Thedoc Replies
Our expert answers your medical questions
What is vitiligo?
Vitiligo is when you get white patches on the skin, usually without any other symptoms. Everyone has pigment-producing melanocytes on the bottom layer of the epidermis (upper layer of the skin), and for some reason in people with vitiligo there is a loss of these melanocytes, so the skin cannot make melanin in the parts affected. It is thought it might be an autoimmune illness, where the body’s immune system damages some of its own cells.
Vitiligo most commonly affects the face, hands, scalp, and neck, and can sometimes affect the genitals and armpits. It can be symmetrical on both sides, and there can be bigger or smaller patches. It is more obvious in people with a darker skin tone, so can be more distressing for them. In lighter-skinned people it may only be noticeable if the rest of the skin tans. Melanin is what protects the skin from the sun, so it is important for people with vitiligo to keep the areas affected out of direct sunlight, covered with clothes or a hat, and/ or wearing high factor sun block. There are some treatments available but nothing that works well for everyone, and the patches are usually permanent. Patients can be given skin camouflage, which is like special make-up. You will be prescribed a cream that most closely resembles the rest of your skin tone.
My skin gets very itchy at night. What is going on?
This is common. Try not to scratch but rather pat or tap the area instead. A cool, damp towel can help soothe it, and it is important to use moisturisers. Loose clothing can also be helpful, as can avoiding lengthy hot baths and showers. If it is not getting better, or very widespread, go and see your GP.
What are bunions?
They are bony lumps that appear on the inner side of the bottom of the big toe. The big toe points outwards towards the other toes, and the bunion tends to be red, swollen and painful. The type of shoe you wear is important – wear wide shoes with a low heel and a soft sole, and avoid high heels and pointy shoes. Use an ice pack on it when it becomes painful, and invest in bunion pads.