A Word with the DOCTOR
by Dr John Winsor
The Sunday Times of Malta

ONE OF MY PATIENTS complained that patches on her neck and upper arms would never tan.

When I inspected the areas, it almost looked as if someone had spilt white matt paint on her brown skin.

Sometimes this common condition is confused with a fungus infection but it is, in fact, only an area of skin bereft of pigment cells which contain melanin -- which turns skin brown in sunlight.

The condition is called vitiligo, which means "white skin". In the UK, up to half a million people suffer from this skin problem and people of all ethnic backgrounds and ages can be affected.

The commonest sites to find this condition are on the face, neck and hands. It can also occur around body openings such as the eyes, nostrils and genitals and folded skin sites such as armpits and groins. Scars or other areas of injury, including grazes and burns, can also be afflicted by pigment loss.

Although re-pigmentation can occur, the condition is progressive. Fortunately, vitiligo is not infectious, dangerous or painful -- except in the sun when, without its protective pigment, the skin burns more readily.

No one knows what causes vitiligo. Many things may trigger off the condition such as emotional stress or the hormonal changes during puberty and pregnancy. Skin injury due to burns or trauma is also closely associated with it. One thing is certain, no one is born with vitiligo.

Many doctors think of the condition as an autoimmune disease. To protect ourselves, the body produces antibodies in response to infection and injury. In autoimmune diseases, these antibodies are directed against the body's own tissues. Vitiligo sufferers have been found to have higher than normal concentrations of antibodies to their own pigment cells.

Sadly, at present, there is no cure for vitiligo but there are a number of treatments.

One of the best things to do is to try to forget your white patches, except when you go out into countryside or the sea -- then use lots of suntan lotion. Cosmetic camouflage can be very useful for work, parties and special occasions.