Vitiligo

What it is

Vitiligo causes milk-white patches where pigment cells have been lost.

How it works

The immune system attacks melanocytes. Patches often appear on the face, hands, around body openings and areas of friction.

Why it matters on darker skin

Vitiligo is very visible on dark skin and can carry stigma; it is not contagious.

Causes and triggers

Autoimmune tendency, family history, stress, skin injury.

What helps — and why it works

See a doctor early: topical anti-inflammatories and phototherapy work better early. Expected timeline: 3–6 months. Sun protection on patches: prevents burning. Expected timeline: daily. Camouflage cosmetics if wished: improves confidence. Expected timeline: immediate.

More detail

Vitiligo affects about one person in a hundred worldwide, across all ethnic groups, and often starts before the age of 30. Patches are usually symmetrical on both sides of the body, commonly on the hands, face, around the eyes and mouth, armpits and genitals, and hair in the patches may turn white. There are two main types: non-segmental (most common, spreading over time) and segmental (on one side of the body, usually stabilising). Vitiligo is more common in people with other autoimmune conditions, such as thyroid disease, and a doctor may check for these. Treatment options include strong anti-inflammatory creams or ointments, newer creams that act on immune signals, and phototherapy; results vary and take months. Sunscreen protects white patches, which burn easily. Vitiligo can affect self-esteem and relationships, especially where it is stigmatised; support groups and talking therapies can help as much as medical treatment.

What to avoid and why

Avoid unproven herbal remedies.

Common mistakes

• Delaying treatment.

Building a routine that lasts

Most skin problems improve with a short routine used every day rather than many products used occasionally. A practical base is a gentle cleanser, a fragrance-free moisturiser and a broad-spectrum sunscreen in the morning, with one targeted treatment at night. Introduce one new product at a time and give it two weeks before adding another, so that if your skin reacts you know the cause. Patch-test on the inner arm or behind the ear for a few days first. Skin renews itself roughly every four to six weeks, so most treatments need two to three cycles — eight to twelve weeks — before you can judge them fairly. Photographs taken in the same light every four weeks are more reliable than memory. In the Nigerian climate, heat, humidity and harmattan all change what your skin needs: lighter gels in the humid season and richer creams in dry months are both reasonable. If a product stings for more than a few minutes, causes swelling, or leaves new dark patches, stop it. Buy from registered pharmacies or official stockists, and use the Authenticity Check if you are unsure whether a product is genuine.

Reading labels and choosing products

On the label, look first for the active ingredient and whether the product is fragrance-free and non-comedogenic. Ingredients are listed in order of amount, so an active at the end of a long list may be present only in a small quantity. Be wary of products that promise results in days, that list no ingredients, or whose label is a sticker or handwritten. Words such as 'natural', 'herbal', 'organic' and 'dermatologist-inspired' are marketing terms, not safety standards. Hydroquinone, mercury compounds (sometimes listed as calomel or mercurous chloride) and strong steroids such as clobetasol do not belong in an over-the-counter cosmetic. A real NAFDAC registration number should be printed on the pack and should match the product on the official Greenbook register. Price is not proof: counterfeiters copy expensive brands. When in doubt, ask a pharmacist, keep your receipt, and use Melanin & Me's Authenticity Check and barcode scanner as a first screen.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.