Psoriasis: Causes, Types, and Modern Dermatological Treatments

Vitiligo is an acquired, chronic skin condition characterized by the destruction of melanocytes—the cells that produce melanin, the pigment that gives skin, hair, and eyes their natural color. This process results in the appearance of white patches (lesions) on various parts of the body.

Vitiligo can develop at any age, although in 50% of cases it appears before the age of 20. It affects men and women of all races equally, though it is more noticeable in people with darker skin. Although it is neither contagious nor dangerous to physical health, it can significantly affect a patient’s mental well-being and quality of life.

What Causes Psoriasis? (Causes & Pathogenesis)

The exact cause of vitiligo remains the subject of scientific research; however, the prevailing theory is that it is an autoimmune disease. In vitiligo, the immune system mistakenly identifies melanocytes as foreign organisms and destroys them.

Various factors contribute to the onset and progression of the disease:

• Genetic predisposition: Approximately 20–30% of people with vitiligo have a relative with the same condition.
• Associated autoimmune diseases: Alopecia areata is often associated with other autoimmune disorders, such as thyroid disorders (e.g., Hashimoto’s thyroiditis), alopecia circulata, type 1 diabetes, and anemia.
• Oxidative stress: Accumulation of toxic free radicals in melanocytes, leading to their self-destruction.
• Psychological & Physical Stress: Highly stressful events, severe skin injuries, or sunburn (Koebner phenomenon) can trigger the appearance or spread of lesions.

What Are the Types and Symptoms of Vitiligo?

The main symptom is painless loss of skin color. The patches usually have clearly defined borders and most often appear in areas exposed to the sun (face, hands, neck), around natural orifices (eyes, mouth, nose), at the joints (elbows, knees), and in the genital area.

Depending on the extent and distribution of the lesions, vitiligo is classified as:

• Focal or Localized: Occurs in one or a few isolated areas.
• Segmental: It is limited to one side of the body (e.g., one limb or one side of the face) and follows a specific nerve segment. It usually appears at a young age and stabilizes quickly.
• Generalized (Non-segmental): The most common type, in which white patches appear symmetrically on both sides of the body.
• Caolic (Universal): A rare form in which it covers almost the entire skin.

At the same time, vitiligo can cause premature graying of the hair on the scalp, eyebrows, or beard (premature graying).

How Is Vitiligo Diagnosed at the Clinic?

The diagnosis is primarily made through a clinical examination by a dermatologist. In the early stages or in people with fair skin, a Wood’s lamp (a special ultraviolet light) is used to highlight areas with a loss of melanin.

In addition, because vitiligo is associated with other autoimmune diseases, your dermatologist may recommend targeted blood tests (including tests for thyroid hormones, antibodies, vitamin B12, etc.) for a comprehensive assessment of your health.

What is the goal of dermatological treatment?

The personalized treatment provided at our clinic aims to address all the underlying causes of the disease:

• To reduce sebum production.
• To normalize desquamation and keratinization in the pilosebaceous follicle.
• To eliminate the acne-causing bacteria and the associated inflammation.
• For the prevention of scars and post-inflammatory hyperpigmentation (marks).

Treatment Options and Management

Although there is no cure that can permanently eliminate the disease, modern dermatological treatments aim to halt the progression of vitiligo and to repigment (restore color) the affected areas:

• Topical Medication: Use of potent topical corticosteroids or calcineurin inhibitors (tacrolimus, pimecrolimus) to reduce local inflammation and stimulate melanocytes.
• Phototherapy (Narrowband UVB): One of the most effective and safest methods, in which the skin is exposed to a specific spectrum of ultraviolet radiation to stimulate melanin production.
• New Targeted Therapies: The use of topical JAK inhibitors, which represent a new era in the management of autoimmune skin diseases.
• Sun Protection & Camouflage: Daily use of broad-spectrum sunscreen is essential, as discolored skin burns easily in the sun. Special medical-grade makeup products can also temporarily cover up the discoloration.

Personalized Care at Dermtherapy

The treatment of vitiligo requires patience, consistency, and scientific guidance tailored to each patient’s needs. At the Dermtherapy dermatology clinic in Galatsi, dermatologist and venereologist Alexandros Soumalevris designs the appropriate treatment plan with the goal of stabilizing the condition and achieving the greatest possible repigmentation.