Explaining your medicines
With the rapidly changing climate in Guyana there are certainly more persons showing up with vitiligo or loss of skin colour than the US statistic of 1-2%. Vitiligo is a non contagious skin disease resembling leprosy where patches of the skin start to get white. It starts as a small spot and can progress to cover a very large area of the skin mostly on extremities such as the hand or wrist. We can now understand why the infamous Michael Jackson wore a hand glove which was later auctioned off for a large sum after his death. Yes, Michael Jackson had vitiligo as a teenager. Lee Thomas, a popular television personality has come out without any cosmetic camouflage as seen above to break the silence on vitiligo and to remove the associated stigma.
Facial patterns can be seen around the opening of the eyes, mouth or nostrils. The depigmentation can also be found around the genitals and the umbilicus area. Vitiligo universalis is where the condition spreads extensively leaving just a small part of the skin pigmented. The hair and eyes can also be affected.
The explanation for the loss of skin colour is due to the death or mal function of the melanocytes, the cells responsible for skin colour. The underlying causes can be either due to a compromised auto-immunity, a genetic problem or environmental factors. This condition can also be linked to under active or over active thyroid. Also some diseases which affect the auto-immunity such as Addison diseases can also induce vitiligo.
Vitiligo is divided into two (2) categories where the more common type is referred to as SV (segmental vitiligo) prevalent in teenagers and is presented with asymmetrical patterns, which can spread rapidly and cover a large area emanating from the spine. These white patches if left untreated can end up as lifetime scars. The second type is referred to NSV (non segmental vitiligo) and can occur at any age, usually in symmetrical patterns. The dermatologist will diagnose this condition based on a physical examination. Treatment prescribed will vary according to the type of vitiligo diagnosed.
Treatment options can range from cosmetic camouflage in mild cases to skin grafting in the more complex cases, the latter may not be available or affordable. Additionally, specific UV radiation referred to as phototherapy can be used to re-pigment the patches of skin affected but generally you are advised to stay out of sunlight and discouraged from sun tanning. A medicated solution called methoxalem is used under specific dermatologist’s orders and is available at Medicine Express where specific amounts of exposure to sunlight is required just after application of the solution. Sometimes steroidal creams can be prescribed if the condition is linked to inflammation. 
However, due to the public lack of knowledge of this condition and its association with leprosy, persons with vitiligo are judged unfavourably resulting in stigmatism. A significant effect on the patient’s mental health may cause psychological damage and create more susceptibility to vitiligo. Patients who are stigmatised for their condition may result in depression and similar mood disorders since they may isolate themselves from their work peers, friends and family. Hence for the successful treatment for those suffering from the disease, support and openness will be helpful especially if they are teenagers.
In a synopsis, encourage discussion about vitiligo with teachers and friends especially if your teenage children are diagnosed with this skin disease condition. If someone suspects they have this condition but is not diagnosed, visit a competent dermatologist and follow up with the necessary treatment required. Don’t ignore small white spots if you notice them (or even one), especially if they start to spread or get larger. Stay out of sunlight or wear an appropriate sunscreen to protect your skin. Vitiligo has no cure and cannot be prevented.
For further information please call the pharmacist at Medicine Express located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.