Vitiligo is an autoimmune disorder that causes depigmentation, or a loss of skin pigment, leading to unusually light patches of skin and hair. The condition is relatively common, affecting up to 1.5 percent of people worldwide.
Like other autoimmune disorders, vitiligo develops when your immune system attacks its own healthy tissues. It targets and destroys melanocytes, the skin cells that produce melanin, which gives your skin its natural color. However, there are a number of other medical conditions that closely resemble vitiligo — and it’s important to be able tell the difference.
7 Skin Conditions Commonly Mistaken for Vitiligo
How can you tell if you’re dealing with vitiligo or something else? The following skin conditions are sometimes mistaken for vitiligo, but there are ways to tell them apart.
1
Albinism
Albinism is a lifelong skin condition that causes the skin to produce little or no melanin. In some individuals, this results in very pale skin and white to brown hair. Black people may have light brown or reddish-brown skin, freckles, and yellow, red, or brown hair. A decrease in melanin can affect the eyes too, leading to issues such as light sensitivity, blurry vision, or poor eyesight.
Unlike vitiligo, albinism is visible at birth, and it affects the entire surface of your skin. It does not worsen over time.
Both vitiligo and albinism can be confused with piebaldism. “This usually presents at birth with a typical white (depigmented) patch seen in the middle of the head, including a lock of white hair,” says Sanober Pezad Doctor, MD, a Dallas-based double board-certified specialist in integrative and holistic dermatology. Piebaldism may also present as leukoderma, or patches of white skin, that appear at birth.
2
Hansen’s Disease (Leprosy)
Also known as leprosy, Hansen’s disease is an infection caused by Mycobacterium leprae bacteria. Like vitiligo, it causes flat, faded, and discolored patches of skin — but unlike vitiligo, it can also cause numbness in the affected patches.
While Hansen’s disease and vitiligo have different underlying causes, it is possible to have both conditions at the same time.
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3
Idiopathic Guttate Hypomelanosis
If you’re experiencing lighter spots on areas of your body that are frequently exposed to the sun, you may have idiopathic guttate hypomelanosis (IGH). IGH spots typically form on sun-exposed limbs, especially the forearms and shins, as well as the chest. Like vitiligo, they can grow larger and more numerous with age. These patches tend to be more noticeable on darker skin, though they may be more common in people with lighter skin.
IGH spots are usually hypopigmented, or low in pigment, not completely free of pigment like those seen in vitiligo. They also tend to be just 2 to 5 millimeters in diameter (though they can be up to 2.5 centimeters in diameter) and don’t appear in clusters.
IGH is far more common than vitiligo. Your likelihood of developing it increases as you age.
4
Melasma
Melasma causes spots on your face that are usually darker than your natural skin tone. Because of that contrast, any areas that lack the melasma could be mistaken for vitiligo, particularly in people with darker skin tones. The condition can also affect your forearms and neck.
Melasma is typically said to affect 1 percent of people worldwide, though some surveys suggest that those numbers could be significantly higher. The condition is more prevalent among certain populations, such as women ages 20 to 40, people with medium to dark skin tones, individuals who have a relative with melasma, and pregnant women. Unlike vitiligo, melasma may be triggered by oral contraceptives, hormonal changes, and sun exposure.
5
Pityriasis Alba
Like vitiligo, pityriasis alba is a relatively common skin condition that leads to lighter-than-normal patches of skin. But unlike vitiligo marks, the light-colored skin patches caused by pityriasis alba start off red and scaly. Pityriasis alba more commonly manifests in children and young adults, and it is most often seen on the face, neck, upper arms, and torso. While the cause is unknown, it is thought to be related to dry skin, or even to a familial history of eczema.
6
Scleroderma
Both scleroderma and vitiligo are autoimmune diseases that affect the skin. But scleroderma’s rarity and severity set it apart from vitiligo. Scleroderma causes hardening and tightness of the skin, which can make it appear lighter, darker, or even shiny. The effects of scleroderma also extend beyond the skin to your blood vessels and connective tissues — and may even cause internal organ and digestive tract damage.
The symptoms of scleroderma tend to be more painful than those of vitiligo. Vitiligo and scleroderma can both cause itchiness, but scleroderma can additionally produce soreness, swelling, and small red spots, or lead to Raynaud’s syndrome (which causes painful or numb fingers).
Scleroderma is also much rarer than vitiligo. It affects an estimated 300,000 adults in the United States, mainly women between ages 30 and 50.
7
Tinea Versicolor
Tinea versicolor is a common condition that may cause patches of discolored skin. These patches tend to be dry and scaly with sharp borders, and they may be lighter or darker than the surrounding skin. But unlike vitiligo, tinea versicolor isn’t an autoimmune disease — rather, it’s the result of a fungal infection.
Tinea versicolor is caused by a buildup of yeast that’s naturally found on your skin in smaller amounts. An overgrowth of this yeast can lead to small spots that may be white, yellow, pink, red, tan, or brown. They are most commonly seen on the chest, shoulders, and back. As with vitiligo, the spots may become larger and eventually connect with one another.
Unlike vitiligo, tinea versicolor is treatable with topical antifungal medications. In more extreme cases, a dermatologist may prescribe oral medications to treat it.
How Do You Know if It’s Vitiligo?
So, how do you know if you are living with vitiligo? Like many of the above conditions, vitiligo also causes patches of depigmented skin, but other symptoms include:
- Itchy skin
- Spots on your skin that are more prone to sunburn than others
- Patches of hair color loss on your scalp, eyelashes, or eyebrows
- Eye color changes
- Hearing loss
Additional features set vitiligo apart from other skin diseases. For one thing, the depigmented patches of skin associated with it tend to be symmetrical. They usually grow quickly and may connect and cover large areas of your body. Early signs of vitiligo also tend to develop during childhood, or before the age of 20. Its symptoms are most often visible on the face, arms, hands, and feet.
About 15 to 25 percent of people with vitiligo have at least one other autoimmune disorder. Examples of other autoimmune conditions include psoriasis, rheumatoid arthritis, lupus, and type 1 diabetes.
How Is Vitiligo Diagnosed?
While there’s no cure for vitiligo, treatment can help slow the progression of the disease and even encourage melanocyte regrowth. But before you seek out treatment, it’s important to get a vitiligo diagnosis first — and rule out the possibility of another condition with overlapping symptoms.
“In most instances, the diagnosis of vitiligo is straightforward and made on clinical grounds,” says Alpana Mohta, MD, a board-certified dermatologist and medical adviser for Better Goods, who is based in the United Arab Emirates. “In order to predict the disease progression and outcome, your dermatologist will ask about your family history, including vitiligo, thyroid disease, or any other autoimmune disorder.” She adds that a diagnosis may include autoimmune blood testing and a skin biopsy to examine melanocytes.
“A very common noninvasive office procedure to differentiate vitiligo from other similar conditions includes the evaluation of the vitiligo patches under a specific UVB light-emitting device known as a Wood’s lamp,” says Dr. Doctor.
If you’re diagnosed with vitiligo or another autoimmune disease, it’s important to keep up with lab testing and follow-up appointments, as recommended by your physician.
When in Doubt, Speak to a Dermatologist
Vitiligo causes light patches of skin to develop over time, but it’s not the only condition that can do so. Knowing how vitiligo differs from other skin conditions on this list can help you narrow down potential diagnoses. If you’re experiencing new or unexplained skin symptoms, reach out to your dermatologist or healthcare provider, who can help make an accurate diagnosis and prescribe treatment.
The Takeaway
- Vitiligo is an autoimmune disorder characterized by a loss of pigment in the skin and hair.
- It is similar in appearance to other skin conditions, including albinism and pityriasis alba.
- Understanding the symptoms of each skin condition can help you distinguish between them.
- If you experience an unexplained skin discoloration, consult your healthcare provider.
Meet Our Experts
Lydia J. Johnson, MD
Medical Reviewer
Member of American College of Lifestyle Medicine
Lydia Johnson, MD, is a board-certified dermatologist. Her medical career of more than 20 years has included work in private practice and in an academic medical center, as well as various medical leadership positions, including department chair. In 2020, Dr. Johnson embarked upon a passionate journey to utilize her medical knowledge and experience to help create a more widespread and lasting impact on the individual and collective health of our community. She is doing this as a board-certified lifestyle medicine physician, board-certified dermatologist, and certified health coach.
Johnson envisions a future of healthcare that prioritizes and values maintenance of health, holistic well-being, and disease prevention. Through lifestyle medicine certification, she is committed to being a part of that transformation. As a coach, she empowers others to enjoy lives of optimal well-being and identify the ways to do so through lifestyle behaviors that are accessible to all. Her purpose is to help others thrive in all aspects of their lives, with a foundation of optimal health.
Johnson envisions a future of healthcare that prioritizes and values maintenance of health, holistic well-being, and disease prevention. Through lifestyle medicine certification, she is committed to being a part of that transformation. As a coach, she empowers others to enjoy lives of optimal well-being and identify the ways to do so through lifestyle behaviors that are accessible to all. Her purpose is to help others thrive in all aspects of their lives, with a foundation of optimal health.
Kristeen Cherney, PhD
Author
Kristeen Cherney, PhD, is a freelance writer, essayist, author, and poet with more than 15 years of health writing experience for digital platforms such as Healthline, The Mighty, and LiveStrong. She’s covered nutrition, women’s and children’s wellness issues, as well as specialized topics ranging from diabetes and thyroid disease to anxiety, depression, asthma, allergies, and skin conditions.
With a doctorate in English (rhetoric and composition), Dr. Cherney focuses her academic scholarship on the intersection between disability and literacy. She also holds a Master of Arts in English and a Bachelor of Arts in communication.
Cherney has contributed to the books The Wiley Handbook on Violence in Education: Forms, Factors, and Preventions, Composing in Four Acts: Readings for Writers, and Georgia State University's Guide to First-Year Writing, as well as to scholarly journals like Praxis, the Journal of Teaching Writing, and the Journal of Dracula Studies.
Cherney enjoys running, meditating, hiking, and paddleboarding.
With a doctorate in English (rhetoric and composition), Dr. Cherney focuses her academic scholarship on the intersection between disability and literacy. She also holds a Master of Arts in English and a Bachelor of Arts in communication.
Cherney has contributed to the books The Wiley Handbook on Violence in Education: Forms, Factors, and Preventions, Composing in Four Acts: Readings for Writers, and Georgia State University's Guide to First-Year Writing, as well as to scholarly journals like Praxis, the Journal of Teaching Writing, and the Journal of Dracula Studies.
Cherney enjoys running, meditating, hiking, and paddleboarding.