Vitiligo affects nearly 65 million people worldwide, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. In the U.S., more than 1 million people have the disease. Characterized by white patches that appear in random locations on the skin, vitiligo's cause remains unknown, as of 2010. One theory points to autoimmunity as a potential explanation; another hypothesizes that oxidative stress triggers the condition. Smoking, known to aggravate oxidative stress, may be related to vitiligo onset, although research still remains at the preliminary stage.
Identification
Vitiligo destroys melanocytes, the cells that manufacture skin pigment, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. It targets both genders and all races equally; however, it shows more distinctly in patients with dark skin. The most noticeable symptom of vitiligo is partial or complete loss of skin pigmentation in the hands, arms, face, feet and lips. White patches can also present in the armpits and groin, or around the eyes, navel, genitals and rectum. Vitiligo tends to manifest young: Onset occurs before age 20 in half of all vitiligo patients, and most develop it before 40. Other symptoms include premature graying of the hair, eyebrows and eyelashes. MayoClinic.com reports additional color loss inside the mouth in some cases, as well as within the retina.
Theories/Speculation
A high correlation seems to exist between vitiligo and autoimmune afflictions such as hyperthyroidism, adrenocortical insufficiency -- in which the adrenal gland underproduces the hormone corticosteroid -- and pernicious anemia, or malabsorption of vitamin B12. At present, neither the National Institute of Arthritis and Musculoskeletal and Skin Diseases nor the Mayo Clinic has an explanation for this association.
Oxidative Stress
The CDC associates smoking with oxidative stress, a decrease in the capability of the body's antioxidant defenses. A 2010 study published by Seoul National University College of Medicine researchers in the journal Annals of Dermatology linked oxidative stress to vitiligo. Vitiligo patients that smoked showed considerably lower levels of the antioxidant glutathione. Researchers concluded that smoking increases antioxidant imbalance and recommended that "smoking should be prohibited in vitiligo patients to prevent the possible aggravation of the condition."
Prevention/Solution
As of 2010, no cure for vitiligo exists. According to MayoClinic.com, treatment aims to slow pigment loss through medications such as topical corticosteroids, which can return color to the skin if applied early enough in the progression of the disease. For smokers with the condition, medical professionals recommend smoking cessation as the first step in treatment.
Warning
Smokers with vitiligo should limit sun exposure, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Use sunscreen that provides protection from UVA and ultraviolet B light to avoid long-term skin damage. The areas of the skin affected by vitiligo become extremely sun sensitive.
