an option for small areas of depigmentation,
though are expensive and entail numerous risks.
Cosmetics to cover depigmented areas work well
for some people.
Another therapeutic approach is to create
hypopigmentation consistently, lightening all of
the skin using topical bleaching agents such as
monobenzone to make the depigmented areas less
conspicuous. Such lightening is permanent, and
establishes heightened sensitivity to sun exposure
with the risk for severe sunburn. The functional
disturbances to the skin also have significant
implications for health, as the depigmented areas
cannot protect from sun damage. Protective, full-
cover clothing and high sun-protection factor
(SPF) sunscreens are necessary to provide this
protection.
In most people, vitiligo progresses despite
treatment. One of the most challenging dimen-
sions to vitiligo, as with other dermatologic condi-
tions that have similarly conspicuous symptoms, is
the sense of social isolation and embarrassment
many people who have the condition feel. Vitiligo
is especially difficult for adolescents and young
adults to manage. Support groups are often help-
ful for coping.Risk Factors and Preventive Measures
Because dermatologists do not know what causes
vitiligo to start, there are few known preventive
measures. It does appear that significant trauma to
the skin, such as a sunburn that blisters and peels,
can trigger vitiligo. Most dermatologists believe
GENE MUTATIONis the underlying cause, as is the
case with many autoimmune disorders, though
researchers have yet to verify this. Limiting sun
exposure by wearing protective clothing and sun-
screen may slow the progression of vitiligo.
See also ALBINISM; ANTIBODY; MACULE; MELANO-
CYTE; TATTOOS.208 The Integumentary System