Understanding this common skin condition can help you provide safer and more sensitive nail services.
by Tracy Morin
You've most likely seen vitiligo before; it manifests itself as light or white splotches of skin. It's one of those conditions that many people recognize when they see it, but few people know the technical term for the disorder, and even fewer understand why it occurs and the process behind its development. Undoubtedly, much of the stigma attached to vitiligo stems from an ignorance on the part of the general population. “Vitiligo can be a very socially stigmatizing disease, especially in patients with naturally darker skin types,” relates Seemal R. Desai, MD, FAAD, dermatologist in private practice at the Center for Skin & Cosmetic Dermatology in Dallas and diplomate for the American Board of Dermatology. “In some cultures, patients with vitiligo are ostracized from society, even though vitiligo isn't a contagious disease.” As a nail technician, you may come across this skin condition, and knowing more about it can greatly improve your services for these clients and put them at ease.
Vitiligo Statistics* |
- About 1% of the world's population, or 40 million people, have vitiligo
- Approximately 1 in 136, or 2 million people, in the United States have vitiligo
- About half of the people who develop vitiligo experience some pigment loss before the age of 20
- About one-third of all vitiligo patients say that other family members also have this condition
- About 75% of the patients who undergo PUVA therapy for vitiligo respond to some extent
*Sources: National Vitiligo Foundation; WrongDiagnosis.com |
Vitiligo 101
Vitiligo is an autoimmune disorder that is easily noticed because it affects levels of pigment in the skin. “Vitiligo is becoming an increasingly common skin disorder, and is characterized by the body's immune system attacking melanocytes, or pigment-producing cells,” says Desai. The attack on healthy pigment-producing cells leads to patches of skin that lack color, meaning affected areas turn completely white. “It often starts in childhood, and is usually associated with other autoimmune diseases, including lupus, hair loss/alopecia, thyroid dysfunction and more,” Desai explains.
Once the symptoms of the condition start to materialize, it's a painless process to determine the condition. A dermatologist can easily diagnose vitiligo with a simple clinical examination, which requires no biopsy, explains Robert T. Brodell, professor of internal medicine, dermatology, at Northeastern Ohio Universities College of Medicine in Rootstown, Ohio. Once vitiligo is diagnosed, there are several methods of treatment available depending on the severity of the case or the client's preference. “The first level of treatment involves applying sunscreen so the adjacent skin doesn't tan and highlight the problem, as well as using cover-up cosmetics,” Brodell says. “The second level of treatment is administration of the drug Psoralyn in combination with UVA light treatment (known as PUVA therapy) to try to stimulate pigmentation, or a UVB laser to try to induce more pigment to develop in these spots. The third level is depigmentation therapy, where the normal skin is bleached to match the skin affected by vitiligo.”
According to the National Vitiligo Foundation (NVF), patients who undergo the second level of treatment (called repigmentation therapy) can expect to gain back pigment on only about one-eighth to one-quarter
inch of skin during each year of
treatment. However, the decision
to undergo depigmentation therapy (the third line of treatment) is a serious one, since it permanently removes pigment from all skin on the body. Unfortunately, no single cure exists for vitiligo.
A Few Simple Steps
Nail technicians are especially prone to seeing vitiligo in the salon, since “this disorder, in its generalized form, often affects the skin color on the hands, especially the fingers,” relates Nanette Silverberg, MD, director of pediatric and adolescent dermatology at St. Luke's-Roosevelt Hospital Center in New York. You'll notice that clients who have had vitiligo for years are likely already aware of the ways in which they can make it less noticeable. Many use self-tanners or other skin-blending makeup to disguise the patches of unpigmented skin.
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A Tech's View
Maybe you haven't seen vitiligo before, and aren't sure what to expect the first time you see a client with it. This frequently misunderstood condition is nothing to be concerned about; just take the advice of Missy Malone, owner of SPAtaneity in Fort Worth, Texas, who regularly performs services on a client with vitiligo.
“My mom has the skin disorder vitiligo, and I do regular manis and pedis on her. There's really no difference in her services versus other clients' services; I do my best to make everyone feel comfortable and at ease. I've discovered that extra care must be taken when providing cuticle grooming, as her hands are completely white, making it very difficult to see the cuticle. I just make sure I keep her nails and cuticles hydrated, and gently push back the cuticles. I've also noticed that she tends to bruise easier than most, so when I'm doing the massage I use a lighter, gentler touch. There is often more sensitivity to water temperature and product being used during service.
“I definitely feel that vitiligo is a skin disorder that nail techs need to become familiar with. Prior to my becoming a nail tech, people would often mistake my mom's condition with that of a burn victim, making her feel even more self-conscious. We shouldn't be so quick to judge one's outer appearance!”
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