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Vitiligo Nursing Guide

The content was created Tiffany Fields, RN, BSN, MSN, DNP, CRNP.

Overview: Vitiligo

This course is intended as a Quick Reference for Vitiligo and will provide an overview and nursing considerations utilizing the nursing process. 

Vitiligo Etiology and Epidemiology 

Vitiligo is categorized as a chronic skin condition that causes skin to lose pigmentation. This occurs when melanocytes are attacked and destroyed leaving the skin with light colored patches. There are two types of vitiligo: 

  • Nonsegmental, which is the most common type. Nonsegmental vitiligo happens when the light-colored patches appear symmetrically on both hemisphere of the body. The most common sites are the bilateral hands and knees. This type of nonsegmental vitiligo can occur rapidly, causing a large area of the body to be affected. 
  • Segmental is less common and occurs when only one hemisphere of the body is affected by loss of pigmentation. The most common sites are one side of face, leg, or arm. Segmental vitiligo usually occurs at an early age and progresses for about two years before it usually ceases. The cause of vitiligo is unknown, but research revealed that it can be an autoimmune disease, which will attack the healthy tissues of the body mistakenly causing conditions to develop (Lee et al., 2019). 

Vitiligo Diagnosis 

To diagnose for vitiligo providers should: 

  • Ask about family history. 
  • Perform a thorough physical exam. 
  • Perform diagnostic testing: 
    • Blood work to check for autoimmune diseases 
    • Eye exam to check for uveitis (caused by vitiligo) 
    • Skin biopsy to examine for missing melanocytes 

Vitiligo Management 

The primary focus for vitiligo is stopping the immune system from destroying the melanocytes to improve the skin’s appearance. The goals of treatment are to: 

  • Slow down the disease from progressing. 
  • Promote the regrowth of melanocytes. 
  • Improve the color of the skin to even out the skin tone. 

Treatments for vitiligo can include: 

  • Medicated creams such as corticosteroids 
  • Phototherapy light 
  • Removal of color from the dark areas to match the white areas 
  • Surgical techniques such as skin grafts or blister grafts 

Vitiligo Nursing Care Plan

Nursing Considerations 

Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnosis, interventions, expected outcomes, and education for individuals with vitiligo are listed below. 

Vitiligo Assessment 

Signs and symptoms: 

  • Skin with milky-white patches, usually on hands, feet, arms, and face 
  • Hair, which loses the pigmentation in the white areas, such as scalp, eyelashes, eyebrow, and beard 
  • Mucous membranes, such as the palate of the mouth and nose with skin changes 
  • Ear infection 
  • Uveitis, swelling of the eye 

Nursing Diagnosis/Risk For 

Interventions 

  • Educate patients on vitiligo. 
  • Allow time for patients to voice concerns. 
  • Monitor for signs and symptoms of: 
    • Infection 
    • Depression 
    • Suicide 
    • Skin changes 

Expected Outcomes 

  • Slow disease progression 
  • Regrowth of melanocytes 
  • Improved color of the skin 

Individual/Caregiver Education 

  • Use sunscreen and wear clothes to protect the skin when exposed to the sun. 
  • Use cosmetic lotions or dye recommended by the provider. 
  • Learn about vitiligo treatments to ensure the right decision is made. 
  • Consider finding a vitiligo support group. 
  • Reach out to families and friends for support. 

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Additional Information

Content Release Date

4/1/2022

Content Expiration

12/31/2028

Course Contributor 

The content for this course was created by Relias staff writer Tiffany Fields, RN, BSN, MSN, DNP, CRNP. Tiffany has been a clinical nurse for over 20 years. She was educated and trained as a Licensed Practical Nurse in Alabama, where she practiced as a Gerontological Nurse at the local Nursing Homes. She earned her Associate, Bachelor’s and Master’s degrees in Nursing and a Doctorate in Nursing Practice. She also as a Certified Family Nurse Practitioner degree. Her clinical expertise is Adult-Geriatric Nursing and Medical-Surgical medical complexity. She is currently Assistant Director of Nursing at a Rural Hospital as well as a writer for Relias. 

Resources 

References 

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