Vitiligo: Methods to prevent it?

Is it possible to prevent the onset of vitiligo?

Vitiligo is regarded as an autoimmune disease in which the malfunction of the immune system leads to the abnormal activation of T lymphocytes that attack melanocytes, resulting in depigmentation of certain areas of the body.

There is no upstream treatment that can definitively eliminate the risk of developing vitiligo as this condition is predominantly linked to hereditary predispositions. However, certain habits could help limit its onset.

Reduce stress to decrease the risk of developing vitiligo.
Studies have hypothesised that stress could be one of the potential factors triggering the onset of vitiligo as chronic stress can promote systemic inflammation. Indeed, persistent inflammation acts as an alarm signal for the immune system, causing an excessive activation of certain immune cells, particularly T lymphocytes involved in the destruction of melanocytes and thus in skin depigmentation. Engaging in a regular physical activity, adopting a healthy lifestyle and avoiding stressful situations could help reduce the risk of developing the disease, although more in-depth studies need to be conducted on the subject.
Prevent skin injuries, such as the Koebner phenomenon, to reduce the risk of disease development.
The Koebner phenomenon refers to the preferential distribution of depigmentation in certain areas of the body that frequently experience friction and microtraumas. This triggers an inflammatory response that activates T lymphocytes involved in the destruction of melanocytes, the cells that produce melanin. To prevent the onset of this phenomenon, it is recommended to minimise the risks of cuts, scrapes, and other skin traumas and treat them as soon as they occur to avoid inflammation and reduce the risk of developing vitiligo lesions. Furthermore, sensitive skin areas, such as elbows or knees, can be prone to irritation due to friction. To protect them, it is advisable to avoid tight clothing or repeated friction.
Use a sun cream and limit sun exposure to reduce the risk of vitiligo occurrence.
According to some studies, although controlled UV exposure is used to treat depigmented areas of vitiligo, prolonged sun exposure in predisposed individuals could trigger the onset of the disease. Indeed, people who have experienced sunburn have a higher risk of developing vitiligo. UV ray exposure generates cellular stress in the skin, stimulating the production of heat shock proteins such as HSP70i. Overexpression of this protein has been associated with a depigmenting autoimmune response, which could promote the attack of melanocytes by the immune system. It is therefore crucial to use adequate sun protection and to limit sun exposure to prevent this risk.
Adopt a balanced diet to lower the chances of vitiligo occurrence.
Although no evidence has clearly indicated the impact of food allergies on the exacerbation or development of vitiligo, the risk cannot be dismissed. Indeed, it is advised to take precautions as these can disrupt the digestive or hormonal system, leading to an imbalance of the immune system, a factor involved in the onset of vitiligo. Moreover, it has been shown that gluten intolerance could have a connection in the worsening of vitiligo. That's why a gluten-free diet might limit the risks of the disease's onset. It is also recommended to identify and limit allergens and inflammatory foods, such as refined sugars, fats, and processed foods. Conversely, a diet rich in fruits, vegetables, and omega-3 could limit the onset of vitiligo.

How to prevent vitiligo recurrence?

Following the cessation of a vitiligo treatment, 40 to 50% of patients may observe a depigmentation of the initially repigmented areas. Studies have shown the presence of a skin memory at the site of old vitiligo lesions. Certain topical treatments in ointment or gel form can limit this recurrence by targeting calcineurin, which plays a role in modulating the autoimmune response. By inhibiting calcineurin, these treatments block the activation of NFAT transcription factors, responsible for the production of inflammatory cytokines (IL-2, TNF-α and IFN-γ). This reduces the proliferation and activity of T lymphocytes, thus limiting attacks against melanocytes and promoting potential stabilisation of depigmentation. To prevent these recurrences, a prolonged or intermittent use of these treatments could be recommended.

Some daily habits can help to reduce the risk of disease onset, although they do not guarantee total prevention. Available treatments can alleviate symptoms and slow its progression. However, it is crucial to consult a healthcare professional if there are any doubts about predispositions or to obtain suitable advice.