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Dr. Zain, Heather, and Courtney explain vitiligo (loss of melanocytes causing flat, milky-white patches), how common it is, key subtypes, possible causes/triggers (autoimmune links, genetics, stress, trauma, sunburn, chemical exposures), and how it’s diagnosed (often clinically, sometimes with a Wood’s lamp). They cover risks like sunburn and increased skin-cancer risk in depigmented areas, stigma and mental-health support, and treatment options including topical steroids/calcineurin inhibitors, topical JAK inhibitor ruxolitinib (Opzelura), narrowband UVB/excimer laser, select procedures/grafting, camouflage makeup, and rare full depigmentation with monobenzone for extensive cases.
00:00 Vitiligo Confidence & Support (and calling out bullies)
00:43 Welcome to Skin Side Out: What Is Vitiligo?
01:31 How Common Is Vitiligo? Who Gets It?
03:08 Stigma, Visibility, and Representation (Winnie Harlow)
03:53 Types of Vitiligo: Non-Segmental vs Segmental
05:14 What Causes Vitiligo? Autoimmune, Genetics, Stress & Triggers
06:57 Is It Really Vitiligo? Lookalikes + Wood’s Lamp Exam
09:17 Where It Shows Up: Face, Hands, Genitals + White Hair (Leukotrichia)
10:39 Course & Patterns: Unpredictable Progression + Trichrome Vitiligo
12:01 Risks & Impact: Sunburn/Skin Cancer + Mental Health
13:02 Diagnosis & Lab Work: Screening for Autoimmune/Thyroid
13:42 Treatment Options Begin: Topicals, Phototherapy, and JAK Inhibitors
15:28 UV Light Therapy: Benefits vs Skin Cancer Risk
16:08 Excimer Laser for Small, Localized Vitiligo Patches
16:23 Oral Treatment Landscape: Steroids, Off‑Label JAKs & FDA Hopes
17:18 Surgical & Procedural Options: Grafts, Transplants, Microneedling + Latisse
19:20 When Vitiligo Is Extensive: Full Depigmentation with Monobenzone
20:49 Daily Management: Sun Protection, Camouflage Makeup & Mental Health Support
22:02 Prognosis: What Impacts Repigmentation Success
22:39 Rapid-Fire FAQs: Contagious, Hereditary, Diet, Stress, Cancer & Albinism
25:04 Wrap-Up: No Permanent Cure, New Treatments, and Embracing It
Creators and Guests
Host
Host
What is Skinside Out?
Welcome to Skinside Out, where science meets beauty, the ultimate dermatology podcast! Dive deep into the fascinating world of skin health with expert insights, evidence-based discussions, and myth-busting truths. Each episode explores the medical, cosmetic, and surgical aspects of dermatology, while keeping you informed about trending skincare topics. Whether you’re a skincare enthusiast, medical professional, or just curious about how to achieve your best skin, Skinside Out is your go-to resource for staying informed and inspired.
45 - Vitiligo:
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Heather: [00:00:00] With the vitiligo, um. I think it looks cool, but
Dr. Zain: yeah, I
Heather: think it's
Dr. Zain: beautiful.
Heather: Yeah.
Dr. Zain: Mm-hmm. Yeah.
Heather: But some people are self-conscious about it, and I think that's reasonable. If you want, you know, some support, definitely. We can definitely help you find it.
Dr. Zain: Yeah.
Courtney: If you get bullied by someone for your vitiligo, just leave a comment with their name and their telephone number and I will call them and yell at them.
Dr. Zain: She'll beat you up with her broken wrist. I'll beat
Courtney: Yeah. See these bruises. Wanna know how I got this.
Dr. Zain: Welcome to Skin Side Out. I'm your host, Dr. Zane, with Heather and Courtney. So today we are uncovering vitiligo from the inside and out. So let's get right into it. What is vitiligo?
Heather: So with vitiligo, you are losing your melanocytes. And your melanocytes are your skin cells [00:01:00] that produce melanin or give your skin its color. And you can either have a decrease in your melanocytes or you can have complete absence of your melanocytes.
And so this very classically, I think we have a really good photo, but it's um, these very well demarcated, um. White areas, it's kind of like a milky white mm-hmm. Um, appearance to your skin. So, um, it's kind of common. We see it pretty frequently, but thankfully there are some really good treatments.
Dr. Zain: All right.
So let's talk about some stats. So what are we seeing in terms of the population? How many people that are affecting.
Courtney: So it affects about 0.5 to 2% of people, which doesn't seem like a grand scheme, you know, a lot of people. Um, I think also we see it really occurring in any age group, any ethnicity. Um, it's a very non-discriminatory, you know, disease.
I would say. Um, usually we'll see it [00:02:00] before 30, but sometimes we will see people in their later age as well getting small spots, and I think more so. I think when people think of vitiligo, they think of more widespread area, but I think more commonly we see just. Smaller patches here or there. It's not normally as widespread as like that photo showed.
Dr. Zain: Yeah. And it can affect all skin types. Mm-hmm. So even lighter skin patients, um, it's harder to sometimes see mm-hmm. Some of the depigmentation and it's definitely a lot more obvious in, you know, its skin of color where there's a lot more contrast. But, you know, we see a whole variety of, you know, grades of this depigmentation Hypopigmentation.
Courtney: Mm-hmm.
Heather: I think we see it a lot more in the clinic in not only like darker skin types, but also in females, even though it's non-discriminatory. Um, I think number one, like you said, with darker skin types, it's more noticeable, but also like with the females, I feel like they're just more like. They have more of that like cosmetic eye, more [00:03:00] observant.
Courtney: Mm-hmm. We can say that. More observant.
Heather: So I feel like they tend to come in sooner when they notice things like
Courtney: that. Yeah.
Dr. Zain: Yeah. And also like it can affect cosmetically sensitive areas, right? Mm-hmm. And you know, unfortunately, vitiligo is one of those conditions that's often stigmatized. Mm-hmm. Um, it's been, you know, stigmatized for years, like millennia, to be honest.
Like something's wrong with. You know, um, it's, there's nothing wrong with you. Mm-hmm. Um, it is totally normal. Um, it's just a condition that, you know, affects the pigmentation.
Courtney: Yeah. I think, you know, there was that super, or is that supermodel? Winnie Harlow, who I think really brought attention to vitiligo and really de-stigmatized it.
And, you know, she's a beau, obviously beautiful woman. And, um, I think she's kind of set the pace of, you know, diversity is important and that it doesn't make you any less. Beautiful. Yeah.
Dr. Zain: So there are different clinical subtypes of vitiligo. So we commonly see nons segmental [00:04:00] vitiligo, these patches that are often, you know, found anywhere on the body and they're, you know, typically bilateral and symmetrical, but does not have to be.
Um, so that's something that we do see, um, quite frequently. There's also segmental vitiligo. So Heather, do you wanna go into that?
Heather: Yeah. So segmental vitiligo is where it's only, um, affecting a segment of your body, so like the left half of your chest or your trunk. And this often is related to dermatomes, which is a, um, term that we use that represents.
Skin areas that a nerve follows. And so there's this hypothesis that's there, that there's some sort of neurogenic contribution to vitiligo, um, especially with segmental vitiligo.
Dr. Zain: And then of course there are like mixed types and others that are unclassified. But there are also like descriptors like, [00:05:00] you know.
You know, you got your hands involved. So some acyl. Mm-hmm. Vitiligo, periorificial, vitiligo around your eyes, around your mouth. Um, so there are different clinical subtypes that we can categorize these patients. Um, so what causes vitiligo.
Heather: It could be a lot of different things. Mm-hmm. Um, there's a long list.
So vitiligo is commonly related to your immune system, so sometimes your immune system can cause that destruction of the melanocytes. There are some associations with different autoimmune conditions like thyroid disease, um, diabetes, some types of hair loss, like alopecia areata. But you could have none of these and still have vitiligo.
Um, we also see a little bit of a genetic predisposition with that. So if you have a family history of vitiligo, you're more likely to get it, but not a guarantee. Um, stress plays a really big role. Mm-hmm. In vitiligo. We do see that very commonly, and I think [00:06:00] that also has to do with the, um, the effect on the immune system.
Um, I also, I know I kind of mentioned the neurogenic hypothesis, so especially with like the sick of mental vitiligo, there might be some sort of. Um, contribution with neural, um, mediators and then triggering factors. So like the stress illness, which I think is also a very stressful event. Um, trauma, we call that the ebner phenomenon.
So like if you scratch yourself and then you get vitiligo there, um, sunburns and then also chemical exposures. And we mostly commonly see that with phenol compounds. Yeah.
Dr. Zain: Um, so obviously vitiligo is not something that we know the exact cause of, but we do have some hunches that it has a lot to do with autoimmunity and other environmental factors can play a role.
Um, so these patients typically come to us [00:07:00] in the office, um, oftentimes with usually limited areas of depigmentation or hypopigmentation. So how do we differentiate between other causes of hypo or depigmentation? So there are conditions that can look very similar, such as a form of ex eczema called pits alba.
Um, we have other conditions such as tinia, versicolor that can lead to hypopigmentation or basically any remnants of old inflammation can lead to hypopigmentation. So, um, there are tools that we can use. Um, obviously. When they're like milk white, very well demarcated patches. It's a pretty easy clinical diagnosis, but sometimes when it's subtle, um, I like using my woods lamp.
Mm-hmm. Um, where we use UV Black Light to really look at, um, and see if it's true depigmentation or it's just hypopigmentation that can help us.
Heather: Yeah. A lot of times with the Woods Lamp, what we're [00:08:00] looking for is if that. Milky white is being accentuated or mm-hmm. Getting even brighter and more pronounced with the woods lamp.
Um, pets Alba I think is a really good one because, um, it's very classic, like on the face, but you get this depigmentation and it's not a full, um, loss of pigment. Mm-hmm. So you have more of like this faint hue of, um, melanin. But when you put a woods lamp on it, it's not going to be accentuated.
Dr. Zain: I usually see in the context of dry skin.
Yeah. So oftentimes these patients aren't moisturizing.
Heather: Yeah.
Courtney: Yeah. I was gonna say, I feel like it's not as well demarcated as true vitiligo is.
Dr. Zain: Yeah. Um, so let's talk about the primary feature. So we talk about the milky white depigmentation. It's always flat. Mm-hmm. So it is not raised. So that's an important point because there are sometimes, you know, patients who get these confetti like [00:09:00] lesions.
Um, they think it's vitiligo, but they're actually a type. A sebo keratosis. Mm-hmm. And it just looks lighter than their skin, but it has elevation. When we look under oscopy, we can see features of these Seria keratosis. So I think that's really important.
Heather: Mm-hmm.
Dr. Zain: Um, common locations. Where do we see vitiligo?
Heather: Um, face, hands, um, it could be anywhere, but I do tend to see them like on the wrists, on the neck. The nice thing is the, the face typically responds pretty quickly. I think the sooner that you treat it, the better improvement. You'll see The hands are really hard to treat. Mm-hmm. And.
Dr. Zain: Yeah, I agree. And sometimes it's limited to the genitals.
Mm-hmm. So we do see that, um, especially men. I see that quite often.
Heather: Yeah.
Dr. Zain: Where either the glands or the shaft, um, you know, is affected with vitiligo.
Heather: You can get it too in the hair, and your hair can turn white in that area. So that's called leuko trachea. I think we have a photo of [00:10:00] that. So you actually have a patch of the vitiligo within your skin.
And then because it's a loss of melanin, your. Hair follicles there no longer have melanin either.
Courtney: This is not to be confused with gray hair, which is what Dr. Hussein has. So, hey, I
Dr. Zain: like it.
Courtney: Stop telling people you have vili again.
Heather: Yeah, it's more of like a striking, um, like a streak. Yeah. Yeah. So that's somebody's eyebrow. Um, and you can see the biggest
Dr. Zain: difference. So do you guys watch expo when you're younger?
Courtney: Yeah.
Dr. Zain: A rogue, yeah. Oh, that's streak.
Heather: Yeah.
Dr. Zain: I think she had vitiligo.
Heather: Yeah,
Dr. Zain: she was, she was a mutant.
So she had a lot of stuff going on. She was awesome.
Heather: Yeah.
Dr. Zain: Um, so how does the course look like for vitiligo? I.
Heather: It's very unpredictable. Um, it can, you can just have one little spot and we treat it and it goes away and then you don't really notice anything else. But you could have, you know, a pretty widespread case.
So it kind of depends on your body and probably your immune system. [00:11:00]
Dr. Zain: Yeah. Sometimes when you catch it in the early stages, you can see the actual inflammation. Like the skin's actually like, looks red, um, it kind of spreads and then you start noticing the depigmentation. So during that inflammatory period, it is actually really responsive to treatment.
Mm-hmm. Um, because we can reduce that inflammation and prevent that pigment loss, but it's really rare to actually catch it during that phase. 'cause patients usually come after the fact.
Heather: Yeah. Mm-hmm. Yeah. There's a type of vitiligo called. Tri Chrome vitiligo, which I think we have a picture of that as well.
And that is where you can see the different stages. Mm-hmm. Within the vitiligo. So like here, it's kind of blurry, but you can see like in the middle you have full de pigmentation of the melanocytes, but then kind of towards the outer edges you can see that either it's starting to progress or they're responding to treatment and, and it's hard to know without knowing their history, but you get the.
Milky white. And then you have a light brown and a dark brown all within the vitiligo patch. [00:12:00]
Dr. Zain: Yeah. Um, and then these types of patients have some considerations for their health. Correct. Um, so since they don't have pigment in those areas, do they have any protection from the sun?
Heather: No.
Dr. Zain: So they're more prone to sunburn, so they have to be really careful.
And then also. 'cause they're more prone to sunburns, they can get skin cancer in those areas. Mm-hmm. So that's something that we really wanna stress with our vitiligo patients for sun protection.
Heather: Mm-hmm.
Dr. Zain: Um, and then let's not discount the psychological effects of this condition. We had mentioned that this has been stigmatized for millennia and you know, sometimes these patients are outcasts in society and it's really sad too.
Kind of see how these patients have been treated, um, you know, in the past certain cultures. And some people are like, thought like, you know, it's an ugly feature. Um, they have difficulty, you know, finding partners and it can be really traumatizing, you know, condition to live [00:13:00] with.
Courtney: Mm-hmm.
Dr. Zain: All right.
So diagnosis. So oftentimes this is a clinical diagnosis. We're assessing the patient. Sometimes use the general wood lamp, but it tends to be pretty obvious in many cases. Um, what other labs can we look at, um, when we have a vitiligo diagnosis?
Heather: I think it might be worth checking for any sort of autoimmune conditions, any sort of screening.
Thyroid is a really common one, especially if you have vitiligo in your underarms. Um, you can, you're, it's not a guarantee, but there's a higher association with. Um, thyroid conditions
Dr. Zain: and, you know, vitiligo was a condition that was very difficult treat for many years, but now there are a lot of different options.
So let's kind of go through the different treatment options for vitiligo. So let's start off with topical therapies. So what topical therapies do we often use for our vitiligo patients?
Courtney: So first [00:14:00] line that, you know, we'll use, especially if it's more localized, a smaller surface area would be something like a topical steroid.
And that's really just gonna reduce that inflammation. Um, you know, you might also have your nonsteroidal, so things like tacrolimus. Um, pimecrolimus they'll use, and that I think we have found to be pretty helpful too, especially in those more localized areas. Um, of course you don't wanna use a steroid over time.
It's gonna thin the skin. So I think switching over to something like, um, the non-steroidal is important. Um, phototherapy, which we don't use as much anymore. I know we don't use that in our office, so that's gonna be that, um, narrow band, UVB. Mm-hmm. Um, it. Again, carries the risk of skin cancer. Um, so it seems a little counterintuitive, I think, for a vitiligo patient.
Heather: Yeah, I, I agree. I totally agree. I, we did narrow band UVB at my previous practice and. It works. It does work. It really [00:15:00] works.
Courtney: And the vitiligo patients that use it will come back. Yeah. Like they get addicted to
Heather: it, especially with one of the newer, um, topicals that we use, Alara, which is a topical JAK inhibitor, and this one I think does a phenomenal job.
It takes time. It takes probably like six months before you really see anything. Mm-hmm. But it works so, so well, and it works even better when you combine it with phototherapy, unfortunately. But like you had mentioned, the, the skin is so much more susceptible to sunburns. Mm-hmm. And any sort of UV damage.
So the UV is going to increase that risk of skin cancer in those areas. But I have, I've seen really, really good success with it.
Dr. Zain: Yeah. I mean, I, we used to do a ton of narrowband UVB in residency. Yeah. And then PVA also. Mm-hmm. Yeah. And
Heather: Eva's scary.
Dr. Zain: It's very scary. Yeah. I mean, we see so many skin cancers from
Heather: Yeah.
Dr. Zain: Um, but it does work. And you know, sometimes, you know, like, I don't advocate for this at all, but some patients, you know, especially with costs, um, you know, go to tanning beds mm-hmm. Or just go outside [00:16:00] without any, some protection mm-hmm. To get some of that re pigmentation. So it is a treatment option. Not really my favorite.
For smaller areas though, I think the excimer laser, um, can be very helpful. It's a specific wavelength of light, um, in the UV spectrum that can really help to. You know, induce some re pigmentation for localized areas
Heather: mm-hmm. For oral treatments. Um, there's nothing that's FDA approved for vitiligo right now, hopefully down the pipeline.
Um, but you could potentially do a short course of a corticosteroid. I don't love that for vitiligo 'cause I don't think it's, um, I don't know what your opinion on is on it, but I don't think it's typically enough to. Get that response going and you can't keep them on it long term. Um, but hopefully, I mean, we're, we're hoping to see really good success with JAK inhibitors, which are, um, like I said, [00:17:00] OPS is a topical jak, um, that does a really nice job.
So we're hoping some orals get approved soon.
Dr. Zain: Okay. And I know that they've been used off-label. Mm-hmm. In a lot of different Yeah. Places and they have seen success with it.
Heather: Yeah.
Dr. Zain: But we're still waiting for that FDA approval.
Heather: Mm-hmm.
Dr. Zain: Um, so let's talk about some surgical options. You know, I love procedures, so there are some really cool techniques out there.
So there are melanocyte, um, keratinocyte transplantation that you can perform. Punch grafting where you take, um, skin from other parts of the body that have normal pigmentation and actually, you know, graft them into places where there's depigmentation, um, suction, blister grafting. So basically we're trying to take cells, um, you know, the melanocytes in areas that are producing normal pigment into areas that are de pigmented.
But my thoughts are, I mean. That can work. But what if you start developing, you know, antibodies? Yeah. It just kind of de pigments that. So I haven't done it, but it's [00:18:00] interesting.
Courtney: Well, and I would think also if it's kind of trauma induced, like I remember a couple years back, um, seeing some reports about microneedling.
Mm-hmm. With lattice, because the lat is supposed to bring back that pigment actually. When you're micro microneedling, of course you're opening those channels and then you apply the lat to that area. Um, and it was interesting. I did treat a, a guy at one of my previous practices who had vitiligo on the face, and we did try that technique and it did, um, I think brought a little bit of pigment back.
Mm-hmm. But. There was still that concern of if we're traumatizing the rest of the skin, you know, we only treated that area 'cause I didn't want him to develop any new vitiligo spots. So it's kind of a catch 22 I think.
Dr. Zain: Mm-hmm. Yeah, it's funny, I actually was talking about that with a patient today, um, who has had vitiligo, um, and just discrete areas, but really hasn't budged with topical steroids.
Calcineurin inhibitors tried slo, so nothing's really worked. So I think we may go down the path of, you know, micro kneeling with lat and seeing if it helps.
Courtney: Mm-hmm. [00:19:00] Yeah, I had, I, I had good results, um, with it, with him for sure. And I think, like I said, it's definitely, um, there have, you know, been nice studies on it, but I, I think unfortunately it's not consistent mm-hmm.
With the results, so.
Dr. Zain: Yeah. Yeah. I mean, sometimes, I mean, you just have to try and see if you respond. Um, so, you know, with patients who have extensive vitiligo, like large body surface areas, I mean, we're talking about like, or 50% of the body. Um, there is a different way that you can actually not treat it, but actually kind of make the patient feel better about their.
Appearance, um, psychologically. So, um, you can actually de pigment your skin. So mono benzone has been used for a long time as like a chemical bleaching agent. Mm-hmm. Um, and it does work, but it really does require some, you know, psychological testing prior [00:20:00] because it can be such a jarring experience after being de pigmented.
And once you do it, you can't reverse it. Right. So it is something that, you know. We can offer, but it's usually very, very rare.
Courtney: Is that what MJ did?
Dr. Zain: I,
Heather: I don't know. Do you, do you bleach just the normal skin and then like, what if your vitiligo patches re pigment? Yeah. Or do you just bleach everywhere? You bleach everywhere?
Oh, yeah.
Dr. Zain: It's, it's interesting.
Heather: Mm-hmm.
Courtney: Yeah.
Dr. Zain: Yeah. I've never done it with any patients and you know, I have, I don't have experience with it, but I know that there is an extensive. Pre-op kind of questionnaire and like testing that you need to do.
Heather: Mm-hmm.
Dr. Zain: And make sure that they're mentally prepared to deal with the consequences.
'cause it is a big change. Yeah. Yeah. Um, what else can we do for vitiligo patients?
Heather: Um, like we mentioned, sun protection is gonna be a big one. Mm-hmm. Um, you definitely don't wanna risk sunburns in those areas. [00:21:00] If you're interested in kind of camouflaging those areas. There are techniques that. You can use.
Um, most of them are just temporary, but we can definitely,
Courtney: Derma blend is a
Dr. Zain: really good,
Heather: yeah. Yeah.
Dr. Zain: One of my attendings like swore by derma blend.
Heather: Mm-hmm. Mm-hmm.
Dr. Zain: Yeah. For her vitiligo patients
Heather: and it
Dr. Zain: works.
Heather: Mm-hmm. Yeah. And I think, like we already mentioned, but um, something that we don't want to just slide by is the, um, the psychological support that people may need mm-hmm.
With the vitiligo, um. I think it looks cool, but
Dr. Zain: yeah, I
Heather: think it's
Dr. Zain: beautiful.
Heather: Yeah.
Dr. Zain: Mm-hmm. Yeah.
Heather: But some people are self-conscious about it, and I think that's reasonable. If you want, you know, some support, definitely. We can definitely help you find it.
Dr. Zain: Yeah.
Courtney: If you get bullied by someone for your vitiligo, just leave a comment with their name and their telephone number and I will call them and yell at them.
Dr. Zain: She'll beat you up with her broken wrist. I'll beat
Courtney: Yeah. See these bruises. Wanna know how I got this.[00:22:00]
Dr. Zain: So how did these patients fare? What's their prognosis like?
Heather: Um, good. Yeah, I think it's pretty good. I. I think it's worth. You know, letting them know that it's gonna take time and just preparing them to be a little patient in the beginning. But people seem to do pretty well.
Dr. Zain: Yeah. And I think it's also a function of how long they've had it.
Mm-hmm. So the longer they've had it, the harder it is to get re pigmentation.
Heather: Yeah.
Dr. Zain: Also, how extensive it is. Certain locations, like the hands, like we talked about, are very, very stubborn.
Heather: Yeah.
Dr. Zain: So there's a lot of different factors in play. Um, so it's kind of variable.
Heather: Yeah.
Courtney: All right. I'm gonna ask you guys, 'cause you're, you're the professionals.
I'm just aesthetician. All right. Is vitiligo contagious?
Heather: No, it's not infectious.
Dr. Zain: Mm-hmm.
Courtney: Is it hereditary?
Dr. Zain: Can be,
Heather: yes.
Dr. Zain: There can be a genetic predisposition.
Courtney: [00:23:00] Is a good diet going to cure your vitiligo?
Heather: No, but I think a balanced diet is going to. Help with, um, just keeping your skin healthy,
Courtney: life in general.
Heather: Yeah.
Courtney: Um, does stress cause vitiligo?
Dr. Zain: I think it could be a trigger. Mm-hmm. Um, it's multifactorial, but I do think that stress can be one of those triggers to start. It
Courtney: is vitiligo associated with any kind of cancer.
Heather: Um, it's not cancerous, but hopefully we've. Speed it into your brains that you are at a higher risk for skin cancer.
So you just have to be cautious.
Dr. Zain: Mm-hmm. Well, interestingly, um, you know, sometimes we do see halo nivi, which are these mm-hmm. Moles that have depigmentation around them, and sometimes they are representative of a regressing melanoma. So anything that's new and changing that is something that you wanna bring up with your dermatologist because.
That could be a subtle clue. Um, you [00:24:00] know, as to an early melanoma, um, that's evolving.
Courtney: Mm-hmm. If someone is albino, is that a form of
Dr. Zain: no ability? No, it's a genetic disorder, yeah. Oh, okay. Where there's actually a, um, mutation in the pathway to produce melanin.
Courtney: Mm-hmm.
Dr. Zain: Yeah.
Courtney: Okay. So they're kinda like cousins, like second cousins.
Heather: Mm,
Courtney: they share a great, great grandfather.
Heather: Yes.
Dr. Zain: Well, one is genetic and that's like in utero, right? Yeah. Um, and then there's one that is
Courtney: autoimmune. Autoimmune on its own. Mm-hmm. Okay. Like an adopted,
Heather: I think
Courtney: cousin.
Heather: Yeah. And maybe albine albinism is affecting. Like the pathway earlier on. Mm-hmm. Than vitiligo.
Courtney: More studies need to be done. No. From Corona. Jot that down. And then last question, is there a permanent cure for vitiligo?
Heather: No. No, [00:25:00]
Dr. Zain: unfortunately.
Heather: Are there good treatments?
Courtney: Mm-hmm. Mm-hmm.
Dr. Zain: All right, so I think this wraps up our discussion on vitiligo. I think it is a condition that many people are aware of but don't really know too much about, and it's good to have knowledge because it can de-stigmatize this condition.
Um, it also allows for patients to have hope because there are newer treatments coming out. There are different treatment options that we have been able to use successfully. So there is always hope. Like Heather had mentioned, it's really important to stress sun protection because you have no protection in those de pigmented areas.
So those are three big things that I wanna definitely emphasize. Um, any other last minute, um, tips, information?
Have you guys heard of the, um, micro-pigmentation for the vitiligo? People will do that sometimes, like tattooing. Mm-hmm. [00:26:00] Yeah. So sometimes people will do, um, pigment. Um, I know I've seen it for even just people doing like makeup on their face, which mm-hmm. I don't recommend, I think. It's probably not good to ta.
I don't know. I don't know. I don't recommend it. But for vitiligo, I've seen some people do it, um, where they're basically filling in that lack of pigment. But again, you do have to worry about kind of the trauma of, once you're creating more trauma, you're again, kind of chasing, yeah, chasing the um, end result.
So. I don't know. I think the derma blend is definitely a better mm-hmm. Option, even though it is temporary. Mm-hmm. Also, vitiligo is not always static, right? Mm-hmm. It can be dynamic. Mm-hmm. And what if you get your tattoo and it starts evolving beyond the right order? So, you know, just get like a cool tattoo.
Don't get like pigment tattoo. Just get like a cool, like my tattoos, get cool tattoos and then. Cover it up if you want, or get a cast instead. We'll cover it up. Yeah. [00:27:00] Get a cast, cover it up in a cast. Just get, go, go snowboarding and almost break both arms and you'll not be able to tell. The bruising will definitely take over the bit of like, or, or just embrace it.
Yeah. Yeah. I think at the end of the day, our message is just embrace it.
Dr. Zain: Well, I think this wraps up our episode Until next time. Skin side
Courtney: out,
Dr. Zain: out.
[00:28:00]