What do we know about vitiligo?

25 June marks World Vitiligo Day, a chronic skin condition characterised by the loss of pigmentation in specific areas of the skin, resulting in the appearance of white or discoloured patches. These areas, over time, tend to become larger and cause self-esteem problems for sufferers. According to the Spanish Association of Vitiligo Patients (ASPAVIT), there are an estimated 900,000 people with this skin disease in Spain. Worldwide, according to the World Health Organisation, it is estimated that vitiligo affects approximately 1% of the world's population. This is equivalent to around 77 million people.To learn more about this skin disorder, from 'Next in Beauty', thanks to Bella Aurora, we have been able to talk to Dr. Matteo Bordignon, an Italian dermatologist who specialises in the study of vitiligo, and who, together with the company, launched Repigment12 Plus several months ago: a cosmetic treatment for white spots.Dr Matteo Bordignon What is vitiligo and what causes it? How long does it usually take to diagnose vitiligo?Vitiligo is a skin disease that causes total depigmentation of the affected areas. In these areas, mainly due to the action of a protein called MIA, the melanocytes (the cells that give our skin its colour) are eliminated, leaving the skin without pigment and therefore white.Diagnosis of vitiligo is usually quite rapid. It is based on observation of the skin, usually with Wood's light (a special lamp that highlights the chromatic characteristics of the spots), which is used to detect areas without melanin in characteristic areas (face, hands, feet, elbows, knees, armpits, etc.). What other symptoms may accompany vitiligo?Apart from the presence of spots, there are no other symptoms of vitiligo. Vitiligo spots do not swell, itch or cause any other discomfort. Patients with vitiligo do not show any particular alteration in their health. The only known association with vitiligo is thyroid disease, which is present in about 30% of patients with this condition and requires appropriate monitoring. What are the risk factors associated with vitiligo?There are no known specific risk factors in the development of vitiligo. It is possible that there is a genetic basis contributing to the onset of the disease. Once present, it is known that psychophysical stress and skin rubbing can worsen the situation. Are there different types of vitiligo, what are they and how do they differ?They exist two main types of vitíligo: the segmentary and the no segmentary. The vitíligo segmentary characterises for affecting only a specific zone of the body and only the half of this (for example, the right half of the front). Whereas the vitíligo no segmentary affects simétricamente to both parts of the body (for example, the hands) and generally has a slower progress. The no segmentary form is the most common (roughly 90% of the patients) whereas the segmentary form is rarer (roughly 10%). What is the most common treatment for vitiligo? What are the results patients can expeNew therapies are available for all patients with vitiligo, especially those with non-segmental vitiligo. In recent years, MIA inhibitors, peptide molecules capable of blocking the activity of the MIA protein and preventing it from causing damage to melanocytes, have been introduced on the market. Blocking the activity of the MIA protein, combined with UV exposure, allows repigmentation of the affected areas, with results that may vary between patients. The formula has recently been improved with another peptide, Acetyl hexapeptide-1, which more directly stimulates melanin production, making the treatment even more effective and faster. Are there lifestyle or dietary changes that could help control vitiligo?Many studies have been conducted on diet in vitiligo, but no specific foods or drinks have been identified that may promote or counteract the onset of vitiligo. However, it is advisable to take specific antioxidant supplements to reduce oxidative stress on the body. On the other hand, a hectic lifestyle and stress can have a negative influence on the development of vitiligo. What preventive measures are recommended to avoid the progression of vitiligo?If a patient already has vitiligo, for example, on the face, it is possible that vitiligo will eventually appear on the hands as well. To prevent this, one should try to limit trauma to these areas as much as possible and apply MIA protein inhibitors. As these treatments are safe, they can be applied anywhere on the body, even on areas of skin not affected by vitiligo but which tend to be affected areas, such as the fingers, and thus limit the appearance of white patches. Can vitiligo disappear spontaneously without any treatment?Yes, it is possible for vitiligo, especially in small patches with a lot of sun exposure, to reduce spontaneously without any treatment. This phenomenon, although rare, is probably due to the spontaneous deactivation of the MIA protein for unknown reasons. The sun, as we know, helps to repigment the skin, as do the MIA protein inhibitor treatments.

What do we know about vitiligo?

We interviewed Dr Matteo Bordignon to find out what's new in the latest vitiligo treatments