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vitiligo: spf, skin health and beauty

a look at managing vitiligo, a skin discolouration condition.

vitiligo:  spf, skin health and beauty
vitiligo can make your skin much more sensitive to the sun. getty
in this series, dr. rohan bissoondath, founder and medical director of preventous cosmetic medicine & preventous collaborative health, answers your questions about skin health.

vitiligo is a skin discolouration condition that affects one per cent of the population and causes different areas of the skin — and sometimes body hair — to lose colour, or even turn white. perhaps the most recent and well known example of someone with vitiligo, who has brought the condition into the spotlight, is canadian model winnie harlow .

 winnie harlow at the 77th golden globe awards in california, january 5, 2020.
winnie harlow at the 77th golden globe awards in california, january 5, 2020. reuters/mario anzuoni
doctors and researchers are not 100 per cent sure what causes vitiligo, but the leading theory is that it is caused by an autoimmune response, essentially meaning that the body’s immune system is attacking the healthy cells that give skin its natural colour, destroying those pigment cells and causing skin discolouration as a result.
in a small percentage of cases (about 10 to 20 per cent), vitiligo will go away on its own over time, but for the majority of people, the condition is likely to spread to more areas of the skin, especially if left untreated.
vitiligo typically affects different areas of the body from person to person and is divided into two main subgroups — segmental and non-segmental.

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non-segmental vitiligo is the most common form of vitiligo, which encompasses several patterns of distribution, including generalized (anywhere on the body and symmetrical in pattern), acrofacial (face, fingers, toes, hands, arms, legs), mucosal (lips, inner nose or genital mucosal surfaces) and universal (all or most of the skin surface).
segmental vitiligo is a subgroup of vitiligo, is the least common, and affects specific segments of the skin called dermatomes, or “nerves.” our bodies are divided into dermatomes based on the distribution of spinal nerves. segmental vitiligo affects only one area of the body on only one side, without crossing the midline of the body usually on the front or back.
although there is no cure for vitiligo, there are ways to manage it. here are a few:

talk to your doctor
as with the majority of skin conditions, the most important step is talking to your family doctor, or a doctor who specializes in skin health, who will be able to properly diagnose vitiligo and set you up with a treatment plan to help limit the extent of the discolouration, while taking your overall health and pre-existing conditions into consideration. as vitiligo is often associated with other autoimmune disorders, your doctor may recommend additional testing to determine if you have any other underlying autoimmune problems.

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outside of this, vitiligo is mainly an aesthetic condition, meaning that symptoms do not typically cause physical discomfort. when looking to treat a patient and ease the appearance of vitiligo, the course of action can include any combination of topical steroids to help control inflammation, topical calcineurin inhibitors, which help suppress the immune response that attacks the body’s skin pigment cells, and light therapy, which uses ultraviolet b rays to stop or slow the skin condition’s progression.

sun avoidance and protection
having vitiligo puts the affected areas of skin at increased risk of damage from the sun. as with all of the patients i see for skin health concerns, another key to managing vitiligo is through sun avoidance and sun protection. i always tell my patients to start with sun avoidance where possible, which includes staying out of the sun, wearing hats and sunglasses when outdoors, and covering up exposed areas of skin, especially those areas affected by vitiligo.

when sun avoidance isn’t possible, sunscreen with an spf is a must, even in colder winter months. for optimal effectiveness, i recommend a sunscreen that is at least spf 30 that blocks both uva and uvb rays. again, working with a skin health physician to find the right sunscreen for you and your lifestyle is important. for example, if you are not a fan of typical cream-based sunscreens, there are sunscreens in a powder format that can easily be applied with an applicator brush, similar to a makeup brush, for areas such as the face and neckline. we want to find a sunscreen that you will actively wear. an example of this would be the zo skin health sunscreen + powder spf 40 . skinceuticals also offers a mineral-based lotion that adjusts to your skin tone, called physical fusion uv defense spf 50.

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high-quality cosmetic products
for those who are concerned about the appearance of their skin, there are also a number of high-quality cosmetic products, such as foundations and concealers, which can help to cover up the patches of skin affected by vitiligo. a high quality brand i recommend is jane iredale , which offers a pressed mineral foundation that includes a built-in spf, called the amazing base powder , and a matte concealer designed to camouflage scars, acne, tattoos and other skin discolouration, called disappear full coverage concealer .

embrace your beauty
at the end of the day, vitiligo is a condition you have to live with. try to manage it as best as you can alongside your skin health physician, and embrace the uniqueness of what you can’t change. it may also be helpful to connect with others who are experiencing the same condition. there are a variety of vitiligo support groups out there — connecting with others sharing the same experience can be comforting.

dr. rohan bissoondath, md, is the medical director and founder of preventous collaborative health and preventous cosmetic medicine . he is an executive board member of the canadian association of aesthetic medicine and is certified by the college of family physicians of canada and licensed through the college of physicians and surgeons of alberta.

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