A tricky question if you have vitiligo
We Brits have a reputation for going a bit bonkers with our #sunbathing whenever we get good weather and, as a result, each mini “heatwave” tends to leave a percentage of the population a tender shade of beetroot. Despite all the health warnings, it seems that the lure of a warm, relaxing sun lounger and the prospect of airing our winter-cocooned flesh for the first time in six or seven months is just too much for some of us to resist and so we throw all caution and common sense to the wind whenever we get the chance.
Having said all that, deciding how much sun exposure is too much is not an exact science, especially as the answer is likely to be different for each person, depending on their age, skin type, whether or not they use an SPF and the strength of the sun in their location on any given day. Then there are other apparently contradictory considerations to take into account, like the fact that sun exposure is good for you because it is a natural mood enhancer, it stimulates healthy blood circulation and it is the body’s main source of vitamin D production, and yet it is bad for you because it causes skin damage and can lead to painful burns or even cancer.
If you then throw into the mix a particular skin condition – like #vitiligo – that involves increased photosensitivity, the question of how much sun is too much becomes even more problematic. Since the #whitepatches caused by vitiligo lack pigment to protect them from UV radiation they are more prone to sunburn than normal skin. Not only that, but the cosmetic and psychological implications of increasing the contrast between the pigmented and depigmented areas of skin by sunbathing are enough to cause most vitiligo sufferers to avoid sun exposure as much as possible. But, on the other hand, many people report improvements in their pigmentation following sun exposure and, of course, UV therapy (especially narrowband UVB) has a well-documented success record in a significant proportion of vitiligo patients.
Sunburn is sometimes cited as a cause of new vitiligo lesions but, as far as I can tell, there is no concrete evidence for this. It seems to me more likely that this is a perception due to the fact that newly formed vitiligo patches are sometimes not clearly visible (except under a Wood’s lamp) until sun exposure has caused the surrounding skin to darken. So, if someone’s vitiligo is spreading, exposing their skin to sunlight will simply highlight what is happening anyway. Another reason for the perception that sunburn can cause vitiligo might be that sunburn often causes the skin to itch and then if the person scratches their skin the trauma can cause new lesions to appear (otherwise known as the Koebner Phenomenon).
In any case, the fact remains that some people find sunlight beneficial and others believe it makes their vitiligo worse. This could be due to a number of different factors. It could be a question of how much sun exposure a person has (too much may be harmful, whereas a moderate amount is helpful). It could be the fact that sunshine consists of a variety of different types of radiation and different people might respond differently to each one. For example, UVA increases oxidative stress, which is now believed by most vitiligo researchers to be a key factor in the development of vitiligo, whereas UVB is known to stimulate the production of new melanin and is used with good results in the treatment of vitiligo. Or it could be because UV exposure only improves vitiligo if the body has sufficient reserves of the raw materials it needs to produce pigment. Some vitiligo sufferers may have just enough of these in their system for sunlight to trigger the mechanism and others may not.
I am certain that regular sun exposure played a part in my repigmentation but only after I had started to supply my body with the nutrients that it needed and, for some reason, was not getting in sufficient quantities from my diet. Without the nutritional programme I put myself on, my experience would still have been that sunshine made my vitiligo worse – because that had always been my previous experience: every summer I used to dread sunny weather because it was then that new white patches became apparent and old ones looked more conspicuous. It was only after supplementing my diet that sunbathing started to trigger the pigmentation process again.
In any event, the conclusion I have reached on the question of sun exposure will probably come as no great surprise: it is a matter of moderation in all things. It seems sensible that the best approach (whether you have vitiligo or not) is to avoid burning your skin since sunburn is uncomfortable, unsightly and potentially carcinogenic. But it also makes sense to get regular, moderate exposure so as to benefit from the health and mood-boosting benefits it delivers, especially if one of those benefits is to wake up dormant pigment and return your white patches to their original colour. So I, for one, am looking forward to soaking up some sunshine this weekend - given half a chance - but I won't be overdoing it!
Here in the UK the May Bank Holiday is upon us. The trees are heavy with blossom, the garden is full of primroses and bluebells and there is definitely more clear sky around than cloud. In fact, we have already had a few days this Spring with temperatures reaching the low 20’s Celsius, which is a veritable heatwave if you live in the north of England! As long as the rain holds off, this long weekend will find many of us out enjoying our gardens, either mowing the lawn, tending the plants or generally lazing about in the welcome heat of the sun (we hope).
My name is Caroline.