I am a physician-scientist who focuses my clinical and research efforts on vitiligo, and therefore I think about this disease a lot – all the time, in fact. Therefore I thought it would be helpful to share my thoughts with others who are interested in vitiligo as well, particularly the patients who suffer from it and their loved ones. I want to make clear that while I am affiliated with many vitiligo organizations, my comments in this blog are my own, and do not reflect the opinions of those organizations. In addition, my research is largely focused on finding new treatments, and ultimately a cure, for vitiligo. This work is supported by a number of sources, including pharmaceutical companies, which by definition creates potential conflicts of interest. In full disclosure, here is a list of our vitiligo research supporters. Please know that, to the best of my ability, all of my comments are unbiased reflections of my understanding of vitiligo as both a physician and scientist. I do not permit advertisements on my website, and do not endorse companies or products that may advertise on other sites that may be referenced here.
While genes clearly influence the risk of vitiligo, they’re not the entire answer. If genes aren’t the whole story, what else is there? This has been asked for other autoimmune diseases as well, and typically the response is “environmental factors”. But what are these factors? One very interesting environmental factor was identified in a large proportion of factory workers who developed vitiligo back in 1939. These factory workers made leather, and wore rubber gloves to protect their hands from the chemicals used in the process. But it turned out that it was the gloves themselves that contained a chemical that induced their vitiligo. The chemical is called monobenzyl ether of hydroquinone, or monobenzone. In fact, it worked so well that we use it now to remove the remaining pigment from the skin of those with widespread vitiligo, in order to make it even. It is prescribed by dermatologists as Benoquin cream.
Why do we need to continue research in vitiligo? If we’re right about what causes vitiligo, why isn’t there a cure? In fact, modern medicine can’t cure most diseases, despite knowing exactly what causes many of them. This reminds me of how difficult it is to take care of my lawn. I would love to have a healthy, green lawn without any weeds. The challenge is to kill the weeds without harming the grass. You can use a broad-spectrum herbicide on your lawn and it will almost surely kill all the weeds. The problem is that it will also kill all the grass.
A report was recently published describing a study to test the ability of afamelanotide to improve the response of vitiligo patients to narrow band ultraviolet light B (nbUVB) phototherapy. In short, the treatment worked. I was not personally involved in conducting the study, but I know the study authors personally, and they are great doctors who are well-known vitiligo specialists.
I just returned from the international Pigment Cell Conference (iPCC) in Singapore, where experts from all over the world who study diseases related to melanocytes, the pigment cells in the skin, discussed their research. It was a fantastic meeting, and overall there were 51 separate lectures on vitiligo and an additional 51 posters presented on vitiligo research.
What is beauty, and how does vitiligo affect it? In less than two weeks (August 18th), America’s Next Top Model will begin its 21st cycle to determine the winner of the reality show focused on identifying fashion models through a reality competition. This is the first time a model with vitiligo, or any skin disease for that matter, will appear as a contestant. Contestant Chantelle Brown-Young (who also goes by Winnie Harlow) has vitiligo all over her body, which is particularly visible on her face as symmetrical white spots that surround her eyes, nose, lips and chin.
Vitiligo patients are frequently told that they are at a high risk for skin cancer because they are lacking the natural protection of the skin pigment melanin against the sun’s harmful rays. The problem is that research studies don’t seem to support this warning. In fact, patients with vitiligo appear to be at a LOWER risk for skin cancer than those without vitiligo.
Obtaining funding for vitiligo research is challenging, and I just submitted a grant application to the NIH today to help us continue our studies. I thought this would be a good time to explain how this all works.
A recent NPR story discussed the relationship between a father and daughter who both had vitiligo. Vitiligo patients often want to know whether their family members will also get vitiligo.
There is no simple answer to this question for a number of reasons, partly because of our still limited knowledge of the disease, and partly because different patients often mean different things by this question. For example, some want to know why them and not someone else, some are asking why this happens to anyone, others want to know the details of how it works, many want to know if they could have done something differently to avoid it, and still others want to know the chances that their children or other family members will also get it. My more inquisitive patients want to know the answers to all of these questions. Read more...
I am a physician-scientist who focuses my clinical and research efforts on vitiligo, and therefore I think about this disease a lot – all the time, in fact. Therefore I thought it would be helpful to share my thoughts with others who are interested in vitiligo as well, particularly the patients who suffer from it and their loved ones. I want to make clear that while I am affiliated with many vitiligo organizations, my comments in this blog are my own, and do not reflect the opinions of those organizations. In addition, my research is largely focused on finding new treatments, and ultimately a cure, for vitiligo. This work is supported by a number of sources, including pharmaceutical companies, which by definition creates potential conflicts of interest. In full disclosure, here is a list of our vitiligo research supporters. Please know that, to the best of my ability, all of my comments are unbiased reflections of my understanding of vitiligo as both a physician and scientist. I do not permit advertisements on my website, and do not endorse companies or products that may advertise on other sites that may be referenced here.