Vitiligo

Picture of Vitiligo on Back

Vitiligo facts* medically edited by Melissa Conrad Stöppler, MD

• Vitiligo is a disease in which the pigment cells of the skin, melanocytes, are destroyed in certain areas.
• Symptoms and signs of vitiligo include loss of skin color in the form of depigmented, or white, patches of skin in any location on the body.
• Vitiligo can be focal and localized to one area, or it may affect several different areas on the body.
• The exact cause of vitiligo is unknown, although most experts believe that it is an autoimmune condition in which the body's immune system mistakenly attacks and destroys certain cells within the body.
• Most people who have vitiligo will develop the condition prior to age 40; about half develop it before age 20.
• Vitiligo may have a genetic component, as the condition tends to run in families.
• Vitiligo is sometimes associated with other medical conditions, including thyroid dysfunction.
• There is no way to determine if vitiligo will spread or remain confined to one location.
• Vitiligo is not painful and does not have significant health consequences; however, it can have emotional and psychological consequences.
• Some medical treatments can reduce the severity of the condition, but it can be difficult to cure.
• There is no known way to prevent vitiligo.
• There are no proven home remedies to cure vitiligo, but the use of sunscreens as well as makeup or dyes to cover the light areas of skin may improve appearance.

Vitiligo (vit-ill-EYE-go) is a disorder in which white patches of skin appear on different parts of the body. This happens because the cells that make pigment (color) in the skin are destroyed. These cells are called melanocytes (ma-LAN-o-sites). Vitiligo can also affect the mucous membranes (such as the tissue inside the mouth and nose) and the eye.

The cause is not known. Vitiligo may be an autoimmune disease. These diseases happen when your immune system mistakenly attacks some part of your own body. In vitiligo, the immune system may destroy the melanocytes in the skin. It is also possible that one or more genes may make a person more likely to get the disorder.

Some researchers think that the melanocytes destroy themselves. Others think that a single event such as sunburn or emotional distress can cause vitiligo. But these events have not been proven to cause vitiligo.

• Many people develop it in their twenties, but it can occur at any age.
• The disorder affects all races and both sexes equally, however, it is more noticeable in people with dark skin.
• People with certain autoimmune diseases (such as hyperthyroidism) are more likely to get vitiligo than people who don't have any autoimmune diseases. Scientists do not know why vitiligo is connected with these diseases. However, most people with vitiligo have no other autoimmune disease.
• Vitiligo may also run in families.
• Children whose parents have the disorder are more likely to develop vitiligo. However, most children will not get vitiligo even if a parent has it.

White patches on the skin are the main sign of vitiligo. These patches are more common in areas where the skin is exposed to the sun. The patches may be on the hands, feet, arms, face, and lips. Other common areas for white patches are:

• The armpits and groin (where the leg meets the body)
• Around the mouth
• Eyes
• Nostrils
• Navel
• Genitals
• Rectal areas.

People with vitiligo often have hair that turns gray early. Those with dark skin may notice a loss of color inside their mouths.

There is no way to tell if vitiligo will spread. For some people, the white patches do not spread. But often the white patches will spread to other areas of the body. For some people, vitiligo spreads slowly, over many years. For other people, spreading occurs quickly. Some people have reported more white patches after physical or emotional stress.

The doctor will use a family and medical history, physical exam, and tests to diagnose vitiligo. The doctor may ask questions such as:

• Do you have family members with vitiligo?
• Do you or family members have any autoimmune diseases?
• Did you have a rash, sunburn, or other skin problem before the white patches appeared?
• Did you have some type of stress or physical illness?
• Did your hair turn gray before age 35?
• Are you sensitive to the sun?

The doctor will do a physical exam to rule out other medical problems.

Tests might include:

• Taking a small sample (biopsy) of the affected skin to be examined
• Blood tests
• An eye exam.

Treatment may help make the skin look more even. The choice of treatment depends on:

• The number of white patches
• How widespread the patches are
• The treatment the person prefers to use.

Some treatments are not right for everyone. Many treatments can have unwanted side effects. Treatments can take a long time, and sometimes they don't work.

Current treatment options for vitiligo include medical, surgical, and other treatments. Most treatments are aimed at restoring color to the white patches of skin.

Medical treatments include:

• Medicines (such as creams) that you put on the skin
• Medicines that you take by mouth
• A treatment that uses medicine plus ultraviolet A (UVA) light (PUVA)
• Removing the color from other areas so they match the white patches.

Surgical treatments include:

• Skin grafts from a person's own tissues. The doctor takes skin from one area of a patient's body and attaches it to another area. This is sometimes used for people with small patches of vitiligo.
• Tattooing small areas of skin.

Other treatments include:

• Sunscreens
• Cosmetics, such as makeup or dye, to cover the white patches
• Counseling and support.

When you have vitiligo, you may be upset or depressed about the change in your appearance. There are several things you can do to cope with the disorder:

• Find a doctor who knows how to treat vitiligo. The doctor should also be a good listener and be able to provide emotional support.
• Learn about the disorder and treatment choices. This can help you make decisions about your treatment.
• Talk with other people who have vitiligo. A vitiligo group can help you find a support group (check your local listings). Family and friends are another source of support.

Some people with vitiligo have found that cosmetics that cover the white patches improve their appearance and help them feel better about themselves. A person may need to try several brands of concealing cosmetics before finding the product that works best.

Scientists have gained a better understanding of vitiligo in recent years, especially through gene research. Current research includes studies to investigate:

• How trauma or stress to the skin can trigger vitiligo or the development of new white patches.
• New treatments and better understanding of vitiligo using a mouse model.
• Genes that may cause or contribute to having vitiligo.
• Analysis of genes already known to be linked to vitiligo.

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
National Institutes of Health

1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
Toll free: 877-22-NIAMS (226-4267)
TTY: 301-565-2966
Fax: 301-718-6366
Email: [email protected]
Website: www.niams.nih.gov