Certain factors like age, marital status, education level, and disease history influence QOL in patients with vitiligo.

Although vitiligo is not life-threatening, research has suggested it can have a significant impact on QOL for people with the skin condition. Studies have found that vitiligo may contribute to feelings of social anxiety and avoidance, helplessness, and anxious-depressive moods. Other research has shown that patients with vitiligo often experience stigmatization, social isolation, low self-esteem, and deteriorating daily and functional activities.

Little is known, however, about how clinical factors, gender, educational status, age, and the extent of skin lesions are associated with different facets of QOL. To address this research gap, Hui-Ju Yang, MD, and colleagues published a study in the International Journal of Environmental Research & Public Health that investigated the impact of vitiligo on the QOL of a sample of patients residing in Taiwan and sought to identify factors that influence QOL. “We wanted to gain a better understanding of the influence of vitiligo so we can empower dermatologists to provide more comprehensive care for their patients,” Dr. Yang says.

Some Patient Groups Are at Higher Risk for Poor QOL

Findings from the study showed that the QOL was not significantly different between patients with vitiligo and a control group that included individuals with general skin diseases. However, adults with vitiligo experienced deteriorating emotional levels and reductions in total QOL when compared with non-adults (median age, 11 years; range, 2.0-18.0). Married women reported having higher levels of emotional disturbance than unmarried women (Table). The study authors noted this finding contradicts the conventional notion that single people care more about their appearance than married people.

The researchers also observed that a higher educational level and shorter history of disease were associated with greater emotional impacts resulting from vitiligo. In addition, investigators found that patients with a generalized type of vitiligo suffered more than the control group regarding total QOL. “Collectively, our findings suggest that patients with vitiligo who are between the ages of 20 and 39, married females, and highly educated experience more deterioration in their QOL than other individuals with this skin condition,” says Dr. Yang.

Impact of Vitiligo Goes Beyond Skin Deep

According to Dr. Yang, the findings emphasize that patients with vitiligo are only marginally affected by the manifestation of vitiligo-related symptoms. Instead, these patients reported experiencing distinct psychosocial complications more frequently than the control group. “Dermatologic and psychiatric diseases might be closely related,” Dr. Yang says. Stress can play a role in causing dermatologic diseases and increasing the severity of skin symptoms. Conversely, he adds, dermatologic diseases can have a distinct psychological impact and cause certain psychiatric symptoms. It is recommended that clinicians consider the psychological effects of vitiligo to ensure that a complete treatment plan is created and initiated.

The research team noted that the aspects of vitiligo that influenced QOL in the study may not be the same across patient groups. For example, married and unmarried men showed no significant differences in their appearance and worry scores, whereas married women experienced significantly greater impairments in appearance and worry compared with unmarried women. In addition, women who developed vitiligo after marriage reported that the skin condition negatively impacted their marital lives. These differences and others should be further explored in upcoming research involving patients with vitiligo.

Efforts Warranted to Promote Psychological Counseling

In the future, studies are needed to see how risk factors identified in the study lead to deteriorated QOL. Vitiligo is a disease that continues to have a significant impact on a patient’s life quality, especially as the vitiligo areas enlarge and spread to other areas of the body. “To improve QOL and subsequent treatment outcomes, it’s important to keep in mind the psychological toll that vitiligo places on patients when caring for these individuals,” says Dr. Yang. “A complete treatment plan for patients with vitiligo should focus more on psychological counseling than on disease-specific therapies.”