Almost 1 percent of the world’s population has vitiligo. When you have vitiligo, the cells that are responsible for your skin color are destroyed. These cells, called melanocytes, no longer produce skin pigment, called melanin. Once the cells no longer produce melanin, areas of your skin will lose color or turn white.
Areas of lost pigment can develop anywhere on your body, including:
- sun-exposed areas like the hands, feet, arms, and face
- inside the mouth or other mucus membranes
- back of the eye
- within the hearing system of the ear
Your hair may also turn grey or white if the areas involved have hair.
Even though vitiligo can affect many different parts of the body, it’s not contagious. A person with vitiligo can’t transmit it to someone else.
The primary symptom of vitiligo is white patches on the skin. And it can affect any area of the body, even the areas around your eyes. The patches can be large or small and appear as one of the following patterns:
Segmental or focal: White patches tend to be smaller and appear in one or a few areas. When vitiligo appears in a focal or segmental pattern, it tends to stay in one area one side of the body. Many times it continues for a year or so, then stops. It also progresses slower than generalized vitiligo.
Non-segmental or generalized: Widespread white patches appear symmetrically on both sides of the body. This is the most common pattern and can affect pigment cells anywhere on the body. If often starts and stops many times over the course of a person’s lifetime. There’s no way to determine when, if, or how fast patches will develop.
One study showed that 75 percent of people with vitiligo have loss of pigment on the hands and face. Other common areas are in body folds, like the skin under your arms and around your groin.
It’s unknown exactly what causes vitiligo. The condition doesn’t appear to be inherited. Most people with vitiligo don’t have a family history of the disorder. But family history of vitiligo or other autoimmune conditions may increase your risk even though it doesn’t cause vitiligo.
Another risk factor may be having genes associated with vitiligo, including NLRP1 and PTPN22
Most researchers believe that vitiligo is an autoimmune disorder because your body is attacking your own cells. But it’s also unclear how your body attacks your pigment cells. What is known is that about 20 percent of people with vitiligo also have one other autoimmune disorder. Depending on the population, these disorders can include the following, from most common to least common:
- scleroderma, a disorder of the connective tissue of the body
- thyroiditis, caused by an improperly functioning thyroid
- alopecia areata, or baldness
- type 1 diabetes
- pernicious anemia, an inability to absorb vitamin B-12
- Addison’s disease
- rheumatoid arthritis
Some experts also report vitiligo appearing after incidents of:
- severe sunburns or cuts
- exposure to toxins and chemicals
- high levels of stress
The good news is that many times vitiligo has few physical side effects on the body. The most serious complications may affect the ears and eyes, but these aren’t common. The primary physical effect is that the loss of pigment that increases your risk for sunburn. You can protect your skin by applying sunscreen with a SPF of 30 and wearing sun protective clothing.
Research shows that vitiligo can cause significant psychological effects. Scientific reviews show that over 50 percent of people with vitiligo reported negative effects on their relationships. Some people reported thinking about their condition all day, especially due to the unpredictability of it.
They also reported:
- avoiding physical activities
- withdrawing from events
- feeling like their condition is a disfigurement
- emotional burden
If you have vitiligo and are feeling any of these negative effects, talk to your doctor or someone who cares about you. It’s also important to learn as much as you can about the disorder. This can help alleviate stress you may have about your condition or treatment options.
During your visit, your doctor will perform a physical exam, ask about your medical history, and conduct lab tests. Be sure to report any events that could be contributing factors, like recent sunburns, premature graying of your hair, or any autoimmune diseases you may have. Also let your doctor know if anyone else in your family has vitiligo or other skin diseases.
Others questions your doctor may ask are:
- Where on your body did it first start?
- Does anyone in your family have vitiligo?
- Does anyone in your family have an autoimmune disorder?
- Have you tried any treatments already?
- Are any areas getting better or worse?
Your doctor may also use an ultraviolet lamp to look for patches of vitiligo. The lamp, also known as Wood’s lamp, helps your doctor look for differences between vitiligo and other skin conditions.
At times your doctor may want to take a sample of skin, known as a biopsy. The lab will look at these samples. Skin biopsies can show if you still have pigment-producing cells in that area of your body. Blood tests can help diagnose other problems that may go along with vitiligo, such as thyroid problems, diabetes or anemia.
Treatments for vitiligo aim to restore color balance to your skin. Some treatments aim to add pigment while others remove it. Your options will vary according to:
- the severity of your condition
- the location and size of your patches