Vitiligo

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is vitiligo?

Vitiligo is a somewhat common condition in which areas of skin lose their pigmentation. This results in white patches. It primarily affects the skin of the face, hands, feet and genitals. The vitiligo skin patches often appear more pronounced in people with darker skin.

Vitiligo is likely an autoimmune disorder in which the immune system attacks the body’s own cells. In this case, it attacks melanocytes, which make the brown coloration in skin. Although anyone can develop vitiligo, it appears to run in some families. Vitiligo can occur at any age.

Vitiligo itself has few physical health complications. However, the appearance of white patches, especially on the face, can be emotionally difficult for many people. Vitiligo is often associated with other autoimmune conditions, such as Graves’ disease and systemic lupus erythematosus.

There are vitiligo treatment options, but most do not significantly change the appearance of the white patches. Makeup can be helpful in covering up the white patches vitiligo causes.

Vitiligo is not a serious medical condition, though it can be associated with a number of autoimmune disorders. Consult your doctor if white patches appear on your skin. White patches from vitiligo are susceptible to sunburn. Seek prompt medical care if you get severe sunburn on any white patches caused by vitiligo.

What are the different types of vitiligo?

There are several types of vitiligo including:

  • Generalized, bilateral or nonsegmental: The patches appear in several places anywhere on the body. It is usually symmetric, affecting corresponding body parts on both sides. The patches usually spread over several months. This is the most common type.

  • Segmental or unilateral: The patches appear in a limited area on one side of the body. They can progress over a couple of years and then stop. This type accounts for about 10% of cases.

  • Focal or localized: The patches are in one small area and do not progress. This type is rare.

  • Acrofacial: The patches appear on the face, hands, and around openings, such as the nose and mouth.

  • Mucosal: The patches affect the mucous membranes of the mouth or genitals.

  • Trichrome: The patches have a colorless center with an area of lighter pigmentation around it, and then normal skin.

  • Universal: The patches cover 80% or more of the skin. This type is rare.

What are the symptoms of vitiligo?

Vitiligo symptoms include the formation of white patches on your skin. The patches can develop slowly or appear suddenly. The skin on and around these patches feels totally normal. Once a white patch appears, it may or may not remain white. The patches usually have irregular borders and occur most often on the face, hands, feet and genitals.

Common symptoms of vitiligo

Common vitiligo symptoms include:

  •  White patches on the skin of your face

  •  White patches on the skin of your genitals

  •  White patches on the skin of your hands or feet

  •  Depigmentation of hair in corresponding affected areas

Symptoms that might indicate a serious condition

Although vitiligo is not a serious condition, in rare cases it may be associated with other, more serious conditions that require immediate evaluation. Seek prompt medical care for serious symptoms including:

What does vitiligo look like?

People with vitiligo develop areas of very light skin due to loss of pigmentation. The patches are more evident in People of Color. Here, a white person with vitiligo on the knees:

vitiligo
Getty

What causes vitiligo?

The exact cause of vitiligo is unclear. It is most likely an autoimmune disorder. It occurs when your own immune system attacks the cells in your skin that make pigment. Vitiligo is not contagious. Some families appear to be more susceptible to vitiligo, suggesting that the condition may have a genetic component.

What are the risk factors for vitiligo?

A number of factors increase the risk of developing vitiligo. Not all people with risk factors will get vitiligo. Risk factors for vitiligo include:

  • Addison’s disease (decreased production of hormones by the adrenal glands)

  • Autoimmune disorders

  • Family history of vitiligo

  • Hyperthyroidism (overactive thyroid)

  • Pernicious anemia (decrease in red blood cells due to poor vitamin B12 absorption)

How do you prevent vitiligo?

Currently, it is not possible to prevent vitiligo since the exact cause is not known.

What are some conditions related to vitiligo?

There are several other conditions that are similar to vitiligo. They cause loss of skin pigmentation. These conditions include:

  • Albinism, a group of genetic disorders that cause a lack of melanin production in the skin, hair and eyes

  • Chemical leukoderma, skin cell damage from exposure to industrial chemicals

  • Pityriasis alba, a skin disorder that causes red, flaky patches that resolve leaving areas of low pigmentation

  • Tinea versicolor, a fungal infection that interferes with normal skin pigmentation

How do doctors diagnose vitiligo?

Vitiligo is usually easy to diagnose by looking at the skin. Your doctor may use a special lamp to look at your skin or take a skin biopsy to rule out other skin conditions. Your doctor may also order blood tests to rule out other causes of skin changes, such as thyroid conditions.

Questions your doctor may ask about your symptoms and medical history include:

  • When did you first notice the patches on your skin?

  • Did you have a sunburn, rash, or other skin problem right before they started?

  • Have you ever had these patches before?

  • Do you have any other symptoms, such as itching?

  • Do you have a personal or family history of autoimmune or thyroid problems?

  • Does anyone in your family have similar skin patches or vitiligo?

  • Do you work with harsh chemicals?

  • What medications do you take?

How is vitiligo treated?

There are treatments that may reduce the progression or decrease the symptoms of vitiligo. They include both medical and surgical approaches, as well as specific medical procedures. Consult with your dermatologist to find out what measures are right for you.

Medical treatments for vitiligo

Medical treatments may improve the look of the white patches of vitiligo including:

  • Corticosteroids, usually in the form of a cream you apply to the skin

  • Creams or ointments that locally inhibit the immune system, such as pimecrolimus (Elidel)

  • Sunscreens to prevent further skin damage

  • Topical drugs that change the way your skin is affected by ultraviolet (UV) light, such as methoxsalen (Oxsoralen)

Surgical and procedural treatments for vitiligo

Procedures and surgery may improve skin appearance including:

  • Depigmentation, which lightens remaining skin to blend the white patches and make them less noticeable. Treatment can take nine months or longer. 

  • Micropigmentation, which is a type of tattooing that can improve the look of patches on the lips

  • Phototherapy, which is a common treatment to improve the look of white patches. UV rays are carefully aimed at white patches to help darken the skin naturally. Doctors often use phototherapy along with the topical drug methoxsalen (Oxsoralen), which changes the way your skin reacts to the phototherapy.

  • Skin grafts, which use small pieces of skin with normal pigmentation to replace small depigmented patches. Skin grafts can be effective in improving the look of vitiligo, but any surgical procedure carries serious risk. You should be aware that skin grafts can fail or lead to scarring, and complications from the surgery and anesthesia can be serious.

Home remedies for vitiligo

Some people use makeup to hide lesions. Special skin dye and cover-up creams can achieve good results.

How does vitiligo affect quality of life?

Vitiligo is not a serious condition from a medical standpoint. However, the disease can take a toll on a person’s mental and emotional health. In that sense, it is a life-altering disease that can decrease your quality of life. This is especially true when appearance is important.

In up to 20% of cases, people with vitiligo will regain their full skin pigmentation. This is most likely in younger people with vitiligo on the face that peaks at six months. Older people who get vitiligo on their lips and hands are least likely to regain full skin color.

What are the potential complications of vitiligo?

Vitiligo does not have any specific medical complications other than increased susceptibility to sunburn on the areas of light skin. Use of sunscreen is important to avoid the complications of excessive UV exposure. White patches, especially in darker-skinned people or on the face, may cause embarrassment or problems with self-esteem and social isolation.

Talk with a dermatologist to find out about measures that can reduce the cosmetic or emotional complications of vitiligo.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Nov 19
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  2. Vitiligo. American Academy of Dermatology. https://www.aad.org/public/diseases/a-z/vitiligo-overview 
  3. Vitiligo. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/12419-vitiligo 
  4. Vitiligo. Genetics Home Reference. https://medlineplus.gov/genetics/condition/vitiligo/ 
  5. Vitiligo. Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/vitiligo/symptoms-causes/syc-20355912 
  6. Vitiligo. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/vitiligo#tab-diagnosis