While still largely unknown, there are various theories which have been put forward by researchers. The most accepted theories are Autoimmunity, Autocytotoxicity, Neural, and Genetic.
A. Autoimmunity: The body makes antibodies (a type of white blood cells), which destroys or kills pigment cells (melanocytes).
B. Autocytotoxicity: Chemicals produced during the synthesis of melanin pigment may be toxic to melanocytes.
C. Neural: Presence of unknown chemical substance at the nerve-ending, which tends to destroy pigment cells. This applies to the segmental type of Vitiligo.
D. Genetic: Vitiligo may appear triggered by known and unknown environmental factors (trauma: physical or psychological) in genetically predisposed individuals. There is no mechanism to find defective genes. It is also not known how it is transmitted to future generations.
Non-Segment Vitiligo (NSV):
- A. Generalized: Patches distributed on both sides of the body in a symmetrical manner.
- B. Acrofacial: Affects face and extremities (Lip-Tip variant: patches are seen on the fingertips and lips)
- C. Universal: Affects almost the entire body, with a few spots/islands of pigment.
- D. Focal: A few spots of depigmentation on one anatomic area without any specific pattern.
- E. Mucosal: Involving only the mucosa (mouth and genitals)
Mixed Vitiligo: Segment & Non-segmental: This is uncommon and is a recently recognized variant, where any of the above patterns can occur in combination.
It affects only genetically predisposed individuals (people with defective genes). There is no method to detect defective genes. In a normal population, 1% to 2% children have the risk of developing Vitiligo, while children of Vitiligo-affected patients may have a 15% to 20% risk of developing Vitiligo. To explain it further, 1 to 2 children from 100 normal parents will develop Vitiligo, and 15 to 20 children from 100 Vitiligo parents will develop Vitiligo.
Vitiligo disease is a cosmetic disability that is definitely not contagious. Vitiligo does not spread by touching.
The present scientific material does not support any co-relation with food. No food restrictions are required in the diet.
Patients who have stable Vitiligo patches for a period of at least 6 months to 1 year are good candidates. Further Vitiligo patients should fulfill the following criteria for surgery:
A. Existing patches should not have increased in size.
B. No new patches should have appeared in other areas.
C. Any injury should heal with normal skin color.
There are three main categories of patients that are suited to melanocyte transplantation.
A. Segmental vitiligo
B. Generalized vitiligo –Affected area
C. Leukoderma-Piebaldism, post-burn leukoderma, post laser de-pigmentation, etc.
(Selection of individual patient will depend upon assessment by a physician.)
The success rate of treatment is 65% – 90%. (A statistical figure of success rate applies to a group of people and not to an individual. Final Results may vary amongst individual cases)
- Segmental – Rare recurrence
- Focal – Low chance of recurrence. It can develop in vulgaris type
- Vulgaris – Can recur
- Acral – Very high rate of recurrence