There is an autoimmune link between certain types of vitiligo and autoimmune thyroid disease. However, the exact basis of this connection is unclear.
People with a specific type of vitiligo are more likely to have autoimmune thyroid disease (AITD) than the rest of the population. This may be because they have similar underlying mechanisms.
This article explores vitiligo and thyroid disease, their potential link, connections to other autoimmune conditions, and some frequently asked questions.
Yes – but only in certain types of vitiligo. There are four main types of vitiligo, each with different presentations:
- Segmental: Segmental vitiligo only appears in one area of the body. This type of vitiligo often starts early, progressing for a few years before stopping.
- Nonsegmental: This appears on opposite sides of the body. The patches are symmetrical to each other. This type of vitiligo often starts later in life and can continue to progress over time.
- Mixed: In this rare vitiligo type, people experience segmental vitiligo and additional color loss in other places.
- Unclassified: In unclassified vitiligo, people experience isolated areas of skin discoloration that do not fit into the above classifications.
Non-segmental vitiligo is the most common subtype, and doctors believe it is an autoimmune condition. Similarly, some types of thyroid disease are autoimmune conditions. This includes Hashimoto’s thyroiditis and Graves’ disease.
The autoimmune connection
Scientists know that non-segmental vitiligo and AITD are a product of autoimmunity, and they somehow link together. However, they do not yet know the exact mechanism behind this.
One theory is that genetics link the two. Research has identified
More research on the connection is necessary to understand it fully.
Estimates for the prevalence of vitiligo and AITD occurring together vary. Still, research shows that if someone has one of the conditions, they are more likely to have the other.
A 2016 study found that 20% of participants with vitiligo had an autoimmune disease. The most common of these was thyroid disease, at 12.9%.
Results from a 2019 review found that, among people with vitiligo, the most common thyroid diseases were:
Both vitiligo and AITD have links with other autoimmune diseases. Vitiligo is associated with:
Scientists are still learning why having one autoimmune disease raises the risk of having another.
Vitiligo and thyroid disorders have different methods of diagnosis.
To diagnose vitiligo, a doctor will examine the skin. The doctor may ask about:
- family history
- skin sensitivity
- changes in pigmentation
Thyroid disorders can be more difficult to diagnose based on symptoms alone. Instead, doctors use diagnostic tests, such as:
- thyroid antibody tests
- thyroid stimulating hormone (TSH) tests
- medical imaging to see the thyroid gland
- free T3 and T4 tests
Sometimes, a physical examination can also reveal if the thyroid is swollen or inflamed.
While both vitiligo and AITD are long-term conditions that may have similar underlying mechanisms, the treatment for each is different. For vitiligo, the options include:
- topical corticosteroids
- topical immunosuppressants, which suppress immune system activity in a small area
- oral immunosuppressants, which suppress the entire immune system
- skin grafts to even out pigmentation
For AITD, the main treatment is levothyroxine, which replaces lost thyroid hormones.
In some cases, doctors may prescribe drugs that suppress the immune system for AITD. This can happen if thyroid disease starts to affect a person’s eyes, which typically occurs in Graves’ disease. If this happens, a doctor may prescribe high dose steroids or immunomodulating drugs.
Some may wonder if these drugs could help treat both conditions simultaneously. However, there is currently no evidence to support this approach.
Additionally, immunomodulating drugs have serious side effects. They affect the immune system, reducing a person’s defense against infections. This can be dangerous.
Doctors will likely try other treatments before prescribing immunosuppressants.
Below are frequently asked questions relating to thyroid disease and vitiligo.
No. While thyroid disease and other autoimmune disorders can be more common in people with vitiligo, it is not a certainty that everyone with vitiligo will develop them.
Can thyroid disease also cause changes in skin?
Yes. Hypothyroidism can cause the skin to become dry, paler than usual, cold, and scaly. Hair may also become dry and break easily. Hyperthyroidism may cause skin to become smooth, flushed, or moist and hair to grow thinner and softer.
The main treatment for thyroid disease is replacing thyroid hormone to reduce the symptoms. While this may help with skin symptoms related to thyroid disease, it will not impact vitiligo.
Research suggests that there is a link between vitiligo and thyroid disease. Many people with vitiligo also have thyroid disease, and autoimmunity can play a role in both conditions. However, researchers are still trying to understand the relationship.
Despite this potential link, vitiligo and thyroid disease have different methods for diagnosis and treatment. It is also important to note that while vitiligo is not dangerous, thyroid disease can become serious if a person does not seek treatment.
A person should speak with a doctor about any concerns or questions about vitiligo and thyroid disease.