Updates in the Treatment of Vitiligo - Episode 1

Understanding Pathology and Prevalence of Vitiligo

David Rosmarin, MD, provides insights on vitiligo and its prevalence among the patient population.

David Rosmarin, MD: Vitiligo is a chronic autoimmune condition in which the immune system, which should fight infections, such as bacteria, viruses, and fungi, is instead killing the pigment cell, or melanocyte, in the body. When you kill pigment cells, that leads these white patches that are often in exposed areas, such as the face and hands, but anywhere on the body can be affected.

In terms of the epidemiology of vitiligo, about half the patients will develop it by age 20 and 80% by age 30. We aren’t sure exactly how many people suffer from vitiligo worldwide. We know it affects all races and ethnicities, and that the disease is found in every country in the world. We aren’t sure exactly how many people have it, but the estimates range from 0.5% to 2% [of all people]. We think there are a large number of patients who may be undiagnosed and don’t realize that the white spots they have are vitiligo. Some newer studies indicate it may be around 1.4% in the United States.

Vitiligo is a medical disease, not a cosmetic problem, and it affects different people in different ways. Some people just want to be accepted for their vitiligo. They want to know what they have and a little more about it, but they’re proud of their vitiligo. In my experience, that’s a minority of the population, but it’s important that we accept people who are happy and living well with their vitiligo. There are others—the majority of the population—who would rather their vitiligo not be there, and it can really affect their quality of life.

For some, it affects their relationships and their ability to go out. When they’re in the grocery store and paying for groceries, the register attendant may say, “Put the money down,” rather than accept it from them, because they see white spots on their hands and they don’t want to catch whatever the person has. In certain cultures, weddings have been broken up, not because the bride or groom has vitiligo but because one of the relatives has it—they’re afraid that it’s going to be inherited. There are other people who don’t like to eat in restaurants because they feel like people are staring at them. Certainly, children feel like they’re bullied and stared at, and they’re asked, “What’s wrong with you?” It can affect people’s quality of life in different ways, and it has a multitude of effects. But I want to emphasize that this is a medical problem, not a cosmetic problem.

Transcript edited for clarity.