Table of Contents
Introduction
Living with a skin condition like vitiligo is concerning because it affects the sensitive areas of the skin, such as the genitals. However, vitiligo can affect any area of the body, such as inside the mouth, penis, scrotum, vulva, and vagina. The condition is not a sexually transmitted infection, and it cannot be spread from one person to another. Genital vitiligo is characterized by skin discoloration in the affected area, such as the genital area. It occurs when the cells that produce skin pigment called melanocytes stop working or die, forming white or light patches on the skin. Although it is a challenging situation, the support from the healthcare provider, counselors, and support groups can help individuals cope with the condition.
What Is Vitiligo?
Vitiligo is an autoimmune chronic skin condition that affects the skin. The immune system protects the body from infections. In vitiligo, the immune system mistakes the body cells and tissues as foreign invaders and attacks them. White patches and patches of depigmented skin characterize the condition. It causes the skin to lose melanin, providing natural color to the skin and hair. So, when the face, mouth, neck, and genital area lose melanin, they become light in color. The types of vitiligo are as follows:
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Non-Segmental Vitiligo: Also called generalized vitiligo, this condition affects all over the body. It is the common form of the condition, causing symmetrical depigmentation patches on both sides of the body.
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Segmental Vitiligo: It is the less common type that affects one side of the body. The depigmentation patches are smaller and affect a limited area.
What Is Genital Vitiligo?
People with vitiligo can experience depigmentation patches anywhere on the body. Depigmentation patches are the white patches that affect the mucous membranes of the genitals. It affects the genital area of both males and females. The common affecting area includes the penis, scrotum, vagina, and vulva.
Vaginal or vulvar vitiligo is an autoimmune skin condition in which a female experiences white patches of skin on the external genitalia (labia or vulva) or inside the vagina. The condition may affect a female in childhood or adulthood. In children, it is also called figure eight disease because of the distribution of white patches along the vulva and around the anus. Sometimes, vaginal vitiligo can be misdiagnosed as lichen sclerosus (the chronic inflammatory skin condition causing white itchy patches on the external genitalia).
Penile vitiligo appears on the foreskin (skin covering the penis head) and shaft (longest part of the penis). There is a formation of white patches that appear from the foreskin to the scrotum. It progresses with time and may affect larger skin areas.
What Are the Causes of Genital Vitiligo?
1. Genital Vitiligo in Women: Several autoimmune disorders increase the chances of developing vitiligo. Around 25 percent of people with vitiligo have at least one autoimmune disorder. The inflammation may induce the immune system to attack other cells and tissues, such as melanocytes. Some researchers found that women are up to four times as likely to have an autoimmune disease. The condition also runs in families; if an individual has a close family member with this skin condition, they are more likely to have it. The examples of autoimmune disorders that are associated with genital vitiligo are as follows:
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Type 1 diabetes (affects the production of insulin).
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Thyroid disease.
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Crohn’s disease (an inflammatory bowel disease).
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Rheumatoid arthritis (joint inflammation).
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Psoriasis (chronic inflammatory skin disorder).
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Systemic lupus erythematosus (autoimmune disorder affecting multiple organs).
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Pernicious anemia (affects vitamin B12 absorption).
2. Genital Vitiligo in Men: The main reasons behind the stoppage of melanin production in certain areas are stress, genetic factors, and autoimmune conditions. Autoimmune conditions in which the immune system attacks healthy cells. Suppose an individual suffers from autoimmune conditions, such as lupus (which affects multiple organs) or Hashimoto thyroiditis (which affects the thyroid). In that case, they have a higher chance of developing vitiligo. In addition, an individual with a family history of vitiligo is more likely to develop the condition.
What Are the Signs and Symptoms of Genital Vitiligo?
The signs and symptoms of genital vitiligo are as follows:
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White Patches: The most common symptom is the appearance of white or light-colored patches on the genital area.
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Skin Discoloration: The loss of melanocytes causes skin color loss or discoloration.
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Itching and Discomfort: Some researchers found that men may experience mild itching and discomfort in the affected area. However, the person experiences only one symptom, such as skin discoloration.
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Psychological Impact: The condition may cause emotional and psychological distress. Sexual health concerns may affect self-esteem and relationships.
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Self-Esteem and Intimacy: The condition is linked to self-consciousness, depression, and social stigma. It can also cause difficulty with intimacy. Some people may feel embarrassed to talk about their condition to their partners. They may also wonder if the condition may be contagious. Stress can cause sexual dysfunction, such as a decrease in sexual arousal and difficulty reaching orgasm.
How Is Genital Vitiligo Diagnosed?
Genital vitiligo can be diagnosed during a thorough physical examination. The healthcare provider may check the associated symptoms. Furthermore, the doctor may take a small skin sample from the genital area and check it under a microscope. This is called biopsy. Biopsy is done to differentiate genital vitiligo from other inflammatory skin conditions.
What Is the Treatment for Genital Vitiligo?
Genital vitiligo does not affect an individual's health, so there is no need for treatment. However, some treatment options may reduce the appearance of genital vitiligo. The treatment options are as follows:
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Topical Treatment: The skin over the genital area is sensitive and thin. It can be easily irritated. The healthcare provider may prescribe anti-inflammatory corticosteroid cream and other topical medications, such as Tacrolimus. Prolonged use of topical medications can cause skin irritation and skin thinning. In addition, topical Calcineurin inhibitors are recommended for the genital area to help with skin repigmentation. The common side effect associated with the medication is a burning sensation. Furthermore, topical Janus Kinase (J and K) inhibitors control skin inflammation. The first topical treatment for managing the condition is using Ruxolitinib cream.
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Phototherapy: It is also called light therapy. It slows down or reduces the condition's progression by stimulating melanocytes to produce more melanin. The doctor uses narrow-band ultraviolet light B (UV-B) light to treat genital vitiligo.
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Surgery: If the above treatments are ineffective, the healthcare provider may suggest surgical management. The surgeon may take a small piece of skin from the other area of the body and graft it into the affected area.
What Are the Tips for Intimacy With Genital Vitiligo?
The tips for intimacy with genital vitiligo are as follows:
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Open and honest communication with the partner.
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The person may talk to the healthcare provider about relationships and self-esteem.
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The person should contact a mental healthcare professional.
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Join support groups.
Conclusion
Genital vitiligo is a chronic inflammatory skin condition that causes white patches or skin discoloration in the genital area. Many people may experience self-consciousness and face challenges with self-esteem and intimacy. Treatment options include topical medications, phototherapy, and surgery. If an individual experiences any white patches in the genital area, they should consult with a dermatologist.
