Last Updated on 31st October 2022 by Caroline Haye
So many variables, so little money!
I sometimes wonder whether those of us with vitiligo (an estimated one in 100 of the world’s population) are justified in feeling frustrated about the lack of progress towards a permanent cure. As far as anyone knows, vitiligo has been around for as long as the human race. And yet no remotely reliable treatment has emerged in all that time. How can this possibly be? Well, justified or not, I certainly think a sense of frustration is understandable. After all, most of us – at some time or other – will have uttered the words “Isn’t it wonderful what they can do nowadays!” So why is there still no solution to vitiligo?
The fact is that science and technology have advanced to a point where we actually expect the miraculous. After all, brain surgery, organ transplantation and sex changes are routine. Even cloning and genetic engineering are no longer science fiction but very much science fact. So, how hard can it be to find out what causes a person’s skin to turn white in patches? And how complicated can it be to fix it? Apparently, the answer is “harder and more complicated than you would think!”
Progress is going on behind the scenes. Inch by inch, researchers are making new discoveries about pigment loss (leukoderma) and vitiligo. Theories as to likely causes have evolved and successive, potential treatments have looked “promising”. But, so far, most of the therapies that have emerged fall into categories that are not mainstream. For example, traditional (e.g. herbal or nutritional), conventional (e.g. phototherapy and topical creams) or experimental… When what vitiligo sufferers the world over are waiting for is a brand new category: definitive.
And the best we can say about existing treatments is that they all seem to work… For some of the people… To some extent… Some of the time. So, why is a universal cure so tantalisingly elusive?
The answer, it seems to me, is that – much like cancer research – it involves so many variables. Meaning that the task is not one of finding a single solution to a simple problem. In fact, it’s more like looking for several million solutions to several million different permutations of the problem. (Unfortunately, unlike cancer research, funding is hard to come by, so progress is that much slower.)
To give just a flavour of what I mean, the sum of all the available knowledge I can find to date on the subject of what causes vitiligo points to a genetic component. (i.e. People who have certain mutations to certain genes are more likely to develop vitiligo.) But, aside from this, any one or more of a number of different triggers may then also cause the skin to start losing its colour. These include chemical or environmental sensitivities, allergies, hormonal imbalances, digestive problems, physical trauma and even mental stress. Not only are the triggers many and varied but so, it seems, are the genetics that make some people more susceptible to them than others.
Like many vitiligo sufferers, I had high hopes when researchers back in 2010 identified a gene mutation that increases the risk of vitiligo. (And, interestingly, decreases the risk of skin cancer.) And again in 2013 when the a genetically modified protein looked like it might lead to a cure for vitiligo (and grey hair!). But, it turns out that there are in fact over 30 genetic variations, occurring in different combinations, that can increase the risk of developing vitiligo. I have no doubt whatsoever that scientists are getting closer to success in their hunt for a cure. But these strides forward feel a little like glimpsing one lion in the long grass. Coming up with the universal cure for the condition could well be more like rounding up the whole pride.
