Symptoms of Vitiligo

Vitiligo results in white patches of skin that may vary in size and appear on any part of the body.

Common skin areas that vitiligo affects include the:

Hands
Feet
Arms
Face
Armpits
Scalp
Mucous membranes (such as the inside of your mouth and nose)
Genitals

Patches typically first appear as small, paler-than-usual areas of skin, which may remain the same size or grow larger over time.

In most cases, the patches will turn completely white, though they may sometimes appear red, pink, or brown.

“The white patches are usually significantly lighter than the patient’s normal skin and more obvious in those patients with darker skin types,” says Adrienne Haughton, MD, director of clinical and cosmetic dermatology at Stony Brook Medicine in Commack, New York.

Before the patches form

or while they’re spreading

, you might experience itchy or tingling skin.

Another sign of vitiligo is gray or white hair in areas of skin with pigment loss. This can affect:

Head hair
Beard hair
Eyebrows
Eyelashes
Body hair

Vitiligo can develop in people of any age or skin tone.

Worldwide, around 0.5 to 2 percent of people live with the condition.

About half of vitiligo cases occur before age 20, says Suzanne Friedler, MD, a dermatologist at Advanced Dermatology, PC in New York City. The condition is also likely to develop in your 20s and 30s, according to other experts.

Most cases of vitiligo are related to a genetic predisposition, followed by an environmental trigger that causes the immune system to attack the body’s melanocytes, Dr. Friedler says.

The same types of environmental triggers that may set off the condition in the first place can also cause vitiligo to worsen. Other triggers, like stress, may also play a role in its development.

Potential vitiligo triggers include:

Ultraviolet (UV) radiation, which can come from the sun, tanning beds, mercury lamps, certain types of lightbulbs, or lasers
Certain chemicals
Skin-whitening products
Skin damage, such as sunburns or cuts
Stress
Hormonal changes in the body
Liver or kidney issues

Types of Vitiligo

No two people will experience vitiligo in exactly the same way, and it’s impossible to say how widespread any one case of vitiligo will be.

Where the patches are located and whether they’ll spread depends on the type of vitiligo.

Types of vitiligo include:

Generalized Vitiligo (Non-Segmental Vitiligo)

This is the most common type of vitiligo. It results in white patches that appear in different places on your body. The patches typically occur symmetrically across your body and have a pearly white color with well-defined edges.

Segmental Vitiligo

People with this type of vitiligo may develop white patches on only one side of the body or one area of the body, such as the hands or face.

This type is most common in people who develop vitiligo between ages 8 and 12, and the condition will often progress for one or two years before stopping.

Mixed Vitiligo

Doctors may classify vitiligo as “mixed” when you have at least one instance of symmetrical white patches on your body along with other white patches in asymmetrical locations.

Mucosal Vitiligo

Mucosal vitiligo affects your mucous membranes, most often in your mouth and on your genitals.

Localized Vitiligo

This is a rarer type of vitiligo, when only a few smooth, light-colored spots appear on only a few parts of your body.

It is sometimes also called focal vitiligo.

Trichome Vitiligo

The term “trichome” may refer to either the appearance of specific vitiligo patches or a type of vitiligo that has those patches.

Trichome patches appear roughly in a bull’s-eye shape. They have a white or colorless center that’s surrounded by an area of lighter pigmentation, which is then surrounded by an area of natural skin.

Universal Vitiligo

This is another rare type of vitiligo. It causes more than 80 percent of your skin to lose pigment.

Potential Complications of Vitiligo

Vitiligo is mainly a cosmetic condition, and experts do not view it as a threat to your overall health. But it can lead to complications and may be associated with other health conditions.

Complications may include:

Increased Sun Sensitivity

White patches lack melanocytes, so this skin can be more sensitive to sunlight than the rest of your skin. This means it can burn more easily, and a sunburn can, in turn, make vitiligo worse.

Sun sensitivity can also cause your skin to itch or tingle, though wearing sunscreen may help reduce the discomfort.

Eye Problems

Melanocytes are also present in the retina and uvea of your eye. Vitiligo affecting the eyes can cause retinitis and iritis, and you may experience light sensitivity, eye discomfort, or vision disturbances.

Hearing Problems

In some cases, immune cells attack cochlear melanocytes in the inner ear, causing hearing loss. It is estimated that between 12 and 38 percent of people with vitiligo have some hearing loss.

Predisposition to Autoimmune Conditions

Because vitiligo involves the immune system, people with this condition may be more likely to have or develop other autoimmune disorders. In fact, about 15 to 25 percent of people with vitiligo are affected by at least one other autoimmune condition, such as autoimmune thyroid disease, rheumatoid arthritis, type 1 diabetes, psoriasis, or Crohn’s disease.

Other Complications and Symptoms

Some complications, such as skin sensitivity, may result simply from physical changes to your skin. Others, such as eye and ear issues or the increased risk of autoimmune conditions, may relate to your immune system response, as it attacks melanocytes present in areas of your body beyond your skin.

One of the main effects of vitiligo is the mental and emotional toll that living with the condition can have. It may lead to depression, anxiety, avoidance of social activities, and low self-esteem.

“Loss of pigmentation can be emotionally distressing, especially in darker-pigmented people because it is more noticeable in those patients,” Friedler says.

Seeking a support group or a psychotherapist can help people with vitiligo cope and feel less alone.

Learning more about your condition and potential ways to manage it may also help reduce any anxiety and fear you might be feeling.

Your doctor can give you educational information or talk with you about your longer-term outlook and options.

Other complications are related to medications, like skin atrophy after prolonged use of topical steroids to treat vitiligo.

When to See a Doctor

If you notice pale patches developing on your skin, arrange a visit to your primary care doctor or a dermatologist, especially if you have a family history of vitiligo or other autoimmune conditions. Some treatments may be more effective early on, when the skin first starts to lose its pigment.

Because vitiligo is only one of several conditions that can cause white patches of skin, it’s important to get a proper diagnosis that can guide any potential treatment. Other conditions that might have a similar appearance include tinea versicolor (a fungal infection), pityriasis alba (a skin disorder), and scleroderma (a rare yet serious autoimmune disease).

To make a diagnosis, a doctor will ask about your medical history and examine your skin. They may use a Wood’s lamp, which relies on UV light to identify pigment loss, especially if your skin is very light, which may make vitiligo harder to detect.

They may want to confirm the findings with a blood test to rule out other autoimmune diseases. They may also perform a skin biopsy, which will show whether melanocytes are present in the affected areas (a lack of melanocytes is a sign of vitiligo).

If you already have a diagnosis of vitiligo and you notice that it’s spreading or changing, it’s also a good idea to talk with a dermatologist.

Vitiligo is not currently curable, but newer treatments may help bring pigmentation back to the skin in some people.

Treatment may include:

Medications: These might include corticosteroids, topical Janus kinase inhibitors, or calcineurin inhibitors.
Light therapy: Also known as phototherapy, this treatment aims to return pigment to the skin by using UV lights or lasers for a short time.
Depigmentation therapy: Doctors can prescribe a topical drug that may reduce color in the areas of skin surrounding vitiligo patches so they blend together more seamlessly.
Surgery: In certain cases, such as for vitiligo that spreads quickly, a doctor might recommend a skin graft or blister graft.

And, though rare, affected skin may also sometimes spontaneously repigment, Friedler says.

Along with potential treatment options, a doctor can share some tips to help you manage vitiligo, such as:

Protect your skin from the sun by using sunscreen with SPF 30 or higher, wearing protective clothing, and choosing shady spots over sunny ones when you’re outdoors.
Avoid tanning beds and lamps with harmful UV rays.
Try your best to avoid injuries like cuts and scrapes, which can trigger vitiligo. For the same reason, know that getting a tattoo could trigger a flare-up.
Aim to eat a balanced, nutritious diet filled with antioxidants, and avoid inflammatory ingredients like added sugars and trans fats. This can help support your immune system.
Find ways to reduce stress, if possible.
Learn more about vitiligo and share your knowledge with others to help reduce stigma around the condition.
Find a support group to connect with other people who also live with vitiligo.

Your doctor can also advise you on whether to add any vitamins or supplements to your daily routine.

The Takeaway

Vitiligo is an autoimmune condition that causes areas of the skin to lose pigment and turn white. White patches can occur all over the body or only in certain areas.
A combination of genetic factors and triggering events, such as sun exposure or stress, is thought to trigger vitiligo or cause the condition to worsen.
People with vitiligo are more likely to have another autoimmune disease. They may also experience complications that affect their eyes and ears.
Having vitiligo is strongly associated with depression and anxiety. Talking with a mental health professional or finding a support group may help you cope and improve your quality of life.

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

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Ross Radusky, MD

Medical Reviewer

Castle Connolly Top Doctor

Ross Radusky, MD, is a practicing board-certified dermatologist at the Dermatology Treatment and Research Center in Dallas. Originally from New York City, he graduated summa cum laude from the City University of New York and then received his MD from the New York University School of Medicine. There, he was inducted into the Alpha Omega Alpha Honor Medical Society and served as chapter president for two years. He completed his residency in dermatology at NewYork-Presbyterian Hospital and Weill Cornell Medical Center, and at Memorial Sloan Kettering Cancer Center.

Dr. Radusky practices general and cosmetic dermatology with a focus on the early detection of skin cancer, and provides patients with a personalized approach to looking their best at any age. He has authored articles and textbook chapters on the clues that our finger- and toenails may provide us about internal disease, as well as on comprehensive therapies for cosmetic dermatology and reversing the signs of skin aging.

Complementing his medical practice, Radusky has a strong passion for the cultural arts, particularly in expanding access to youths and seniors. He previously served as an artist instructor for the Rockaway Artists Alliance, a New York City nonprofit arts and education organization, and then served as both a board director and treasurer of the organization throughout his medical school training.

Radusky enjoys spending time outdoors with his wife Robyn, son Oliver, and poodle Lucy, where he can usually be found preventing photoaging and reducing the risk of skin cancer beneath an umbrella in a wide-brimmed hat. He is also the proud inventor of Sunshotz, the world’s only sunscreen measuring cup, designed to help patients of all ages apply the proper amount of sunscreen needed to enjoy all the sun without the burn.

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Christina Frank

Author

Christina Frank is a Brooklyn-based writer and editor specializing in health and medical topics. Her work has been published in over 50 digital and print publications, including Berkeley Wellness, Health, The New York Times, Parenting, and WebMD.

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