By Nada M. Bullock, Physician, As Told by Susan Bernstein
One of the most challenging aspects of generalized vitiligo is how far it has progressed. This varies from person to person. Newly diagnosed people often ask, “How common or stable is it?” Some people may have stable disease for years. But others may suffer from vitiligo, which can spread at any point in their lives. If you are undergoing treatment, this may help keep your condition stable. If not, you can develop new patches.
[Choosing to camouflage vitiligo] It is a very personal decision. Everyone with vitiligo deals with this differently. Some people want to hide it. Others are more comfortable with the look of their skin and don’t want to wear makeup. First, we’ll have a conversation about camouflage. I want to know how you feel emotionally about the appearance of your skin. I might also ask, “Do you want to start treatment, or are your treatments not responding?” There are makeup products for vitiligo that you can get without a prescription. Some people also use self-tanners that help camouflage areas of the skin.
I also direct people to the various support resources available, such as the Global Vitiligo Foundation. They have a section on their website about support resources for vitiligo patients, as well as support groups across the country. It may help to control your feelings of meeting other people who also have vitiligo. Talking to others in a support group can be a very supportive and positive experience. There are online support groups for vitiligo, too. I try to suggest reliable sources of information on the Internet.
The emotional impact of skin color changes
Research has conclusively shown that vitiligo can have a profound psychological, social, and emotional impact. First, you no longer feel in control of your appearance – how your skin looks. Vitiligo changes the color of your skin, and you may develop white patches anywhere on your body, including your face. There is also a great deal of variance in vitiligo and how widespread it is on your body. People also feel uncertain about their vitiligo’s progression: Will I have an attack? Will these spots grow?
Vitiligo can affect people of all skin colors. I have patients of all colors. We see it in both
adults and children. It can first appear early in life, but it can develop when you’re an adult. For children, it can be difficult to understand what is happening to them, and it can also be difficult for other children around them to understand.
Treatment and support groups for people with vitiligo can be very helpful. It depends on how affected you are, but seeing a psychologist or psychiatrist can also be helpful. We encourage anyone with any negative feelings to seek medical attention.
Famous role models reduce stigma
Winnie Harlow was one of the first people with Vitiligo to proudly announce it. She is a beautiful and successful model, often modeling without using makeup to cover her vitiligo. This has helped reduce the stigma of vitiligo. There has been a positive wave in recent years around self-acceptance in general. People are starting to accept beauty in all its forms which is very important. CoverGirl also recently chose her first model with Vitiligo. Mattel released a Vitiligo Barbie doll. You see retail stores and marketing campaigns using vitiligo models.
Self-acceptance of your vitiligo does not eliminate the need for treatment options for those who want them. But everyone should know that they are beautiful and have self-worth. It is important to educate our community about vitiligo. People may ask you if it’s contagious – it’s not. My patients also ask if it is genetic. While there is a genetic and hereditary component to vitiligo, the chances of it occurring in the next generation are low. There is less than a 10% chance that you will pass it on to your children.
Protect your skin from sun exposure
If you don’t treat it and just choose to live with vitiligo as it is, you may not need to see a dermatologist regularly. If you’re on medication, or if you have vitiligo that’s spreading quickly, you should usually see a board-certified dermatologist just every two months to monitor your condition and any changes.
My message to anyone wondering if they have Vitiligo or if they have been diagnosed with Vitiligo is to visit a board-certified dermatologist, especially one who specializes in treating Vitiligo. Again, it is entirely up to each person if they want to seek treatment or not. A dermatologist can guide and talk to you about all of your options.
If you have vitiligo, you should apply sunscreen with an SPF of 30 or higher, just as we would recommend anyone. We used to worry that people with vitiligo were more likely to get skin cancer. However, with further research, we have found that this is not the case and, in fact, you are less likely to develop skin cancer. However, we recommend using sunscreen as a general precaution, and if you’re out in the sun all day, reapply every two hours.