A disputed new treatment could be on the way to the UK to treat vitiligo — the condition that causes skin pigments to change.
The cream, named ruxolitinib (brand name Opzelura), has been dubbed a “miracle cream” by users. This is due to its reported ability to return the skin to its natural colour and remove whitened patches, something which has not been possible before.
But the cream is causing controversy because it can reportedly cause serious side effects. These include seriously depleting a user’s immune system — making them more susceptible to other illnesses.
The cream is also alleged to affect the skin by causing more inflammation in the body, creating conditions the user may not have previously had such as acne and rosacea.
People supporting the body-positivity movement have also questioned whether the cream should even be made available. They claim vitiligo should be celebrated rather than covered or treated.
The new cream is reportedly so strong that it would be available only on a doctor’s prescription — if it is approved.
It is the first and only vitiligo repigmentation treatment approved by the United States Food and Drug Administration (FDA).
The price per tube is approximately $2,000 (£1,660) in the US.
So what is vitiligo, what causes it, are there any other treatments available and famous sufferers?
What is vitiligo?
The NHS defines vitiligo as a condition in which pale white patches develop on the skin and often grow with age.
Vitiligo can affect any area of skin, but it commonly happens on the face, neck and hands, and in skin creases. It can also the inside of the mouth and the genitals.
It can also sometimes develop where there are hair roots, such as on your scalp. The lack of melanin (a substance in your body that produces hair, eye and skin pigmentation) in your skin can turn the hair in the affected area white or grey.
Vitiligo is believed to be an autoimmune condition in which the person’s own body attacks itself, and in this case, targets the skin's pigment. This causes visible whitened patches or blotches that are prone to sun damage.
There are two main types of the condition, the NHS says: non-segmental vitiligo and segmental vitiligo.
In non-segmental vitiligo (also called bilateral or generalised vitiligo), the symptoms often appear on both sides of your body as symmetrical white patches.
In segmental vitiligo (also known as unilateral or localised vitiligo), the white patches affect only one area of your body.
The NHS says segmental vitiligo is less common than non-segmental vitiligo, although it’s more common in children. It usually starts earlier and affects three in 10 children with vitiligo.
Experts say that living with the condition can massively affect a person’s mental health and affect the way they see themselves. People with it can suffer anxiety, depression, low self-esteem and even suicidal thoughts.
What causes vitiligo?
Vitiligo affects all races but is more noticeable in people with skin of colour. It is not infectious or contagious, and is an auto response by the body. Those affected with it cannot control it.
The NHS says vitligo is caused by the lack of a pigment called melanin in the skin. Melanin is produced by skin cells called melanocytes and gives your skin its colour.
In vitiligo, there are not enough working melanocytes to produce enough melanin in your skin. This causes white patches to develop on your skin or hair. It’s not known exactly why the melanocytes disappear from the affected areas of skin.
What are the current treatments available?
Current treatments are limited, which is why the new cream has been hailed as a game-changer.
The NHS says the white patches caused are usually permanent, although treatment options are available to reduce their appearance.
If the patches are relatively small, skin camouflage cream can be used to cover them up.
Steroid creams can also be used on the skin to restore some pigment, the NHS says. However, long-term use can cause stretch marks and thinning of the skin.
If steroid creams do not work, phototherapy (treatment with light) may be used.
Although treatment may help restore colour to your skin, the effect does not usually last. Treatment cannot stop the condition from spreading, the NHS warns.
The BBC reports that the British Association of Dermatologists says that if one treatment worked well for one patient, it might not work for another at all,
Is the new treatment available yet?
It has not been approved yet. Ruxolitinib needs to be approved by the drug regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), to be sold or prescribed in the UK.
The advisory body the National Institute for Health and Care Excellence (NICE) is planning to assess its merits and risks “imminently”. It will also decide whether the cost can be justified for the NHS.
Are there any famous people who have vitiligo?
Yes. Winnie Harlow, a superstar model, has it. She has spoken about her struggles of living with the condition from a young age.
Harlow says she has now embraced having vitiligo rather than trying to hide her patches. However, she admitted she found it “hard” and “isolating” as a child.
She told Cosmopolitan magazine: “I vividly recall being in third grade and trying to befriend two girls who would run away from me because their mothers didn’t want them to ‘catch’ what I had, as if I were contagious.
“It has taught me, from the time I was a little girl, to use it as a megaphone: to be louder, prouder, and always fuelled by passion and love. It’s helped me look beyond my own cover — and everyone else’s, too.”
Love Island 2023 contestant Tanya Manhenga also has spoken about having the condition.
“It’s on my lip and I have a stripe on my hair,” she said. “Not many people know that but I think it’s quite cute. I don’t care about covering it up all the time, I think it’s a vibe.”
