Vitiligo: causes, stress, treatments

Vitiligo causes stress treatments

Edouard Philippe, the former Prime Minister has vitiligo. In excerpts broadcast by Daily, he appeared with fully transparent eyebrows. What is vitiligo and what causes it?

During a report broadcast on September 19, 2022 on TMC, Edward Philip appeared on the screen with completely transparent eyebrows. Indeed, the former Prime Minister is suffering from vitiligoas he confided in 2020. On TF1, during an interview, Edouard Philippe returned to the depigmentation of part of his beard, due to this skin pathology. “My beard has whitened perhaps as a result of stress, no doubt its impact on my metabolism: I can confirm that I have a disease called vitiligo, which is neither painful nor contagious, but very visible!”.

On the same subject

Vitiligo, what is it?

In France, approximately one person in 100 suffers from this autoimmune dermatological disease which is characterized by the appearance of white spots on the skin and which affects both men and women, adults and babies.

To understand vitiligo, we have to go back to basics: our skin is made up of three layers: the hypodermis, the dermis and the epidermis, the most superficial. The epidermis itself is divided into five layers and, in the deepest (the basal layer) are cells called “melanocytes”. Their role is well known to all those who like to bask in the sun: they synthesize melanin, a dark brown pigment responsible for the color of the skin.

But people with vitiligo produce abnormal antibodies that directly attack melanocytes and block their action, thus preventing melanogenesis (or melanin production). And since vitiligo results from a malfunction of the immune system (to which antibodies belong), it is said to be an autoimmune disease. As a result, patients see their skin (and even, sometimes, their mucous membranes) become covered with hypopigmented “spots”: well-defined whitish patches devoid of pigment because the melanocytes have been blocked.

“There are two types of vitiligo, specifies Dr. Valérie Callot, dermatologist. In the case of generalized vitiligo, there are spots all over the patient’s body, in particular at the level of the friction zones which are the tops of the hands. , the knees or the tops of the feet. Conversely, localized vitiligo only results in spots on one side of the body, for example on a hand, an arm or a leg.”

What are the causes of vitiligo?

Not easy to pinpoint a culprit: the causes of vitiligo are still poorly understood. However, several hypotheses shed light on the origins of this multifactorial disease, which is found more frequently in India, in the countries of the Middle East and in the Maghreb.

First, genetics. In 2010, an American study conducted by the National Center for Biotechnology Information managed to isolate 10 genes involved in immune response mechanisms that may play a role in people with vitiligo. “In addition, in consultation, we frequently find a family history of vitiligo,” adds Dr. Valérie Callot.

But free radicals could also have their share of responsibility in the development of this dermatological disease. In 2009, another American study commissioned by the National Center for Biotechnology Information showed that the accumulation of free radicals could lead to the “self-destruction” of melanocytes…

“It is also important to consider the psychosomatic causes of vitiligo,” adds Dr. Valérie Callot. “The disease can very well be triggered following an emotional shock or trauma”.

What are the symptoms of the illness ?

People with vitiligo are “simply” covered with whitish spots, more or less numerous, more or less extensive depending on the patient. Vitiligo is neither painful nor contagious; the spots are not raised and do not itch either; the life expectancy of the sick is not reduced. In short, on the physical level, the disease is benign.

However, it is out of the question to minimize its psychological consequences… If some patients manage to sublimate their pathology, by transforming it for example into a work of art, in the vast majority of patients, self-esteem is deteriorated. 20% of patients even suffer from a permanent sensation of itching.

“The symptoms are aesthetically unsightly, analyzes Dr. Valérie Callot. Thus, the patients develop stress, anxiety, even depression. They feel obliged to hide their pathology, as if it were ashamed.” Moreover, as vitiligo has no physical consequences, patients frequently have the feeling of not having to complain, which reinforces their psychological discomfort… The vicious circle is set in motion.

What are the treatments for vitiligo?

To date, there is no miracle treatment that would stop or even cure vitiligo. Nevertheless, patients have the option of having their white spots repigmented.

For this, several methods exist but the most widespread of them is exposure to UV-Bwhich stimulates the remaining melanocytes to make them produce melanin again. This is done either in a cabin or using an excimer lamp which will concentrate UV-B only on the spots, when these cover less than 10% of the surface of the body. “This method gives good results,” explains Dr. Valérie Callot. However, it takes at least 24 sessions to see an improvement in pigmentation, and the treatment lasts at least 3 months. It is long and expensive, although it is partly reimbursed by social security. »

At the same time, the patients are led to expose themselves to the sun, again in order to stimulate the remaining melanocytes. “We also prescribe a cream containing immunomodulatory compounds, which make it possible to slow down the action of abnormal antibodies”, adds Dr. Valérie Callot.

Finally, as a last resort, there remains surgery via autograft (this involves taking a piece of non-depigmented skin from the patient on his thighs or buttocks to graft it onto a white patch) or even dermotatoing (this involves tattooing color on less receptive white spots to UV-B, such as the nipples)… but these techniques remain quite expensive.

“With these treatments, we generally manage to repigment the spots on the face in 80% of cases, and the spots on the back of the hands or feet in 20% of cases, summarizes Dr. Valérie Callot. The evolution of the disease depends of each patient: sometimes it will stabilize quickly, sometimes new spots will appear or even disappear…”

A spokesperson for vitiligo sufferers since posting her photos, the model Chantelle Brown Young, she decided to accept her illness. His advice to all victims of vitiligo? “Love yourselves! We can totally pursue our dreams despite our little imperfections…” A beautiful message of hope.

>> Discover Tiger Lily’s testimony on vitiligo on video.

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