Vitiligo: Can it be concealed?

Vitiligo is a depigmenting skin disease, explained by the selective loss of melanocytes, the cells that synthesise melanin. This destruction of melanocytes is visually manifested by the appearance of white patches of varying sizes on the skin. A common misconception is to view vitiligo as a mere aesthetic concern, when in fact, this disease is far from harmless and can have significant impacts on the daily life and psychology of patients. Indeed, several studies have shown that people affected by vitiligo generally have a poorer body image, a lower self-esteem and higher levels of social and psychological distress.

To better manage their condition, which is currently incurable even though there are several relatively effective treatments to halt the progression of vitiligo and repigment certain areas, some patients seek to camouflage their patches, particularly on visible areas such as the face, neck, and hands. For this, it is possible to use highly covering tinted creams, which allow the macules to blend into the natural skin tone. It is often recommended to opt for long-lasting products, robust enough to last throughout the day. Some brands even offer ranges specifically designed for people with vitiligo.

Beyond tinted creams, other patients opt for self-tanning products, particularly for areas such as the hands, which are exposed and difficult to conceal. These products work by colouring the superficial layer of the epidermis and provide a natural colouration, similar to that of melanin, even though their mechanism of action is different from that of tanning and involves the amino acids of the horny layer. Although the application of a self-tanner requires a certain precision to avoid demarcations, this product can be a practical and discreet solution for some patients.

These camouflage techniques for vitiligo are, of course, not a medical treatment, but they meet a fundamental need: that of regaining self-confidence and feeling more comfortable in one's own body.

For many patients, concealing their vitiligo can restore a degree of comfort in social interactions and reduce feelings of embarrassment or stigmatisation, which are unfortunately still often associated with vitiligo. This has been highlighted in certain studies that have evaluated the evolution of the quality of life index, or Dermatology Life Quality Index (DLQI) in English. Ranging from 0 to 20, this index is higher the more significant the impact of a dermatosis on quality of life. The results of two studies are presented below. However, while the first study shows a significant improvement in the DLQI due to the concealment of lesions, this is not the case in the second. This illustrates that the impact of the visible nature of vitiligo on quality of life varies from person to person: some live with their condition with serenity, while for others, it represents a significant burden.