help of antifungal agents and does not lead to irreversible loss of pigment.
In addition to these diseases, there are many other causes of lighter spots on the skin, including post-inflammatory hypopigmentation, pityriasis alba, nutritional deficiencies, certain drugs, chemicals or rare genetic disorders.
Many skin conditions that are associated with light spots on the skin can look very similar. It means that patients should not try to diagnose their condition without consulting specialists. Self-medication, especially with the help of OTC creams (steroid combination preparations) can worsen their condition.
Therefore, if you have noticed new white spots on the skin that spread, change quickly or appear repeatedly, you should consult a dermatologist as soon as possible. Clinical examination and some ancillary methods (for example, Wood’s lamp examination and, rarely, skin biopsy) will help your doctor determine the exact cause of your condition.
Stress connection
Many vitiligo patients wonder if stress can cause or worsen their condition. It should be noted that stress is not the cause of vitiligo. However, there is a lot of information proving that stress can have a significant impact on the development and worsening of the disease.
Scientists hypothesize that psychological stress can negatively affect the immune system and cause increased oxidative stress that contributes to the death of pigment-producing cells. Many patients reported the onset of vitiligo after such stressful events as the loss of a loved one, relationship issues, exam pressure or work stress.
Patients who have vitiligo suffer emotionally due to social prejudice and cosmetic reasons. Therefore, doctors emphasize that the treatment of vitiligo should include not only medical therapy, but also counseling and stress management.
There are many ways to treat this disease, including topical medications, phototherapy, oral agents in certain cases, and surgery if the disease is persistent. Early diagnosis of the condition and timely intervention can improve treatment outcomes.
The first steps
Try not to panic. Not all white patches mean vitiligo as some causes are temporary and can be easily treated.
Do not use any OTC steroids without consulting your doctor because this therapy may worsen the condition.
Consult a dermatologist if you notice that the spot is spreading, changing quickly or remaining for several weeks.
Protect your skin from intense sun exposure and use sunscreen and special clothes because depigmented skin is more sensitive to sunlight.
If you have been diagnosed with vitiligo, you need to start treatment quickly to reduce the speed of its development and achieve a better repigmentation.
Remember that the white spots are not contagious and people with vitiligo can lead a healthy life.
White patches on the skin should never be ignored, but neither should they be automatically assumed to be vitiligo. While some causes are temporary and easily treatable, others require long-term management. Seeking an early dermatologic evaluation remains the best way to obtain an accurate diagnosis, initiate appropriate treatment, and address concerns before the condition progresses.
by Dr Sooriya S, Senior Consultant, Dermatology, SRM Global Hospital, Chennai
