White is beautiful. But white patches on the skin are not. There’s real anxiety about whether the spots are leprosy or leukoderma.
Leprosy is a bacterial infection which affects the skin and nerves. It is associated with loss of sensation and, if untreated, deformities. The number of leprosy cases has come down in recent times.
Vitiligo is another relatively common disorder which is triggered off because melanocytes, the pigment-producing cells in the skin and hair, stop functioning, partially or completely.
While leprosy patches are pale or flesh coloured, vitiligo patches are ivory-white. In most cases, it is auto-immune which means that the body’s immunity starts acting against its own melanocytes.
In India, vitiligo is identified as safed kodh which can be literally translated as ‘white leprosy’. It is often considered contagious and something that runs in families. It is true that afflicted parents or close family members who have a history of vitiligo can pass it on. But the risk is not absolute and cannot be quantified.
Vitiligo stands out on pigmented skin like ours. In the very fair-skinned, it is hardly noticeable and may show up for the first time after a day on the beach which leaves the surrounding skin tanned.
Pale rain-drop like spots can also result from a fungal infection called pityriasis versicolour. Humidity and excessive sweating predispose to versicolour. When children get pale blotchy patches on the face, it could be a low-grade childhood eczema called pityriasis alba. It is commonly believed that this is due to vitamin or calcium deficiency, which is not true.
Other myths surrounding pale spots are ‘worms in the tummy’ and ‘eating incompatible foods like milk and sour foods or milk and fish together’. If pityriasis alba does not fade away by three months, a dermatologist should be consulted.
Beware of the so-called guaranteed cures for vitiligo. There is no sure-fire way to eradicate it or prevent it from spreading. But it can be controlled, particularly if treatment is instituted in the early stages.