Among the possible triggering factors, different types of physical or psychological trauma, which act separately or in conjunction with each other, even if we do not know with what specific weight.
This is the so-called Koebner phenomenon, the phenomenon that associates the appearance of spots with factors such as oxidative stress (the presence of toxic molecules deriving from cellular metabolism, which accumulate due to a defect in the physiological detoxification mechanisms) or the production of toxic molecules by the same melanocytes.
Among the physical traumatic events, one of the most decisive is represented by burns: in many cases, in fact, vitiligo appears following reckless sun exposure and following the redness typical of erythema.
The psychological causes of vitiligo.
Among the traumas of psychological origin, the mournful events are in first place among the triggering causes of vitiligo. However, these are very complex factors to investigate and the psychological approach does not appear to be among the main ones to be followed in the treatment of the disease.
- The skin is the organ with the greatest extension and is our link with the outside world: in psychosomatic medicine, it is therefore a site characterized by numerous interesting clinical implications.
- Probably further studies will allow us to better understand the mental mechanisms underlying vitiligo and to identify new treatments.
- In all cases, the last common route that leads from the pathogenic stimulus to the manifestation of symptoms is the state of inflammation that involves the melanocytes and which is triggered by the attack by the immune system.
Infographic showing the characteristics and consequences of vitiligoPerinevic vitiligo and other types of vitiligo Depending on the number and location of the patches, vitiligo can be classified as:
- Perinevic: develops around a common mole, to configure an area of depigmentation (ivory white) surrounding one of hyperpigmentation (dark);
- Segmental: the depigmentation is localized and affects a few areas or entire areas of the body;
- Universal: affects the whole body;
- Generalized: it spreads in several but limited areas;
- Acrofacial: involves the extremities and the face.
In some patients, the lighter spots are surrounded by borders of intermediate gradation between that of the depigmented areas and that of the normal areas. In these cases, the disease is called trichrome vitiligo.
Vitiligo: how to cure it
There is no cure for Vitiligo. Solutions have not yet been formulated to restore skin pigmentation to its physiological state. But dermatologists have several treatments available with an aesthetic function. Although the stigma attached to this disease today is limited compared to the past, it can have a very powerful psychological impact.
Are there any creams for the treatment of vitiligo?
The local and early application of steroids in the areas where the lightening occurs helps to slow down the inflammation process of the melanocytes and, consequently, to restore the color of the skin (repigmentation).
The best results are obtained with children, who respond significantly to therapy, although not earlier than 3-6 months after its onset. The greater the time interval since onset, the lower the response from the drugs. The administration of steroids, which modulate the responses of the immune system, must take place twice a week and last for at least two years.
While in the more localized forms, skin application is sufficient, in cases where the depigmentation is generalized or universal, the administration of steroids must be systemic (by mouth or injectable).
- The side effects of steroids include depigmentation and atrophy of the areas surrounding the spots.
- Topical calcineurin inhibitors (tacrolimus and picrolimus) can also be used, particularly in areas such as the face and groin, which are more at risk for adverse steroid reactions.