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This article argues against our current way of looking at vitiligo, asserting that patients would benefit from additional mental healthcare in conjunction with or instead of other clinical approaches.

Although vitiligo is not associated with symptoms that can cause direct loss of life, it does carry a significant and profound psychosocial impact. Because most of the course of vitiligo treatment is medical in nature and focuses on repigmenting the skin, the psychosocial impact of vitiligo can often go untreated as it is overshadowed by other complications that the disease causes. 

This article, published in the journal Clinics in Dermatology, evaluates the way that psychosocial considerations can impact thow clinicians treat vitiligo. The article includes a discussion of how vitiligo affects patients’ social lives and psychological experience, a debate over the disease-ification of vitiligo, considerations related to quality of life and mental health, and methods that can be used to holistically help individuals dealing with vitiligo that go beyond the treatment of the disease itself.

Should We Abandon the Idea That Vitiligo Is a Disease?

A central part of the discussion addresses whether vitiligo can, or should, even be considered a disease. Because in many cases vitiligo is associated with no particular physical harm or pain, it may make sense to think of it solely as a cosmetic condition, or even as one of many physiological variants in how humans look, such as hair or eye color. 

Vitiligo as a Natural Variant in Human Appearance

However, this discussion can be quite complex: looking at vitiligo as a disease provides more insights into its pathogenesis and treatment options, and also makes it more likely that insurance providers offer coverage for vitiligo treatment, even if vitiligo isn’t causing any physical morbidities and could be conceived of as entirely cosmetic. On the other hand, seeing vitiligo as a natural type of appearance may be psychologically freeing for some individuals.

Furthermore, vitiligo can mean different things to different people, and this makes it uniquely complex when it comes to understanding its psychosocial effects. For example, the authors cite model Winnie Harlow who considers vitiligo to be a unique aspect of her beauty, while recognizing that many individuals that deal with vitiligo see it as a “disfigurement” that should be fixed. 

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Why We Need More Vitiligo-Focused Mental Healthcare

In order to review past research on the psychosocial effects of vitiligo, this article includes a literature review from 2007 to 2022, gathering data related to quality of life and vitiligo. According to the analysis, quality of life was worse among patients with vitiligo when compared to other conditions like atopic dermatitis, even though those conditions can often have more complications. Overall, patients with vitiligo were found to exhibit worse quality of life results compared to many symptomatic dermatologic and non-dermatologic diseases that have more complications and/or pain, due to their complex relationship with societal pressures and self-consciousness. The researchers urge healthcare providers to increase the focus on the mental treatment of vitiligo-related suffering, even if treatment of vitiligo as a physical disease is not wholly abandoned.

Source:

Mahama, A. N., Haller, C. N., & Ahmed, A. M. (2023). Psychosocial Considerations in the Management of Vitiligo. Clin Dermatol. https://doi.org/10.1016/j.clindermatol.2023.02.008