Vitiligo

Vitiligo is a chronic autoimmune skin condition that causes loss of skin pigment.

Overview

Vitiligo is a chronic, long-lasting autoimmune disease that causes patches of skin to lose their natural color or pigment. This happens when melanocytes (the skin cells that make pigment) are attacked and destroyed by the body’s own immune system, causing the skin to turn a milky-white color.

In most people with vitiligo, white patches appear symmetrically on both sides of the body, such as on both hands or both knees. Sometimes, color loss can happen rapidly and cover a large area.

A less common form, called segmental vitiligo, causes white patches on only one segment or side of the body — such as a leg, one side of the face, or an arm. This type often begins at an early age, progresses for 6 to 12 months, and then usually stops.

Although there is no cure for vitiligo, treatments can be very effective at stopping the progression and reversing its effects, which may help skin tone appear more even.

Signs and Symptoms

Anyone can develop vitiligo at any age. However, for many people with vitiligo, white patches begin to appear before age 20 and can start in early childhood.

The main symptom of vitiligo is loss of natural color or pigment, called depigmentation. Depigmented patches can appear anywhere on the body and may affect:

  • Skin, which develops milky-white patches, often on the hands, feet, arms, and face, though patches can appear anywhere on the body
  • Hair, which can turn white in areas where the skin is losing pigment (this can happen on the scalp, eyebrows, eyelashes, beard, and body hair)
  • Mucous membranes, such as the inside of the mouth or nose

People with vitiligo can also develop:

  • Uveitis, a general term that describes inflammation or swelling in the eye
  • Inflammation in the ear

Living with vitiligo can be hard. Some people with the condition feel embarrassed, sad, ashamed, or upset about the changes in their appearance. Sometimes, this can lead to low self-esteem and depression.

Causes and Risk Factors

Scientists believe that vitiligo is an autoimmune disease in which the body’s immune system attacks and destroys the melanocytes. People with vitiligo may be more likely to develop other autoimmune disorders as well.

Sometimes an event, such as a sunburn, emotional distress, or exposure to a chemical, can trigger vitiligo or make it worse.

Vitiligo seems to be more common in people who have:

Biologically, vitiligo occurs at similar rates in men and women. Recent population-level research indicates that lifetime risk may vary among ethnic groups, with some studies showing higher cumulative incidence in Asian, Black, and Hispanic populations compared to White populations.

Diagnosis

To diagnose vitiligo, your doctor will ask about your family history and perform a thorough physical exam, including a close evaluation of your skin. Sometimes doctors use a Wood’s lamp — also known as a black light — which is an ultraviolet light shined on the skin. If you have vitiligo, the light makes affected areas of your skin appear chalky and bright.

Other tests can include:

  • Blood tests to check for other autoimmune diseases
  • An eye exam to check for uveitis, an inflammation of part of the eye that sometimes occurs with vitiligo
  • A skin biopsy, which means taking a small sample of skin to be examined under a microscope, to examine the tissue for the missing melanocytes seen in the depigmented skin of a person with vitiligo

Treatment and Management

Your doctor may prescribe medicine that focuses on stopping the immune system from destroying the melanocytes and improving the skin’s appearance. In most cases, the goals of treatment are to:

  • Slow or stop the disease from progressing
  • Encourage the regrowth of melanocytes
  • Restore color to the white patches of skin, which can help the skin color look more even

It is important to remember that treatments may take time, and not everyone responds. Results from treatments can vary from one part of the body to another, and new patches may appear in the meantime. Sometimes, doctors recommend more than one treatment to get the best results.

Treatments can include:

  • Medicines or medicated skin creams, such as corticosteroids or a calcineurin inhibitor may return color to the white patches of skin.
  • Phototherapy (light therapy) helps return color to the skin. Doctors may use light boxes to treat large areas of vitiligo and laser treatments on more localized areas.
  • Depigmentation can remove color from dark areas of the skin, so they match the white patches. Doctors usually recommend this treatment for people who have vitiligo on more than half of their bodies; Depigmentation tends to be permanent and can take more than a year to complete. It is very important to limit exposure to sunlight during and after this treatment.
  • Surgery, which dermatologists may consider for long-standing segmental vitiligo or vitiligo of any type for which other treatments do not work. Surgery is typically not recommended when vitiligo is spreading or for people who scar easily or develop keloids — raised scars that grow larger than the wound that caused the scar.

Living With Vitiligo

High visibility of vitiligo patches often causes stigma. The visual contrast of depigmentation patches is significantly higher on darker skin tones. Consequently, the condition is often noticed much earlier—and can carry higher social or cultural stigma—in non-White communities, driving higher diagnosis awareness in those populations.

Seeking advice and help from a mental health professional can help you cope with vitiligo and treat depression. 

Managing Symptoms

In addition to the treatments your doctor recommends, you can help manage the condition by:

  • Protecting your skin from the sun (use sunscreen and wear clothes to help protect your skin from sunburn and long-term damage)
  • Wearing cosmetics, such as self-tanning lotions or dyes, to cover depigmented patches of skin (talk to your doctor about which lotion or dye to use)
  • Finding a doctor who has experience treating people with vitiligo
  • Learning about the condition and available treatments to help you make decisions about your care
  • Talking with other people who have vitiligo (consider finding a vitiligo support group in your area or through an online community)
  • Reaching out to family and friends for support

Find Clinical Trials

Clinical trials uncover better ways to prevent, diagnose, treat, and understand diseases and conditions. To ensure results apply to everyone, volunteers of all ages, sexes, and backgrounds, including both healthy individuals and those with specific medical conditions, are needed. Find clinical trials on vitiligo.

Find Treatment

Healthcare providers who treat vitiligo include:

  • Dermatologists, who specialize in diagnosing and treating disorders of the skin, hair, and nails
  • Primary care physicians, such as a family practitioner or internist
  • Other specialists, such as ophthalmologists (who treat eye problems), may also provide care

Community Support

The following organizations offer information and support for people with vitiligo:

Note: This resource list is for informational purposes only. It is not comprehensive, and an organization’s inclusion does not constitute an endorsement by NIH.

Research Information

The National Institutes of Health (NIH) is the largest public funder of biomedical research in the world. NIH invests most of its budget in medical research seeking to enhance life and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.

NIH supports research to help treat and possibly prevent vitiligo. Researchers are studying the immune response to understand the body’s natural mechanisms that trigger and control autoimmune diseases, which could help develop new treatment strategies. Studies are also looking for genes and other factors that may contribute to vitiligo and are exploring possible new treatments for the disease.

Researchers continue to study how family history and genes may play a role in causing vitiligo.

Find NIH-funded research projects using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.