Managing Your Emotional Health With Vitiligo
If you have vitiligo — an autoimmune condition that causes skin to lose color in patches — you likely know that it’s more than just a cosmetic problem. Although vitiligo isn’t contagious or fatal, it is a chronic condition whose main impact can be psychological because it’s so visible to other people.
According to a September 2021 article published in the American Journal of Clinical Dermatology, people with vitiligo often experience emotional and mental issues like low self-esteem or confidence, sleep problems, anxiety disorders, negative self-perception, loss of identity, and depression, due to living with this highly visible condition.
About 75 percent of people with vitiligo report having psychiatric issues such as depression, anxiety, and stress, according to a September 2021 study published in the journal Middle East Current Psychiatry.
Although there are treatments available, vitiligo has no cure. As an autoimmune condition — meaning the immune system attacks healthy cells — people with vitiligo may be at higher risk of developing other autoimmune disorders, like type 1 diabetes, hypothyroidism, psoriasis, and Crohn’s disease, according to the National Library of Medicine.
While these risks are distressing enough, people with vitiligo — especially people with darker skin tones — can also face stigmatization and discrimination in their experiences with others due to their appearance.
Although vitiligo can impact your well-being, there are ways you can live confidently with the condition.
How Vitiligo Can Impact You According to Mohammad Jafferany, MD, professor of psychodermatology, psychiatry, and behavioral sciences at Central Michigan University in Mt. Pleasant, vitiligo is classified as a secondary psychiatric disorder, meaning though vitiligo skin patches don’t cause any physical damage, their psychological consequences can be profound. Vitiligo can interfere with almost every aspect of a person’s life: career, relationships, identity, behavior, habits, and mental and emotional health.
“Some people just stop going outside or working to avoid stigma and meeting with people,” Dr. Jafferany says. As a result, they may experience loneliness, social isolation, and in more severe cases, suicidal thoughts and intents.
In March 2021, the U.S. Food and Drug Administration conducted a public meeting to hear how people with vitiligo and their caregivers experience the condition. Many participants said it caused them to have anxiety, suicidal thoughts, low self-confidence, and loss of identity. Due to the stigma attached to the condition, they’ve also had difficulty growing friendships and relationships and meaningfully engaging in everyday and social activities.
Cultural View of Vitiligo The societal aspect of vitiligo should not be ignored, Jafferany says. In many cultures around the world, particularly in countries with people who have darker skin tones, those with vitiligo have a higher incidence of relationship breakups and divorces and may struggle to find a partner, he says. Many people mistakenly think vitiligo is contagious. Because of that, people with vitiligo are especially prone to experiencing discrimination, loss of privileges and opportunities, and difficulty progressing in different aspects of their life owing to their appearance.
For these reasons, researchers in an article published in the International Journal of Women’s Dermatology noted that vitiligo is “one of the most psychologically devastating diseases in dermatology,” with its impact most prominent in racial and ethnic groups with darker skin.
How You Can Feel More Confident With Vitiligo Despite how disruptive living with vitiligo can be, you can take control of your experience and thrive with this condition. Consider these strategies:
1. Acknowledge your feelings. Vitiligo can make you feel self-conscious and have other unpleasant emotions, which can be difficult. But rather than ignore these feelings, it’s better to own them, says Brett King, MD, PhD, a dermatologist at Yale Dermatology in Middlebury, Connecticut, and associate professor of medicine at Yale School of Medicine. “Too often, people with vitiligo hear things like, ‘It could be worse,’ or ‘You could have cancer,’” Dr. King says. Although they might mean well, people who make such statements can dismiss your feelings. Rather than discounting yourself, instead, acknowledge your emotions.
2. Learn about your condition. Understanding your symptoms and potential treatment options can make you feel more in control of the condition and your overall health. “A basic understanding of what causes skin-color change in vitiligo is an essential step toward building self-confidence,” Jafferany says.
With more knowledge, you can become your own advocate, identifying and dispelling myths about vitiligo — including those that could affect your mood and confidence — and asking for the best treatment for you when you’re talking with a dermatologist. Check out the Global Vitiligo Foundation, the Vitiligo Research Foundation, and the American Academy of Dermatology for information.
3. Rely on your support system. Although living with vitiligo can feel isolating, you don’t have to experience it alone. A solid support system, which may include family members, friends, and colleagues, plays a significant role in mitigating the many psychological impacts of vitiligo, according to Jafferany. “Even if they don’t personally have vitiligo, connecting with others may help remind you that you are a valuable part of society,” he says.
4. Join support groups. It can be helpful to talk to others who know exactly what you’re going through. By participating in vitiligo support groups, you can meet people who can relate to you, feel less isolated, and hear how others are navigating life with the condition. In addition, having conversations with people who make you feel seen can help you develop resilience, hope, and confidence with vitiligo, according to a study published in the Dermatology Online Journal.
Dr. Jafferany recommends finding support groups and other helpful resources through the Vitiligo Research Foundation, Vitiligo Support International, and Global Vitiligo Foundation.
5. Seek professional help. A December 2022 article published in the International Journal of Women’s Dermatology found that cognitive behavioral therapy — a type of talk therapy — can improve mental symptoms, stress levels, and quality of life in people with vitiligo and other skin diseases.
If you’re experiencing overwhelming symptoms of depression, anxiety, or stress, Jafferany advises seeking professional counseling to learn coping skills and treat your symptoms. You may want to look specifically for a psychodermatologist — a therapist who works with people who have skin conditions — or another therapist who has experience working with people with chronic health conditions.
6. Practice body positivity. Learning to appreciate your appearance can help you live unapologetically with vitiligo. Start with being comfortable with yourself, advises Alex Dimitriu, MD, founder of Menlo Park Psychiatry and Sleep Medicine in California. “This can be built on the core belief that appearances are only skin deep, and your personality, kindness, intelligence, or other attributes you cherish matter far more than anything on the outside,” Dr. Dimitriu says. It might also help to realize that people who judge your color or appearance may not be the people you want in your life.
7. Consider treatment for vitiligo. Because vitiligo isn’t life-threatening or contagious, you can decide whether you want to treat it. If it feels right to cover it up — such as with microskin — cover it up, King says. “You can also do nothing and let it show if that feels right, too.”
If you notice people staring at you, King recommends helping to educate them by saying, “I see you noticed the white spots on my skin. I have a condition called vitiligo, where the skin loses color leading to white spots. But I’m okay.”
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“Doing this can give you more control over what’s happening, which can be helpful,” he explains.
Other vitiligo treatments include:
Medications like topical steroids, ruxolitinib, or calcineurin inhibitors Light therapy Depigmentation therapy Surgeries like melanocyte transplants, micro pigmentation, and skin grafting You can explore these treatment options with a dermatologist, who can help you decide which treatment may be best for you.