WHITE SPOTS ON SKIN A COSMETIC NUISANCE

Question: I recently developed these little white areas on my fingers. My mother has them too, and she insists they are nothing to worry about. She says they’re called vitiligo and that she has had them as long as she can remember. Dangerous or not, I think they are ugly. What causes these? Are they anything to worry about? How can I make them go away?

Answer: Vitiligo is a relatively common skin condition that affects about 2 percent of all people in the world.  It usually develops before the age of 20, and it seems to occur equally in both men and women and across all nationalities. Vitiligo results when melanocytes, the cells in the body that produce dark skin pigment, called melanin, stop working. When this occurs, the affected skin turns a pinkish white. If melanocytes stop producing melanin on the scalp, the hair in the affected area also turns white.

While there is no definitive cause for vitiligo, many theories exist. The most widely accepted theory is that it is an autoimmune disease, which occur when your immune system attacks your body’s healthy cells, destroying them.  Although it is largely considered an autoimmune disease, most people with vitiligo do not have an underlying autoimmune disorder. Instead, vitiligo is more common in people with hyperthyroidism, adrenal insufficiency, pernicious anemia and alopecial areata. Also, vitiligo does seem to run in families, which might explain why both you and your mother experience the same symptoms.
The diagnosis of vitiligo involves a simple visual inspection of the affected skin by a trained physician.  Sometimes the doctor will want to do a biopsy to confirm the diagnosis. She may also check your personal and family history for associated diseases like those mentioned above.  If you or your family members do not have documentation of these conditions, your doctor may still want to test for them. 
There are treatments for vitiligo. Topical steroid creams can help in restoring color to the de-pigmented areas, but it may take several months of regular use before you notice any improvements. Another treatment that works well is phototherapy with ultraviolet light, plus medication applied to the skin. These treatments are effective but they can be time-consuming, and the results are often delayed. For extreme cases –- people who have lost pigmentation on more than 50 percent of their skin surface, there are prescription cream treatments that fade the rest of the skin to match. Some people also choose skin grafts, which remove the affected areas of skin, but there can be complications from this treatment.
There is good news in all of this: interestingly, recent studies have shown that people with vitiligo may actually be at decreased risk for developing serious skin cancers.