Both albinism and vitiligo are skin conditions affecting the pigment (color) of the body. The conditions can appear similarly on the skin, potentially leading to confusion between the two. However, there are some key differences between albinism and vitiligo, including how they look, what causes them, and how they are treated.
Vitiligo presents as patches of white-colored skin that have lost their pigment, which is also called melanin. These patches can occur anywhere on the body, including hair and mucous membranes. They may develop symmetrically on both sides of the body, or they may only be present on one side.
Some people only experience patches of color loss covering a few areas of the body, while others experience it in various places over the whole body. Occasionally, vitiligo’s effects are limited to the skin on or near the face.
While vitiligo involves a patchy loss of pigmentation, most people with albinism have no color or very little color on all their skin from the time they are born. Their skin — and, in many cases, their hair — is very pale. However, some people diagnosed with albinism have a skin color similar to their parents or siblings who are not diagnosed with albinism.
Person with albinism
Some people with albinism will have a skin tone that never changes, while others may experience small fluctuations in skin tone as they get older. However, their skin never takes on the patchy appearance of vitiligo.
People diagnosed with albinism often have very light-pigmented eyes, though their eye pigmentation can range from nearly translucent to brown. Many people diagnosed with albinism have vision problems. Vitiligo, however, does not affect the color of the eyes.
Both vitiligo and albinism often cause sensitivity to the sun, and people with either condition can be more prone to sunburn. For those diagnosed with vitiligo, the extra sensitivity is limited to the patches of skin that have faded in color. Those diagnosed with albinism are usually sensitive to the sun over their entire bodies.
One particular type of albinism may be mistaken for vitiligo: partial albinism. This form of albinism can cause a person to have multiple patches of skin that are either lighter (called hypopigmentation) or darker (called hyperpigmentation) than the rest of their skin. These patches are symmetrical and are also often found on the midline of the body. A person with partial albinism will also likely have a characteristic midline patch of white skin or a white patch of hair on the scalp.
Both albinism and vitiligo are caused by a lack of melanin — the pigment that gives skin its color. The reason for this lack of pigment differs between the conditions.
The cells responsible for making melanin are called melanocytes. In vitiligo, melanocytes are destroyed by the immune system, resulting in the loss of pigment seen in the disease. People with vitiligo usually have an even skin tone when they are born and as they are growing up, and they develop lighter patches of skin over time.
There are many theories about what causes some people to develop vitiligo. Most researchers agree that in the majority of cases, vitiligo is an autoimmune disease. In other words, white patches and other symptoms of vitiligo are caused by the body’s immune system attacking the melanocytes. Vitiligo may be passed down through families and triggered by a stressful life event.
Albinism, on the other hand, is known to be an inherited disorder. It is caused by a mutation in one of the genes that play a role in melanin production. When melanin-producing proteins don’t exist or are deformed, the body cannot produce the melanin that it needs, leading to widespread skin color loss. The only risk factor for albinism is having relatives who have had it, which indicates the presence of those mutated genes in the family tree.
There are several types of albinism. Oculocutaneous albinism (OCA) is the most common type. OCA occurs when a person has inherited two mutated copies of one of seven OCA genes — one from their mother and one from their father. The location and severity of the albinism will depend on which gene they have mutated copies of.
Ocular albinism primarily affects the eyes, and the skin may appear similar or slightly lighter than other family members’ skin. It is passed on by a mutated gene on the X chromosome. Since males have only one X chromosome, the condition is significantly more common in males than in females.
Partial albinism is extremely rare. It occurs when there are mutations in one particular gene known as the KIT gene.
It is important to visit your doctor or dermatologist if you notice any changes in your skin tone. They will be able to assess your symptoms and perform a thorough physical examination to help diagnose the cause.
If the doctor suspects vitiligo, they will ask for a thorough medical history. Although vitiligo is usually diagnosed by clinical exam, the doctor may also look at your skin under a special light called a Wood’s lamp and request a skin biopsy — a procedure in which a small sample of the affected skin is removed for examination. Blood tests may be used to rule out other conditions that may be behind your symptoms.
If the doctor suspects albinism, they will perform a similar exam, also asking about your symptoms and medical history. They may also compare your skin tone to a family member’s. Unlike vitiligo, a diagnosis of albinism will likely involve seeing an ophthalmologist (eye doctor). An ophthalmologist will be able to conduct an eye exam and determine whether any eye signs are present.
Doctors assessing a person for albinism may recommend genetic consultation. Genetic testing done via blood test can help reaffirm a diagnosis of albinism and determine which kind of albinism you have. This information can help your doctors provide the right treatment for your condition.
Diagnosing partial albinism involves a similar process, but the doctor will also check for telltale signs of this condition. These signs include a light or white forelock (the hair just above the forehead), as well as having family members with similar skin markings.
Neither vitiligo nor albinism can be cured at this time. However, treatment options can help improve the condition or stop further changes in skin tone.
Vitiligo treatment may include using topical creams and ultraviolet light therapy (phototherapy) on the white patches of skin. Both treatments can help slow the progression of vitiligo and often bring back normal color to the skin. Some surgical procedures can graft pigmented skin into the depigmented areas. Also, a new class of medicine known as Janus kinase (JAK) inhibitors are currently being studied for their use in treating vitiligo.
Some people with vitiligo take medications that control the immune system (called immunosuppressants) to prevent the immune system from continuing its attack on the melanocytes.
Depigmentation or skin bleaching — removing the melanin from nearby skin — can help smooth the look of the skin nearby, though some people simply choose to cover up the lighter areas with makeup or dye.
People diagnosed with albinism will be taught how to care for their skin and eyes to limit the effects of the condition. People with albinism will likely need frequent visits with an eye doctor to make sure their eyes are working well and to address any problems that develop.
People diagnosed with vitiligo and those diagnosed with albinism need to learn how to take care of their skin to avoid skin damage from sun exposure, especially sunburns that blister. People with either condition need to be assessed regularly for skin cancer. They should also make sure they always practice good skin care by wearing powerful sunscreen and protective clothing to protect their skin from sun damage.
Read more about sun protection and vitiligo.
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