Vitiligo is an autoimmune condition which causes some areas of your skin to lose color or pigment. The skin discoloration disorder is more than just cosmetic concern and often affects the self-image of the victims. It can affect your ability to find work, connect with others, and even meet a life partner. In this article, we look at the impact of vitiligo on the Black community and how to maintain healthy skin with vitiligo.
Quick Facts
- Vitiligo is an autoimmune disease
- Vitiligo can affect people of any age, ethnicity, and sex
- Vitiligo is more obvious in Black people because of the darker skin tones
- Vitiligo is not contagious
- Vitiligo is not fatal and you can lead a happy healthy life with it.
- Vitiligo is a lifelong condition with no cure.
- Treatment options include medications to restore color while slowing down the development of new depigmented patches
- Exposure to special UV light wavelengths is also a common treatment option
What is Vitiligo?
Vitiligo occurs when melanocytes, the cells responsible for producing the skin pigment, die off. The pigment gives the skin its color and offers protection against the sun’s UV rays. When the melanocytes die, white or light patches form on the skin, affecting our overall skin appearance. The acquired skin pigmentation disorder leaves you with milky-white skin patches. The common causes of vitiligo include a disorder of the immune system or family history. It may also be caused by a trigger event, such as severe sunburn, stress, or skin trauma like contact with a chemical.
Vitiligo, in some people, starts in areas that are more exposed to the sun or prone to repetitive trauma. In addition to the skin, vitiligo may affect other parts of the body like:
- Eyes
- Nose
- Inside of the mouth
- Hair
- Genitals
The disorder varies greatly from one person to the other. It may develop as a small patch in one person and as multiple patches on the body of another. This makes it difficult to predict how the disorder will manifest in an individual. However, vitiligo usually starts before the individual reaches 20 years old across all races and sexes.
Vitiligo’s Impact on Black Health
Vitiligo has a profound impact on people of color because of their darker skin tones. Although the autoimmune condition affects people of all races at about the same rate, vitiligo is more noticeable in Black people. Overall, vitiligo affects about 0.5 to 1% of the global population, but it is more noticeable in Black people because of our dark skin tones.
Understanding Vitiligo in Darker Skin Tones
Vitiligo in Black skin is still a major public health issue with access to treatment being an ongoing problem. Both the current and historical factors in healthcare continue to make it difficult for the Black community to get proper care for vitiligo and other skin problems:
- Vitiligo can be more challenging to diagnose in Black skin
- Black and other people of color generally have less access to health insurance
- Black people often may not have the type of health plan that approves or pays for vitiligo treatment
- Many insurance plans consider vitiligo a cosmetic plan rather than a medical condition, limiting coverage
- Many healthcare providers and doctors have no experience in treating vitiligo
The stigma of vitiligo is also more impactful in the Black community compared to other races. On a personal level, it can be a huge challenge to accept the condition. Even though people with light and dark skin are both upset by their vitiligo, the lived experience between the two is quite different. The psychosocial impact of Vitiligo on Blacks can range from self-esteem and discrimination. In addition, embarrassment can often lead to anxiety and depression.
One of the major contributing factors to stigma is that vitiligo is more obvious in Black people because of the contrast between dark and light pigments. This means that our condition is more visible to the outside world and they are easily noticeable. Considering how important the concept of skin color is to the function and identity of the Black community, this discoloration tends to have a significant psychological impact.
Vitiligo stigma is also attached to other health conditions and treatments. For instance, depigmentation is a year-long process of blending skin tone by lightening dark patches. While this helps to make your skin color uniform throughout the body, it makes you look different and may raise the issue of colorism. This is when people attach different values to the shade of your skin. With the new look, some people may change their relationship with you.
Vitiligo and Vitamin D
Melanin plays an important role in the production of Vitamin D. When your skin is exposed to sunlight, the body uses melanin to synthesize Vitamin D. The vitamin is useful for bone health and immune function. However, having vitiligo and a Vitamin D deficiency is a common concern for many people with this condition.
Due to the reduced pigmentation, people with vitiligo may not meet the required vitamin D levels. It becomes difficult for their bodies to maintain adequate Vitamin D levels, and this affects their overall well-being. Eating food rich in Vitamin D and taking supplements can go a long way in resolving this issue.
Maintaining Healthy Skin with Vitiligo
There are several ways you can manage vitiligo and boost the quality of your life. Although there are a handful of treatments available, none can bring pigment back. However, as more options are being discovered, we can hope for better treatment approaches in the future.
1. FDA Approved Home Treatment for Vitiligo
The FDA recently approved the first at-home treatment for vitiligo. The skin screen, sold under Opzelura brand name and ruxolitinib generic name aims to reveal symptoms of vitiligo. It is a topical Janus Kinase inhibitor, which is type of medication formulated to target the part of the immune system associated with vitiligo.
The approval of the medicine is considered a breakthrough, providing a more friendly solution than the topic and systemic steroids that have been used for ages. Medication has also involved light therapies and other immune system drugs or depigmentation that removes skin color from darker areas. With more resources and time put into understanding vitiligo, it is expected that even better solutions will be introduced soon.
2. Sun Protection is Key
Sun protection for vitiligo is as important as anyone else. Regardless of your skin tone, wearing sunscreen offers an extra layer of protection. With individuals with vitiligo being more susceptible to sunburn because of the lack of melanin in the affected areas, sun protection becomes even more important. Be consistent in using a broad-spectrum with an SPF of at least 30 to prevent sunburn and potential complications.
3. Moisturizing Matters
A well-hydrated skin helps prevent irritation and itching, which are common problems for Black people with vitiligo. Be sure to use gentle, fragrance-free moistures daily to soothe and protect your skin. After all, moisturizer for vitiligo will leave your skin feeling fresher and healthier.
4. Building a Support System
Vitiligo can take an emotional toll on you. Connecting with support groups for vitiligo can provide a valuable source of information and emotional support. An easy way is to join the vitiligo black community through online or in-person support groups where you can interact with others living with the same condition. Increasing awareness about vitiligo by talking with friends about it and finding role models with vitiligo can also help overcome the emotional difficulties associated with the condition.
Vitiligo and Skin Cancer Risk
Although the disorder has a significant impact on the skin, there is limited data on a direct link between Vitiligo and an increased risk of skin cancer. However, some research suggests that the areas of unaffected skin that have normal melanin production may be more susceptible to sun damage. Even though the risk of skin cancer is relatively lower among Black people, regular skin checks by a healthcare professional are recommended for everyone.
What the Future Holds
Vitiligo is a unique condition that can pose challenges, particularly within the Black community. However, with proper diagnosis, management strategies, and a supportive network, individuals with Vitiligo can lead fulfilling lives. However, the systematic challenges remain evident amongst the Black Community in relation to stigma and access to healthcare.
As a community, we have been historically underserved and marginalized. Although there is still a long way to go, especially in terms of healthcare equity, recent efforts are headed toward a more thoughtful direction. The integration of culturally competent care has seen more doctors and hospitals take steps to address ethnic and racial health disparities. There is also increased research and medical education on disorders affecting people of color. With the number of people of color clinics also on the rise, these efforts are a promising sign of a better healthcare future for our community with vitiligo.
Read More:
Incidence and Prevalence of Diagnosed Vitiligo According to Race and Ethnicity, Age, and Sex in the US. https://pubmed.ncbi.nlm.nih.gov/37466934/
The Nuances of Treating Vitiligo in People of Color. https://www.webmd.com/skin-problems-and-treatments/features/vitiligo-poc-nuance
What to know about vitiligo on black skin. https://www.medicalnewstoday.com/articles/vitiligo-black-skin
The real pain behind vitiligo and its unequal effect on people of color. https://whyy.org/segments/vitiligo-and-its-unequal-effect-on-people-of-color/
Spotlight On: Vitiligo in Darker Skin Tones. https://www.webmd.com/skin-problems-and-treatments/features/vitiligo-darker-skin-tones
Vitiligo on Darker Skin. https://www.verywellhealth.com/vitiligo-on-dark-skin-5218635
What is Vitiligo and What Does Look Like? https://www.healthline.com/health/skin-disorders/vitiligo-pictures
