Vitiligo causes patches of skin to lose their color. It can also affect the eyes and hair. People of any age, sex, and ethnicity can develop it. Vitiligo patches are more sensitive to sunlight.
Vitiligo patches appear when melanocytes within the skin are destroyed.
Melanocytes are the cells responsible for producing melanin. Melanin gives skin its color and protects it from the sun’s ultraviolet (UV) rays.
Fast facts on vitiligo
Here are some key points about vitiligo:
- Vitiligo can affect people of any age, sex, and ethnicity.
- There is no cure, and it is usually a lifelong condition.
- Vitiligo is an autoimmune disease.
- Vitiligo is not contagious.
- Treatment options may include exposure to special UV light wavelengths and medications to restore color and slow the development of new depigmented patches.
Vitiligo is a skin condition in which patches of skin lose their color.
The total area of skin that vitiligo affects varies between individuals. It can also affect the eyes, the inside of the mouth, and the hair. In some cases, affected areas may remain discolored for the rest of the person’s life. Others may experience spontaneous re-pigmentation.
The condition is photosensitive. This means affected areas are more sensitive to sunlight than unaffected areas.
It is hard to predict whether the patches will spread and how much. The spread might take weeks, or the patches may remain stable for months or years.
According to the American Academy of Dermatology, there are multiple types of vitiligo depending on the appearance of the patches, how much of the body they cover, and how they spread.
These types can include:
A doctor may diagnose localized vitiligo if only a few patches cover a small area. These patches may develop in a few places on the body.
If a person develops patches on both sides of the body, this suggests a type of vitiligo known as nonsegmental vitiligo. Its development is slower than if the patches are in only one body area.
The patches often appear equally on both sides of the body, with some symmetry. In addition, they often appear on the skin commonly exposed to the sun, such as the face, neck, and hands.
Nonsegmental vitiligo is the
Some researchers consider the following types of vitiligo as
- Acrofacial: This occurs mainly on the face, on the scalp, around the genitals, and on the fingers or toes.
- Mucosal: This appears mostly around the mucous membranes and lips.
- Generalized: In generalized vitiligo, there is no specific area or size of patches. This type causes scattered patches on different areas of the body.
- Universal: In this rare type of vitiligo, depigmentation covers most of the body.
- Mixed: This type of vitiligo is also rare. It can cause a person to have both segmental and nonsegmental vitiligo.
- Rare variants: This includes other rare variations of vitiligo.
Segmental vitiligo can cause
According to a 2020 review article, segmental vitiligo is less common and affects only about 5–16% of people with vitiligo.
Furthermore, it most often appears at a younger age than nonsegmental vitiligo and only affects one body area, such as one leg, one side of the face, or one arm.
Segmental vitiligo usually affects areas of skin attached to nerves arising in the dorsal roots of the spine. Conventional vitiligo treatments, such as topical steroids and phototherapy, may not work for this type.
The characteristic symptom of vitiligo is the appearance of flat lighter-colored spots or patches on the skin. The first white spot that becomes noticeable is often an area of a sunburn or minor injury.
It may start as a simple spot, a little paler than the rest of the skin, but as time passes, it becomes paler until it turns white.
The patches vary in shape and size. The edges can sometimes be inflamed, sometimes resulting in itchiness.
Typically, however, it does not cause any discomfort, irritation, soreness, or dryness in the skin, though it typically is more prone to sunburn.
The effects of vitiligo vary between people. For example, some people may have only a handful of white dots that develop no further, while others develop larger white patches that join together and affect more significant areas of skin.
Some people may also experience hearing loss, loss of eye pigmentation, and other autoimmune disease, such as thyroid disease.
Any person can develop vitiligo at any age. However, it
When a person seeks medical treatment, a doctor typically asks about family history and performs a physical exam, especially on the skin.
A doctor may also use a black light, an ultraviolet light shined on the skin, to help identify depigmented skin that appears chalky under the light.
The American Academy of Dermatology describes vitiligo as “more than a cosmetic problem.” It is a health issue that needs medical attention.
Several remedies can help decrease the visibility of the condition, though some people may not want to treat the condition at all.
The American Academy of Dermatology recommends using sunscreen to protect the skin. The lighter patches of skin are especially sensitive to sunlight, and they can burn quickly. A dermatologist can advise on a suitable type of sunscreen.
Phototherapy with UVB light
If a person goes to a clinic for treatment, a healthcare professional may recommend two to three visits per week.
If there are white spots across large body areas, UVB phototherapy may help. It involves full-body treatment in an office setting.
UVB phototherapy, combined with other treatments, can positively affect vitiligo. However, the result is not predictable, and there is still no treatment to fully re-pigment the skin.
Phototherapy with UVA light
Done in a healthcare setting, UVA treatment involves people taking a drug that increases their skin’s sensitivity to UV light. Then, in a series of treatments, a qualified healthcare professional exposes the affected skin to prescribed doses of UVA light.
According to a 2017 meta-analysis, progress is typically evident after
While many people feel comfortable or enjoy how vitiligo looks, it may not be comfortable for everyone with the condition.
In cases of mild vitiligo, a person can camouflage the white patches with colored cosmetic creams and makeup. They can select tones that best match their skin tone.
Corticosteroid ointments are creams containing steroids. A
Corticosteroids should be used with caution on the face and only under the guidance of a physician because of potential side effects, such as:
Calcipotriene is a form of vitamin D used in topical therapy, often in combination with corticosteroids or phototherapy. Side effects may include:
Drugs affecting the immune system
The topical medications tacrolimus and pimecrolimus are drugs known as calcineurin inhibitors. They may help with smaller patches of depigmentation.
However, pimecrolimus contains a boxed warning from the Food and Drug Administration (FDA) about rare cases of malignancy, such as skin cancer and lymphoma, reported in people treated with calcineurin inhibitors.
In a skin graft, a surgeon carefully removes healthy patches of pigmented skin and uses them to cover affected areas.
This procedure is not very common because it takes time and can result in scarring in the area.
Blister grafting involves producing a blister on more typical skin using suction. The top of the blister is then removed and placed on an area where the pigment was lost.
Drawbacks can include difficulty matching the color of skin and the fact that tattoos fade but do not tan. Sometimes, skin damage caused by tattooing can trigger another patch of vitiligo.
Depigmentation can be an option when the affected area is widespread, covering half of the body or more. It works by reducing the skin color in unaffected parts to match the whiter areas better.
Depigmentation involves applying strong topical lotions or ointments, such as monobenzyl ether of hydroquinone (MBEH), 4-methoxyphenol, and phenol.
The treatment is permanent, but it can make the skin more fragile. In addition, people must avoid extended exposure to the sun. Depigmentation can take 1–4 years depending on the depth of the original skin tone.
Opzelura is a topical Janus kinase (JAK) inhibitor. It’s the only medication approved by the FDA to restore lost pigment in people with vitiligo. It can treat a small area of the body in people 12 years and older with nonsegmental vitiligo.
What causes vitiligo
Some possible causes include:
- Genetics: An estimated 20% of people with vitiligo have a first degree relative with the condition.
- Autoimmune response: The body’s immune system attacks and kills melanocytes.
- Oxidative stress: When people have an imbalance of oxygen molecules and antioxidants, it may lead to vitiligo.
- Environmental factors: Emotional distress, sunburn, or chemical exposure may lead to vitiligo.
A person has a greater chance of getting vitiligo if they have a family history of the condition. However, certain autoimmune diseases are linked to an increased risk. About 15–25% of people with vitiligo have another autoimmune condition.
These other autoimmune conditions include:
Vitiligo may not develop into other diseases, but people with the condition are
- painful sunburn
- hearing loss
- changes to vision and tear production, such as iritis
- social stigmatization and mental stress
- increased risk of skin cancer
Most people with vitiligo do not have these conditions, but a doctor may do tests to rule them out.
Overcoming social challenges
If the skin patches are visible, the social stigma of vitiligo can make it more challenging to cope. Embarrassment can lead to problems with self-esteem, and in some cases, anxiety and depression can result.
Increasing awareness about vitiligo, such as by talking with friends about it and seeking role models with vitiligo, can help people with the condition overcome these difficulties. Connecting with others who have vitiligo may also help.
Anyone with this condition who experiences symptoms of anxiety and depression can ask their dermatologist to recommend a mental health professional.
Vitiligo is not fatal. People with this condition can lead happy and healthy lives.
However, the diagnosis can be emotionally challenging for some people. Some develop a concern about their appearance, especially as it grows to larger areas of the skin, which can affect one’s quality of life.
People can also develop secondary conditions, such as inflammation in the ear or eyes.
Can vitiligo go away on its own?
Vitiligo will not typically go away on its own, but some people may experience periods of inactivity or remission. People may choose
Is vitiligo a serious condition?
Vitiligo is not life threatening but can affect one’s quality of life regarding self-image. Treatment is possible but may not always result in permanent reversal of symptoms. Mental health care may be a part of condition management for some people.
Can anyone get vitiligo?