Psychosomatics of vitiligo (white patches on the skin)
Vitiligo is pale or white patches on the skin where cells have stopped making the pigment melanin. It is not contagious and not life-threatening. Most often it is an autoimmune condition, and sometimes it starts after stress, childbirth or sunburn. If pale patches appear on your skin, see a dermatologist. The Ladder method adds questions about how you live with what other people see.
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When to see a doctor
Book a doctor’s appointment if you notice:
- Pale or milky-white patches on the skin
- Patches on the face, neck, hands, around the mouth and eyes, in skin creases
- The patches have clear edges, sometimes they are pinkish
- Hair on a patch turns white or grey
- Patches grow or new ones appear
- The patches burn quickly in the sun
Start with a dermatologist: they diagnose vitiligo by examining the skin, sometimes under a special lamp. Vitiligo is linked to other autoimmune conditions, so the doctor may suggest checking your thyroid with an endocrinologist.
What medicine knows
Vitiligo is a long-term condition in which pale or white patches develop on the skin because of a lack of melanin, the pigment that gives skin its colour (NHS). The patches most often appear on the face, neck, hands and in skin creases, and hair growing there may turn white or grey. The patches are usually not dry or painful, though they sometimes itch.
About 9 in 10 people with vitiligo have the non-segmental type, with patches on both sides of the body. The NHS says it is thought to be an autoimmune condition: the immune system destroys the cells that make pigment. That is why vitiligo is more common in people with other autoimmune conditions, such as thyroid problems, and in families where these conditions occur. MedlinePlus adds that it usually starts before the age of 40.
Among possible triggers the NHS names stressful events such as childbirth, skin damage such as severe sunburn or cuts, hormonal changes, liver or kidney problems and certain chemicals. Vitiligo is not caused by an infection, and you cannot catch it from another person.
A dermatologist chooses treatment: camouflage creams, steroid creams, light therapy and sometimes surgery. It can take a long time and does not work for everyone, and regained colour does not always last (NHS, MedlinePlus). Pale patches burn easily, so you need a high SPF sunscreen. The NHS also notes that vitiligo can affect self-confidence and recommends support groups.
In the Ladder method
In the Ladder method vitiligo is not explained by "resentment" or "character". It is thought to be an autoimmune condition, and it is not your fault that it appeared. But the NHS names stressful events among possible triggers and says vitiligo can affect self-confidence, so questions for yourself make sense here.
Often the hardest part is not the patches themselves but the looks: wanting to hide your hands, foundation in summer, questions from acquaintances. This is a pain of its own, and you can talk about it even if the patches are not a danger to your health.
On the ladder this shows up as the step "I am judged by my appearance". You can work through it. A dermatologist chooses the skin treatment, the method does not replace it.
These are questions for reflection, not an explanation of what causes the condition and not a treatment.
Frequently asked questions
Is vitiligo contagious?
No. The NHS says vitiligo is not caused by an infection and you cannot catch it from another person. It is thought to be an autoimmune condition in which the immune system destroys the cells that give skin its colour.
Can vitiligo appear because of stress?
The NHS names stressful events, such as childbirth, among possible triggers, along with sunburn and hormonal changes. But stress is not the only cause: immunity and heredity matter. So see a dermatologist first, and you can work through the tension in your life separately, for example in the Ladder method.
Can vitiligo be treated?
There are camouflage creams, steroid creams, light therapy and other options. According to the NHS and MedlinePlus, treatment can take a long time, does not work for everyone, and regained colour does not always last. A dermatologist decides which treatment suits you.
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Psychosomatics does not replace tests and treatment. Only a doctor can make a diagnosis.