Vitiligo (vit-ill-EYE-go) is a disorder in which white patches of skin appear on different parts of the body. This happens because the cells that make pigment (color) in the skin are destroyed. These cells are called melanocytes (ma-LAN-o-sites). Melanocytes normally occur throughout the skin, and in the hair follicles, mouth, eyes, and some parts of the central nervous system. Vitiligo can also affect the mucous membranes (such as the tissue inside the mouth and nose) and the eye. In Vitiligo, pigment cells can be lost in any of these areas. Common sites of pigment loss are:

• Exposed areas: hands, face, upper part of the chest*Around body openings: eyes, nostrils, mouth, nipples, umbilicus, genitalia*Body folds: arm pits, groin
• Sites of injury: cuts, scrapes, burns*Hair: early graying of hair of the scalp, beard or other areas
• Area immediately surrounding pigmented moles
• Choroids of the eye

Vitiligo is an important skin condition having major impact on quality of life of patients, many of whom feel distressed and stigmatized by their condition. Society greets vitiligo patients in much the same way as it does anyone else who appears to be different. They are stared at or subjected to whispered comments, antagonism, insult or isolation. The somewhat chronic nature of the health condition, long term treatment, lack of uniform effective therapy and unpredictable cause of the condition is usually very demoralizing for people living with vitiligo.

Is vitiligo a spiritual thing, attack, curse or burn that refuses to darken?

Vitiligo is a skin condition like we have Eczema, Acne, and Skin Cancer etc which is not just an African thing but happen to all races and all sex equally. The difference is that itÆs not contagious or life threatening but disfigures and has psychological effect.
What is the cause of Vitiligo?

Although the exact cause of vitiligo is unknown, it has been confirmed that an autoimmune component plays a role in the disorder. An autoimmune disorder causes your immune system to mistakenly attack some part of your own body. A combination of genetic, immunologic and neurogenic factors is of major importance in most cases. It is also possible that one or more genes may make a person more likely to get the disorder.

Some researchers think that the melanocytes destroy themselves. Others think that a single event such as sunburn or emotional distress can cause vitiligo. Vitiligo may also be hereditary, that is, it can run in families.

However, these events have not been scientifically proven to cause vitiligo. The cause of vitiligo remains a mystery.

How can Vitiligo be prevented?

As the definitive causes of vitiligo are still largely unknown to the scientific and medical communities there is no known way to prevent vitiligo. Despite this, taking proactive steps to address the above possible ‘triggers’ of vitiligo, such as stress, you might be able to reduce the spread of vitiligo.

Who is affected by Vitiligo?

About 1 to 2 percent of the world’s population has vitiligo, a prevalence which is also seen in West Africa. While vitiligo can begin at any age, 95 percent of people who have vitiligo develop it before their 40th birthday. The disorder affects all races and both sexes equally. People with certain autoimmune diseases (such as hyperthyroidism) are more likely to get vitiligo than people who don’t have any autoimmune diseases, although the exact correlation is unknown.

Even though most people with vitiligo are in good general health, they face a greater risk of:

• Hyperthyroidism or hypothyroidism (increased or decreased thyroid function);
• Pernicious anemia (Vitamin B12 deficiency);
• Addison’s Disease (decreased adrenal function);
• Alopecia Areata (round patches of hair loss); and/or
• Uveitis (inflammation of the eyes).

Vitiligo may be genetic; about one third of all vitiligo patients say that other family members also have this condition. Children whose parents have the disorder are more likely to develop vitiligo, yet most children will not get vitiligo even if a parent has it.

What are the symptoms of vitiligo?

White patches on the skin are the main sign of vitiligo. The patches may be on the hands, feet, arms, face, and lips. Other common areas for white patches are:

• The armpits and groin (where the leg meets the body)
• Around the mouth
• Eyes
• Nostrils
• Navel
• Genitals
• Rectal areas.

In addition to white patches on the skin, People with vitiligo often have hair, eyelashes, eyebrows, and beard that turn gray early. Those with dark skin may notice a loss of color inside their mouths.

Vitiligo generally appears in one of three patterns:

• Focal pattern: the depigmentation is limited to one or only a few areas.
• Segmental pattern: some people develop depigmented patches on only one side of their bodies.
• Generalized pattern: but for most people who have vitiligo, depigmentation occurs on different parts of the body.

How is vitiligo treated?

Vitiligo treatment is aimed at stopping the spread of depigmentation and repigmenting areas of skin where color has been lost. A number of treatments exist.

The choice of treatment depends on the spread and variance of the disease and access and preference of treatment for both patient and physician.

Some treatments are not right for everyone. Many treatments can have unwanted side effects, can take a long time, and sometimes they don’t work.

Current treatment options for vitiligo include medical, surgical, and other treatments. Most treatments are aimed at restoring color to the white patches of skin.

Medical treatments include:

• Topical medicines (such as steroid creams) that you put on the skin
• Light treatment using oral psoralen medicine plus ultraviolet A (UVA) light (PUVA) or specific wavelengths of ultraviolet B (broadband or narrowband UVB)
• Removing the color from other areas so they match the white patches (Dipigmentation).

Surgical treatments include:

• Skin grafts from a person’s own tissues. The doctor takes skin from one area of a patient’s body and attaches it to another area. This is sometimes used for people with small patches of vitiligo.
• Melanocyte Transplant

Other treatments include:

• Camouflage (such as makeup) or tattooing of skin
• Alternative Therapies
• Nutritional Supplements and Herbal Remedies
• Adjunctive Therapies
• Counseling and support.

The use of sunscreen to protect skin with vitiligo is also important

NOTE: One of the distinct attitude and behavior of vitiligo patients is that they do not give up in seeking new treatments when current treatment failed to show any results. They are ever prepared to try something new!

Are vitiligo treatments options readily available in Nigeria and Africa?

Not exactly, but we have to make do with what we have now; find out from your dermatologist (you can find these specialists in Teaching Hospital, Medical Centers, National Hospitals and Private Skin Clinics) what treatments are available. Discuss treatment in depth with your doctor before pursuing.

There are some concealers/make-up food, herbs and the Nutritional supplement which are available (contact the center vitsupng@gmail.com for more information).

VITSAF is working towards getting most Nutritional Supplement locally available in our one stop Vitiligo Resource Center.

Who is a Good Candidate For Repigmentation?

Not all individuals with Vitiligo are good candidates for repigmentation therapies. Good candidates generally meet the following requirements:

• Pigment loss of less than five years duration for patients over 20 years of age. In general, children and young adults respond better than older people.
• Patients should be at least 10 years old (when settling for PUVA). Treatment is safe for younger children, but because treatments may be tedious to them, better results may be achieved when the child is interested in treatment. An individual must be committed to the treatment because it is a long process that requires a great deal of patience.
• Patients should be healthy. Any associated illness, such as hyperthyroidism, should be treated at the same time as the vitiligo.
• For PUVA therapy only, a pregnant woman should not be treated because of the potential harmful effects of the drug on her developing baby.

How can people cope with the emotional and psychological aspects of vitiligo?

The change in appearance caused by vitiligo can affect your emotional and psychological well-being. You may experience emotional stress, particularly if vitiligo develops on visible areas of your body, such as your face, hands, arms or feet. You may feel embarrassed, ashamed, depressed or worried about how others will react. Young people, who are often particularly concerned about their appearance, can be devastated by widespread vitiligo.

There are several things you can do to cope with the disorder:

Finding the Right Doctor (Dermatologist) – A dermatologist is a doctor who specializes in the care of skin. It is important to find a doctor who is knowledgeable about Vitiligo and takes the disorder seriously. The doctor should also be a good listener and be able to provide emotional support. Patients need to let their doctors know if they are feeling depressed, because doctors and other mental health professionals can help people deal with depression – http://depression.emedtv.com/depression/depression.html.

For non-sufferers, do not ignore any white patch you notice on you or family member, see a dermatologist immediately. Vitiligo is better managed at early stage.

Learning About Vitiligo – Find out as much as you can about vitiligo and its treatment options so that you can participate in making important decisions about your health care. We really have to read and research as much as we can, Internet, books are good sources.

Talk with others (Finding Support) – Ask your doctor about support groups in your area for people who have vitiligo. Take your loved ones along with you. Talking with other people who have vitiligo may also help a person cope. In vitiligo support groups, patients or their family members get together to share what they have learned about living with Vitiligo and the effects of treatment. These groups may offer support in person, over the telephone, or on the Internet.

A note from VITSAF founder Ogo: One thing I have noticed is that we “persons living with vitiligo tend to stay quiet and lay low…. I think it is due to the fact that vitiligo affects our appearance and self-esteem. I cannot say enough how important it is to share things we have tried which have worked and failed and how we cope so others can benefit.”

Confide in loved ones. Seek understanding and support from your family and friends. Family and Friends are another source of Support (they need to find out as much as they can about Vitiligo).

Self-care – Certain self-care tactics may help you care for your skin and improve its appearance.

Protect your skin. If you have Vitiligo, particularly if you have fair skin, use sunscreen to protect your skin from the sun’s harmful rays. Sunscreen helps protect your skin from sunburn and long-term damage. We live in the tropical area; persons living with Vitiligo should avoid sun like plague especially between the hours of 11am and 4pm to avoid sunburn. During long periods outdoors, they should wear long sleeves, pants and wide- brimmed hats and alternatively sun protective wears (contact vitsupng@gmail.com for more information).

Conceal imperfections (Using Cosmetics). Some people have found that cosmetics that cover the white patches improve their appearance and help them feel better about themselves. These cosmetic products may be particularly effective if you have vitiligo in limited areas of your body. You may need to experiment with several brands of concealing cosmetics before finding a product that blends best with your normal skin tone. In most cases, the color is completely gone after bath, in some after several days.

Stay on a healthy diet – Foods is nature’s way to repair, restore and rejuvenate. They heal your body without dangerous side effects. Food rich in antioxidant, Psoralen and phytochemical (green leafy vegetables) are strongly encouraged, do not cook for more than 1min (you can eat raw), you can juice or anyway you feel like. Green tea, vegetables, (carrots, cabbage, broccoli, brussels sprouts, radish etc) and fruits are a good way to give your skin the extra boost and antioxidants needed to produce pigment and sound health. Generally eat healthy, replace flavored drinks with water, natural fresh juice and Soy Milk. Dogonyaro (Neem) leaf and oil helps a lot.

Is vitiligo curable?

At present, the answer is no. Vitiligo results from a variety of factors (genetic and environmental) interacting in unknown ways. While research has advanced our understanding of the physical and psycho-social causes underlying vitiligo, a cure for this skin condition does not currently exist. More research is required to fully understand the factors involved and to find ways to reverse or block them. However there several management options for vitiligo that help to reduce the spread of the disease, repigment the skin and reduce its impact upon quality of life.

What research is being done on vitiligo?

Scientists have gained a better understanding of vitiligo in recent years, especially through gene research. Current research includes studies to investigate:

• How trauma or stress to the skin can trigger vitiligo or the development of new white patches
• New treatments and better understanding of vitiligo using a mouse models and human clinical studies
• Genes that may cause or contribute to having vitiligo
• Analysis of genes already known to be linked to vitiligo.

One of VITSAF’s objectives is to support ongoing research to understand the ultimate cause of vitiligo and try to determine a cure.

Does anyone care?

Yes, there is much concern for the vitiligo patient, but there is relatively little emphasis on funding clinical and basic science research on this disease because it is not lethal and is often considered cosmetic in nature. The National Institutes of Health (NIH) awards about $500,000 annually toward pigment research programs. However, this pales in comparison to money awarded to research on cancer, AIDS, cardiovascular disease, etc. Despite this, research does continue in the United States and around the world to various degrees. Universities such as Denver, Loyola, Cincinnati, Howard, and Boston have active programs in vitiligo research. But, for the reasons mentioned above, funds are limited.

Vitiligo Awareness and Enlightenment, one of VITSAF’s core objectives, has not received much attention before our entrance. We have been making effort to achieve this as much as we can to improve the Quality of Life (QoL) of persons living with vitiligo, related skin conditions and the disfigured.

http://www.youtube.com/watch?v=v_wBWmewlhE
http://www.youtube.com/watch?v=HiwbYbHLnSA
http://www.youtube.com/watch?v=svYjaVMkHNw
http://www.youtube.com/watch?v=Ll9MA2Wefqo
http://www.youtube.com/watch?v=yLTOcCgET00

We are working towards creating greater global awareness of vitiligo and achieving World Vitiligo Day for global awareness on Vitiligo.

It is because of this that your contributions to VITSAF are so crucial for enabling extensive awareness, education and enlightenment on vitiligo.

The Vitiligo Support and Awareness Foundation (VITSAF) really Cares

We are incorporated in Nigeria and working around Africa to achieve our goals. The Foundation has begun to grow and reach out across the country and now have VITSAF Vitiligo Support Group in Ghana and Kenya. Each chapter will be helping by forming support groups of patients, families and physicians to inform, direct and counsel the patient.

How can I help?

Anyone can help with their time and Resources. The simplest way you can help is by joining us and, if you are able, making a donation to the Foundation. If you are interested in being more actively involved, please contact us on vitsaf@vitsaf.org to discuss various volunteer opportunities.

VITSAF Objectives

• To identify, inform and counsel vitiligo patients and their families.
• To create public awareness and concern for the vitiligo patient.
• To enlighten and enthuse those living with and affected by vitiligo to live positively with the condition.
• To enlarge the concern for the patient within the medical community.
• To set up a West African Vitiligo Resource centre (for info, help and support)
• To encourage, promote and fund increased scientific, clinical and alternative research on the cause and ultimate cure of vitiligo.
• To make locally available drug and alternative drug that helps vitiligo and set up local treatment facilities around the country