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Vitiligo is a condition where the cells that produce melanin, the pigment responsible for the color of the skin, are destroyed. This results in patches of lighter skin or depigmentation. The exact cause of vitiligo is not fully understood, but it's believed to involve a combination of genetic, autoimmune, and environmental factors.

When vitiligo appears on the hands or other areas of the skin, it typically starts as small, pale patches that gradually expand over time. The progression of vitiligo can vary from person to person, with some experiencing slow and steady spread, while others may have periods of rapid expansion followed by stability.

The spreading of vitiligo over the years can occur due to the continued destruction of melanocytes in the affected areas. Factors such as stress, trauma to the skin, and exposure to certain chemicals or environmental triggers may exacerbate the condition and contribute to its progression.

Treatment options for vitiligo aim to halt the spread of depigmentation and restore color to the affected areas. These may include topical corticosteroids, phototherapy, depigmentation therapies, and surgical interventions. However, the effectiveness of treatment can vary, and not all cases respond equally well. It's essential for individuals with vitiligo to work closely with dermatologists to develop a management plan tailored to their specific needs.