Conversation with Patients about Vitiligo

Brett King, MD, PhD: It's a great lead into our next discussion which is patient education and communication. In this section, we're going to touch on issues that we've discussed, but also go more in-depth into some other issues. Heather, can you start us off by talking about quality-of-life issues, and do patients talk about these directly with you? Do you have to address them specifically? What are the key points about living with vitiligo that you communicate with patients about?

Heather Woolery-Lloyd, MD: The most important thing I do is reassure my patients that their feelings are valid because the vast majority of patients with vitiligo tremendously impacts their quality of life. As we've talked about, it impacts their interactions with other people where they're going around their daily lives, interacting with cashiers and with teenagers. I have some young patients with vitiligo. They can be bullied. They can be considered an outcast at school. I have seen that in teenage patients. Teenage patients tend to become introverted because they feel like their vitiligo prevents them from interacting with their friends and their peers and doing all the fun things outside that people do because they're worried about how people will perceive them with vitiligo on their skin. At my practice, I do spend a lot of time reassuring patients that it's OK, their feelings are valid and it's OK to be angry, resentful, sad, and all those feelings associated with vitiligo. Then I do try to focus on the good. I do try to change gears and say, let's jump in headfirst. We're going to work on this together. I do find in vitiligo, it's one of those diseases where it's a team effort and the dermatologist and the patient work together to get their skin better, to see repigmentation. I do change gears once I've truly validated their feelings, but I never rush anyone through talking about how the vitiligo impacts their life because in some ways that's even more important than the physical changes in the skin. We know vitiligo has a tremendous impact on quality of life, equivalent to major diseases like congestive heart failure and asthma and we need to validate those feelings and then talk about the positive and what we can do to get those patients better. It's important to give vitiligo patients who want to have treatment hope. I do try to do that. I never say, oh, there's no treatment for this and you're just going to have to live with this. I do know that some people will tell me they saw other doctors and they basically were told that, and that's devastating to a patient with vitiligo I do always try to offer hope and talk about us treating their vitiligo as a team.

Transcript Edited for Clarity