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This quote from Oman Quayyam is still unfortunately true today, as this disease causes severe psychological trauma and social stigma in our sociey.There is much misinformation among the lay population about this disease.

What is vitiligo?
Vitiligo is a skin disorder which presents as white spots and patches on the skin. This is due to a progressive loss of the pigment, melanin, which gives us our skin colour. The loss of pigment occurs when pigment cells (melanocytes) are destroyed and melanin cannot be produced. Vitiligo is not contagious. 

Common sites affected include: 

• Bony surfaces - back of Hands and fingers, elbows and knees. 
• Around body orifices - around the eyes, mouth and nose. 
• Body folds - armpits and groins. 
• Others areas - legs, wrists, nipples and genitalia. 

Vitiligo may also develop over an area of injury such as a cut or burn. Hair within the affected patch may be white too.

What causes vitiligo ?
The cause of vitiligo remains unknown. However persons with vitiligo have a higher incidence of association with : diabetes mellitus, thyroid disease, other autoimmune diseases. 

can vitiligo be treated ?
Yes. Several forms of treatment are available but the response to treatment varies with each person and site affected.  Some chemicals can destroy the skin pigment cells leading to vitiligo-like skin lesion. Avoidance of contact with such chemicals is important. 

How can vitiligo be treated ?
1. Corticosteroid creams :

Potent corticosteroid creams are effective in some patients. Regular monitoring by your doctor is necessary to prevent side effects. 

2. Psoralen photochemotherapy(PUVA) 

PUVA is a combination treatment involving the use of a drug called Psoralen(P) and then exposing the skin to UltraViolet light A (UVA) - hence the tern PUVA. Psoralen makes the skin temporarily sensitive to UVA which forms part of natural sunlight. Psoralen can either be used in the lotion form or as tablets. When the lotion is used with subsequent exposure to UVA, the treatment is known as topical PUVA. If the oral tablet is used, it is called oral PUVA. PUVA therapy can be done either through. Exposure to sun or artifical UV light machines.

Disadvantages of PUVA are that the tablets cause frequent sideeffects and exposure to UV light has to be performed 2-3 hours after taking tablets, which is cumbersome . Further treatment is not safe for children and pregnant women. Also, the patiets on PUVA should wear dark goggles while this treatment through out the day.More importantly, there is an increased of skin cancer associated with this treatment. For these reasons, PUVA therapy has largely been replaced by narrow band UVB therapy.

3.Narrow band UVB therapy: is the latest form of therapy and is currently the treatment of choice. It is simple, safe even in pregnancy children, highly effective, and does not involve use of any drugs. For these reasons , this treatment has replaced PUVA therapy in most countries.

Targetted phototherapy involves the use of high energy light sources and delivery of high energy through fibre optics. The treatment is very quick, no of sessions is less and the treatment is highly safe as exposure of whole body to UV light is avoided.

4. Camouflage cosmetics 

Some cosmetics can provide very good colour match and camouflage and are particularly useful for white patches on the face and back of the hands. 

A special tanning chemical (dihydroxyacetone) which does not require sunlight, is also available to camouflage the patches of vitiligo. 

5. Surgery:Skin Grafting can be done in selected cases with localised stable lesions. There are different methods for grafting such as epidermal grafting, suction blister grafting, and punch grafting.All the above modalities are available at our clinic.

Melanocyte transplantation is still not widely available and is very expensive)