Vitiligo
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is vitiligo?
Vitiligo is an autoimmune condition in which pigment producing melanocytes are destroyed, leaving well defined white patches of skin. It is not contagious or painful, but the psychological impact can be considerable, particularly on darker skin where contrast is greater. Treatment can restore pigment in many cases, especially when started early.
Causes
- Autoimmune destruction of melanocytes
- Genetic susceptibility
- Oxidative stress within pigment cells
- Koebner phenomenon at sites of skin trauma
- Association with other autoimmune diseases
Symptoms
- Well demarcated milky white patches
- Common sites include hands, face, and around body openings
- Symmetrical distribution in generalised vitiligo
- Premature whitening of hair in affected areas
- Patches that sunburn easily
- Usually no itch or pain
Risk factors
- Family history of vitiligo
- Personal or family history of autoimmune thyroid disease
- Type 1 diabetes
- Pernicious anemia
- Skin trauma or sunburn
Diagnosis
- Clinical diagnosis from characteristic depigmented patches
- Wood lamp examination to define extent
- Thyroid function and autoantibody testing
- Full blood count and vitamin B12 where indicated
- Skin biopsy only in atypical presentations
Treatment
- Topical corticosteroids or calcineurin inhibitors
- Topical JAK inhibitor therapy such as ruxolitinib cream
- Narrowband UVB phototherapy
- Combination of phototherapy with topical treatment
- Rigorous sun protection of depigmented skin
- Camouflage cosmetics
- Psychological support, which is often as important as skin treatment
Self care
- Protect depigmented skin with high factor sunscreen and clothing
- Avoid skin trauma, which can trigger new patches
- Consider camouflage cosmetics if you wish
- Apply prescribed creams consistently, since repigmentation is slow
- Seek psychological support, as impact is often underestimated
- Check thyroid function if advised
When to see a doctor
Book an appointment if:
- New or spreading patches of pale skin
- Patches on the face or hands, which respond best to early treatment
- Fatigue or weight change suggesting thyroid disease
- Significant impact on mood or confidence
- Treatment not producing repigmentation after several months
- Patches appearing after skin injury
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Vitiligo cannot be prevented
- Progression may be limited by early treatment
- Avoid skin trauma and sunburn
- Manage associated autoimmune conditions
- Protect depigmented skin from ultraviolet damage
Outlook
Vitiligo is unpredictable. Some people have stable patches for years, others progress. Repigmentation is achievable in many cases, particularly on the face and with early treatment, and newer topical JAK inhibitors have improved outcomes. Hands and feet respond least well. It carries no physical health risk beyond sun sensitivity.
Common questions
Is vitiligo contagious?
No. It cannot be passed to anyone by touch or any other contact. It is an autoimmune condition in which the body immune system destroys its own pigment cells.
Can pigment come back?
Yes in many cases, particularly on the face and with early treatment. Hands and feet respond less well. Repigmentation is gradual and typically takes several months of consistent treatment.
Why is sun protection important?
Depigmented skin has no melanin protection and burns very easily, raising skin cancer risk. Sun protection also reduces contrast with surrounding skin, which many people find helpful.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.