Winnie Harlow has been in the news this week, owning the red carpet at Haute Couture week in Paris. The 22-year-old Canadian model has vitiligo, which has given her distinctive white patches on her skin.
The photos that came out of the event have meant that more people have been asking about vitiligo, what causes it and what happens when you have it.
Vitiligo is a skin condition that causes white patches to form on the skin as the cells that usually produce pigment (melanin) – called melanocytes – are destroyed.
The cause of vitiligo is not known, but most experts believe it is likely to be an auto-immune disease in which the body’s immune system mistakenly attacks and destroys cells within the body.
In vitiligo, the auto-immune system could be destroying the melanocyte cells and therefore halting melanin production.
There are two main types of vitiligo, non-segmental vitiligo and segmental vitiligo. In rare cases, it is possible for vitiligo to affect the whole body. This is called universal or complete vitiligo.
Non-segmental vitiligo – the most common type and the type that Winnie Harlow has, also known as bilateral or generalised vitiligo, affects 9 out of 10 people with vitiligo.
In non-segmental vitiligo, symptoms often appear on both sides of the body as symmetrical white patches.
In segmental vitiligo, also known as unilateral or localised vitiligo, the white patches appear on only one part of the body.
Is vitiligo painful?
Vitiligo does not cause discomfort, though the white patches may occasionally be itchy. The skin is more susceptible to sunburn so extra precautions should be taken in the sun.
While there is no significant physical discomfort, vitiligo can have emotional and psychological consequences.
When does vitiligo occur?
Around half of those with vitiligo begin to see the condition develop before the age of 20. Most will have seen it develop before the age of 40. However, it can develop at any age, and many – including Winnie Harlow – have it as children.
People with any skin colour can have vitiligo, but it is more noticeable in people with dark skin.
Michael Jackson famously said his whitening skin was caused by vitiligo.
Who gets vitiligo?
Vitiligo may run in families – children whose parents have vitiligo are more likely to develop it themselves. However, even if a parent has vitiligo, the likelihood their children will also develop it is low.
Some doctors have associated vitiligo with stress, some with sunburn. However, neither theory has sufficient proof behind it, though doctors do ask about these elements when testing for vitiligo.
Will the white patches of vitiligo spread?
There is no way of knowing if somebody’s vitiligo will spread. It may remain the same or it may spread slowly or quickly to other parts of the body. The areas usually affected are the face – particularly around the mouth and eyes – hands and wrists, armpits, groin, genitals and inside the mouth.
Areas of the scalp can also be susceptible to vitiligo and where the white patches occur, the hair may turn white or grey.
The skin usually turns white, but may have a pink tone if there a blood vessels under the skin. It is also possible to have vitiligo with hyperpigmentation, where the vitiligo patches may have a brownish colour to them.
Can you cure vitiligo? What is the treatment?
It is difficult to cure vitiligo altogether, however some treatments can lessen the appearance of white patches or camouflage them.
Vitiligo in adults can be treated with corticosteroid creams, which can sometimes stop the spread of white patches and can restore some of the original colour.
The steroid creams can only be prescribed to adults with non-segmental vitiligo on less than 10% of their body.
Camouflage creams can be very effective and many people will use them over steroid treatment.
PUVA light therapy in combination with the medication psolaren can be used as treatment to stop patients developing new vitiligo macules. The UVA light + medication can cause side-effects, including nausea, sunburn, hyperpigmentation and dryness.
The treatment can only be used past 12 years of age. For children under 12 with extensive vitiligo, dermatologists have the option of treating with narrowband UVB light treatments.