Vitiligo causes growing patches of skin to lose their color. It can also affect the eyes and hair, and can affect people of any age, gender, or ethnic group. There is currently no cure for vitiligo.

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Vitiligo patches appear when melanocytes within the skin die off.

Melanocytes are the cells responsible for producing the skin pigment, melanin, which gives skin its color and protects it from the sun’s UV rays.

Fast facts on vitiligo

Here are some key points about vitiligo.

  • Vitiligo can affect people of any age, gender, or ethnicity.
  • There is no cure, and it is usually a lifelong condition.
  • The exact cause is unknown, but it may be due to an autoimmune disorder or a virus.
  • Vitiligo is not contagious.
  • Treatment options may include exposure to UVA or UVB light and depigmentation of the skin in severe cases.

Vitiligo is a skin condition in which patches of skin lose their color.

The total area of skin that can be affected by vitiligo varies between individuals. It can also affect the eyes, the inside of the mouth, and the hair. In most cases, the affected areas remain discolored for the rest of the person’s life.

The condition is photosensitive, which means affected areas will be more sensitive to sunlight than those that are not.

It is hard to predict whether the patches will spread and how much. The spread might take weeks, or the patches remain stable for months or years.

The lighter patches tend to be more visible in people with darker or more tanned skin.

The only 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 exposed to the sun.

It starts as a simple spot, a little paler than the rest of the skin, but as time passes, this spot becomes paler until it turns white.

The patches are usually irregular in shape. The edges can sometimes be inflamed with a red tone visible on all skin tones, sometimes resulting in itchiness.

Typically, however, it does not cause any discomfort, irritation, soreness, or dryness in the skin.

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.

What causes vitiligo is unknown, but there are a few theories about its etiology.

Some possible causes include:

  • genetics: an estimated 20% of those diagnosed with vitiligo have a first degree relative with the condition, according to a review
  • 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: such as emotional distress, sunburn, or chemical exposure

The American Academy of Dermatology (AAD) 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.

Using sunscreen

The AAD recommends using sunscreen because the lighter patches of skin are especially sensitive to sunlight, and they can burn quickly. A dermatologist can advise on a suitable type.

Phototherapy with UVB light

Exposure to ultraviolet B (UVB) lamps is a common treatment option. However, home treatment requires a small lamp and usually requires daily use, which is more effective.

If a person goes to a clinic for treatment, they will need two to three visits a week, and the treatment time will be longer.

If there are white spots across large body areas, UVB phototherapy may help but involves full-body treatment in a hospital.

UVB phototherapy, combined with other treatments, can positively affect vitiligo. However, the result is not predictable, and there is still no treatment that will fully re-pigment the skin.

Phototherapy with UVA light

Done in a healthcare setting, UVA treatment involves patients taking a drug that increases their skin’s sensitivity to UV light. Then, in a series of treatments, the affected skin is exposed to high doses of UVA light.

According to a 2017 meta-analysis, progress will be evident after 6 to 12 months of therapy.

Skin camouflage

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 should select tones that best match their own skin tone.

Depigmenting

Depigmentation can be an option when the affected area is widespread, covering more than half of the body or more, and works by reducing the skin color in unaffected parts to match the whiter areas.

Depigmentation involves applying strong topical lotions or ointments, such as monobenzone, mequinol, or hydroquinone.

The treatment is permanent, but it can make the skin more fragile. In addition, extended exposure to the sun must be avoided. Depigmentation can take 12 to 14 months, depending on the depth of the original skin tone.

Topical corticosteroids

Corticosteroid ointments are creams containing steroids. A 2017 review of studies concluded that applying topical corticosteroids to the white patches is a very effective treatment. However, one should never use corticosteroids on the face because of the potential side effects like thinning of the skin, spider veins, and acne lesions.

Calcipotriene (Dovonex)

Calcipotriene is a form of vitamin D used as a topical ointment used with corticosteroids or light treatment. Side effects include itching, redness, and burning.

Drugs affecting the immune system

Ointments containing tacrolimus or pimecrolimus, drugs known as calcineurin inhibitors, can help with smaller patches of depigmentation. However, the United States (U.S.) Food and Drug Administration (FDA) warn of a connection between these drugs and skin cancer and lymphoma.

Psoralen

Psoralen may be used with UVA or UVB light therapy, making the skin more susceptible to UV light. As the skin heals, a more typical coloration sometimes returns. Treatment may need to be repeated two or three times a week for 6 to 12 months.

Psoralen increases the risk of skin damage and skin cancer in the long term. Additionally, the drug is also not recommended for children under ten years old.

Skin grafts

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.

Tattooing

Micropigmentation, or medical tattooing, includes implanting pigment into the skin and can work best around the lips, especially in people with darker skin tones.

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.

Any person can experience vitiligo at any age. However, it usually appears before 20 and often in early childhood.

When a person seeks treatment from a doctor, they will ask about family history and perform 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.

There are two types of vitiligo, non-segmental and segmental.

Non-segmental vitiligo

If the first white patches are symmetrical, this suggests a type of vitiligo known as non-segmental vitiligo. The development will be slower than if the patches are in only one body area.

Non-segmental vitiligo is the more common type.

The patches often appear equally on both sides of the body, with some symmetry measured. In addition, they often appear on the skin commonly exposed to the sun, such as the face, neck, and hands.

Common areas include:

  • backs of the hands
  • arms
  • eyes
  • knees
  • elbows
  • feet
  • mouth
  • armpit and groin
  • nose
  • navel
  • genitals and rectal area

Non-segmental vitiligo breaks down further into sub-categories:

  • generalized: There is no specific area or size of patches.
  • 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.
  • universal: Depigmentation covers most of the body and is very rare.
  • focal: A few scattered white patches develop in a discrete area. It most often occurs in young children.

Segmental vitiligo

Segmental vitiligo spreads more rapidly but is considered more constant, stable, and less erratic than the non-segmental type. According to a 2020 review article, it is much less common and affects only about 5-16% of people with vitiligo.

Furthermore, it most often appears around four to ten years of age and only affects one body area.

Segmental vitiligo usually affects areas of skin attached to nerves arising in the dorsal roots of the spine. It responds well to topical treatments.

A person has a greater change of getting vitiligo if they have a family history of the condition. However, certain autoimmune diseases are linked to an increase in one’s risk. About 15 to 25% percent of those with vitiligo are living with another autoimmune condition.

These could conditions include:

Vitiligo may not develop into other diseases, but people with the condition are more likely to experience:

  • 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, for example, by talking with friends about it and seeking out role models with vitilgo, 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 should ask their dermatologist to recommend someone who can help.

Vitiligo is not fatal, and those with the condition can lead happy and healthy lives.

However, the diagnosis can be challenging for some, especially for self-esteem. 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 go away on its own. Instead, it requires treatment to help manage its symptoms.

Is vitiligo a serious condition?

Vitiligo is not life threatening but can affect one’s quality of life in terms of self-image. Treatment is possible, but may not always result in permanent reversal of symptoms. Learning to live with the condition may be part of the process.

Can anyone get vitiligo?

According to a 2021 study, vitiligo affects an estimated 2% of the worldwide population of all ages, genders, and races.