Vitiligo: an under-estimated problem

Vitiligo is a common skin complaint, affecting approximately 500000 people in the UK with cosmetically and psychologically devastating effects. An average GP will have 10 sufferers on his list. The aims of this survey were to determine the effects and extent of vitiligo, treatments used and whether these differed from those reported in the current medical literature. There has been no previous work in this area.

A self-administered questionnaire was distributed to 25% of the members of the Vitiligo Society (a patients' self-help group) who were likely to be concerned about their condition. The questionnaire covered demographic characteristics of the group, the vitiligo itself, treatment and sufferers attitudes towards vitiligo.

The response rate was 77%: the median age of onset was 13 years. Half related the onset of their vitiligo to a stressful event (e.g. marital and financial problems). Only 14% had noticed any spontaneous improvement in their vitiligo [negatively related to the percentage of vitiligo on the body (P < 0.05)]; 80% had used no treatment. Use of camouflage was high (41% of males and 70% of females). Sunscreen use was suboptimal, and 20% were depressed about their vitiligo.

In this self-help group it appears that improvement occurs less frequently with more extensive vitiligo, so treatment (for vitiligo and depression) should be offered early. Further work on this subject is needed. GPs should be ideally placed to help vitiligo sufferers. The suboptimal use of therapies suggests that GPs need education about the topic.