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The Medical and Psychological Journey of Living with Vitiligo

Vitiligo is a chronic skin depigmentation caused by an autoimmune dermatologic condition that affects about 0.5–2% of the population worldwide (Bergqvist & Ezzedine, 2020). Disfiguring milky white spots or macules appear on the skin, most commonly on the hands and face, as a result of the condition. These lesions have an unpredictable course and result in varied degrees of disfigurement.

Since 2011, every year June 25 th is celebrated as the World Vitiligo Day. The campaign arose from the determination of non-profit organisations VR Foundation in the United States and VITSAF in Nigeria, as well as their supporters around the world to shine a light on the challenges faced people with vitiligo. Its mission has evolved through time, from spreading awareness of vitiligo to recognising the bullying, social neglect, psychological trauma, and hardship that millions of people with vitiligo face.

Vitiligo is frequently overlooked as a cosmetic issue, despite the fact that its symptoms can be psychologically distressing and have a significant impact on everyday life. The physical impact of vitiligo can be all-consuming, as a result of which individuals may be dealing with psychological effects of the condition, without even being aware of them. People with chronic illnesses are more likely to develop symptoms of depression than those with no chronic conditions, according to the National Institute of Mental Health (NIMH). Consequently, it also works the other way around as mental health well-being can impact the disease activity. Vitiligo is one of these diseases, and it is estimated that 75 % of people with vitiligo undergo mental health conditions (Simons et al., 2020).

There are several reasons why having vitiligo may put individuals at a higher risk of mental health difficulties. These include chemical and hormonal changes, spending excessive time worrying about the condition, feelings of isolation due to long periods of doctor visits or not being comfortable in social settings as one used to be, and inflammation in long-term caused due to stress. Skin conditions can have a significant impact on a person’s health and
can elicit negative emotions including shame, embarrassment, and anxiety. It can lead to low self-esteem and increased mood disturbances. Individuals may also feel inferior, stigmatised, and discriminated against, especially if the condition affects exposed regions of the body. Vitiligo’s variability, chronicity, and lack of standardised treatment can leave individuals with visible lesions that significantly reduce their quality of life and capacity to cope.

In addition to the psychological conditions associated with vitiligo, there are societal and cultural factors also to consider. The role of gender in vitiligo, for example, has been extensively studied. Researchers have found significant gender differences, with females with vitiligo experiencing greater psychological burden. This gender disparity can be explained by the greater emphasis that society places on women’s cosmetic appearance and beauty. Furthermore, many individuals feel that vitiligo can threaten ethnic and cultural identity. In various societies including India, people with vitiligo have to face stereotypical beliefs which are irrational and discriminatory in nature, thus further impacting their mental health negatively.

A person with Vitiligo writes in a personal account:
“For people with vitiligo, learning to cope can be very difficult—but it’s essential. For me, it took months of complaining to family and friends and feeling sorry for myself to realize I needed to make a change. I met with a therapist, who helped me uncover deeper-rooted self-esteem issues that had nothing to do with my skin…..I challenged myself to turn my focus away from my condition. Refocusing my energy helped build my confidence and prove to myself there was more to me than a few white spots.”

Thus, recognising that one might actually be dealing with mental health issues and seeking professional help for it is very important. In many cases, individuals may not be even aware of the associated symptoms because the feelings come on slowly over time, or one might have become accustomed to feeling this way. It’s critical that you adhere to your vitiligo treatment plan while simultaneously addressing your mental health issues and making lifestyle changes. While at the same time, it is equally essential to spread awareness about vitiligo- that it is a skin condition, is autoimmune and thus not contagious. Spreading awareness and educating people around us can assist in alleviating some of the stigma that has been attached to the condition.

At You’re Wonderful Project; (YWP;), we promote and provide accessible mental health services. Feel free to reach out to us at https://yourewonderfulproject.org/

 

 

 

References:
Bergqvist, C., & Ezzedine, K. (2020). Vitiligo: A Review. Dermatology, 236(6), 571–592.
https://doi.org/10.1159/000506103

Chelsey Hamilton Updated July 07, &Hamilton, C. (n.d.). I Have Vitiligo. Here’s What It’s Like to Live With This Rare Skin Condition. Health.com.
https://www.health.com/condition/vitiligo/autoimmune-disease-vitiligo.

How Vitiligo Can Affect Your Mental Health. MyVitiligoTeam. (n.d.).
https://www.myvitiligoteam.com/resources/how-vitiligo-can-affect-your-mental-health.

PatientsWorld Vitiligo Day. Vitiligo Research Foundation | World Vitiligo Day. (n.d.).
https://vrfoundation.org/wvd.

Simons, R. E., Zevy, D. L., & Jafferany, M. (2020). Psychodermatology of vitiligo: Psychological impact and consequences. Dermatologic Therapy, 33(3).
https://doi.org/10.1111/dth.13418

U.S. Department of Health and Human Services. (n.d.). Chronic Illness and Mental Health:
Recognizing and Treating Depression. National Institute of Mental Health.
https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/.