Lifestyle Choices

Pigment

The pigment in our skin is called melanin and this same substance gives color to our hair and eyes. Fair -skinned people have only a little melanin while those with dark skins have a lot. The main function of melanin is to protect the skin from ultraviolet in the sun’s rays.

Vitiligo

Intensive research, around the world, has so far failed to reveal the trigger for vitiligo or the mechanism. We know that antibodies against the melanocyte are found in the blood, that antibodies against the thyroid gland are also present but that they seem to do no harm.

The effect of vitiligo is mainly a psychological one. Fair-skinned people may not be troubled and some individuals notice it for the first time when they have been abroad and have acquired a suntan - only then does the white skin show up against the rest. In brown- or black-skinned races vitiligo is a far greater problem. The white patches stand out starkly, especially if the face is involved. In countries such as India it was confused with the effect of leprosy and could lead to a man being shunned by his people: in fact the two diseases are easy to distinguish and anyway no one has caught leprosy in Britain for over two hundred years.

Living with vitiligo can be made easier in several ways. A good sun-blocking cream is important to stop the white patches burning in the sun. Camouflaging the pale areas with Covermark, Clinique Continuous Coverage or other cream is especially useful on the face. There is some research into the use of PUVA treatment (as used for psoriasis) but it has not been fully evaluated yet. Useful information about vitiligo can be obtained from the Vitiligo Association.

Chloasma

This is a darkening of the face, often giving a mask-like appearance. The forehead, cheeks and chin are most often involved. It sometimes occurs in pregnant women or those on the contraceptive pill and is therefore assumed to have something to do with the changing levels of hormones. It may last for months after delivery or stopping the pill but no treatment is known to help.

Pigmentation after inflammation

Many causes of inflammation can lead to melanin pigment escaping from the epidermis in the affected area. Examples are eczema, infection and burns. This leads to a darker color which may last for months - an effect more pronounced in people with dark skin. Care must be taken with proprietary preparations marketed for the removal of pigment because if the melanocyte is permanently damaged it may cease pigment production altogether. A cream called Fade Out is available and after several applications can produce a useful lightening of the color.

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