Is Vitiligo Hereditary?

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Is Vitiligo Hereditary?

Question:

In my family, vitiligo is very common. Is it hereditary? Can it be stopped?

Answer:

Vitiligo is a disorder in which a person loses pigment (or color) in the skin. The affected skin appears white. This results from the destruction of melanocytes, cells that give skin its color. No one knows why the melanocytes are killed in vitiligo, but there are many theories.

The genes that determine the possibility of developing vitiligo can be passed on from parent to child. However, not everyone who has the vitiligo genes will actually show any skin changes. When genes behave this way, they are said to have variable penetrance.

Vitiligo usually begins around ages 20 to 30. The most common areas to lose color are the face, neck, arms, wrists, and legs, but any areas may be involved. There may be only a few areas of skin that lose color, or many areas.

There is no single best treatment for vitiligo. Here are some options that may improve how the skin looks:

• Phototherapy. Certain wavelengths of light are directed to the affected areas of skin. This stimulates repigmentation (bringing the color back) of skin.

• Phototherapy with psoralen. Phototherapy may be enhanced by psoralen, a substance found in fig, parsley, celery and other substances. Psoralen makes skin more reactive to the effects of UVA light, and this increases pigmentation. Psoralen may be applied to the skin or ingested before the light treatment.

• Narrow-band UVB radiation. This is another type of phototherapy that can be helpful.

• Topical corticosteroid creams and topical tacrolimus preparations. These can get expensive and the benefits are limited.

Surgery can be used to transplant little pieces of normal skin into the areas where skin color has been lost. Some of the melanocytes from the normal skin can then move into the areas of skin that lost color. These treatments can sometimes slow the progression of vitiligo, but the person can lose color again.

If you have a loss of skin color, see your doctor for the best treatment for your skin.

It is very important to protect areas of skin where color is lost from sunburn. Losing melanocytes from skin leads not only to a loss of color but also to an increased risk of skin cancer from sun exposure to those areas.

Rebecca Campen, M.D., J.D. is an Assistant Professor of Dermatology at Harvard Medical School. She divides her time between clinical practice of dermatology at the Massachusetts General Hospital and private practice in Savannah, Ga.

Last updated:	July 20, 2009