Real-World Impact of Vitiligo

Amit G. Pandya, MD, FAAD: Even though vitiligo doesn’t seem to affect internal organs, except the thyroid gland, it can have profound psychological implications. I tell patients that inside they’re normal; they must have their thyroid checked once a year with a TSH [thyrotropin] check, which is important, but otherwise their heart, lungs, kidneys, liver are normal. However, vitiligo can have a profound effect on patients’ psychological well-being. It can affect their careers; many patients don’t want careers in which they’re in the public eye and are giving presentations, because they say that people look at their vitiligo and are not listening to them. It can have a profound social impact in terms of their relationships with friends or intimate relationships. They may be reluctant to form these relationships because of their vitiligo. It can cause various psychological disorders, anxiety, depression, even suicidal ideation in many patients, and body dysmorphic disorder. There are many psychological comorbidities that have been found and published about in patients with vitiligo.

It can have an economic impact as these patients often have a high burden of disease in terms of treatment. They need to go sometimes 3 times a week to the doctor’s office, there are a lot of expenses with that. Purchasing medications for their vitiligo can have an economic burden, and they may be afraid to even seek a job because they’re concerned about the way they look and how people will treat them. There are many psychological implications that patients have with vitiligo, and we as clinicians must keep this in mind when we’re evaluating patients.

Transcript Edited for Clarity