Vitiligo (vit-ih-LIE-go) is a disease that causes loss of skin color in patches. The discolored areas usually get bigger with time. The condition can affect the skin on any part of the body. It can also affect hair and the inside of the mouth.
Normally, the color of hair and skin is determined by melanin. Vitiligo occurs when cells that produce melanin die or stop functioning. Vitiligo affects people of all skin types, but it may be more noticeable in people with brown or Black skin. The condition is not life-threatening or contagious. It can be stressful or make you feel bad about yourself.
Treatment for vitiligo may restore color to the affected skin. But it doesn't prevent continued loss of skin color or a recurrence.
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Book: Mayo Clinic Family Health Book, 5th Edition
Vitiligo signs include:
Patchy loss of skin color, which usually first appears on the hands, face, and areas around body openings and the genitals
Premature whitening or graying of the hair on your scalp, eyelashes, eyebrows or beard
Loss of color in the tissues that line the inside of the mouth and nose (mucous membranes)
Vitiligo can start at any age, but usually appears before age 30.
Depending on the type of vitiligo you have, it may affect:
Nearly all skin surfaces. With this type, called universal vitiligo, the discoloration affects nearly all skin surfaces.
Many parts of the body. With this most common type, called generalized vitiligo, the discolored patches often progress similarly on corresponding body parts (symmetrically).
Only one side or part of the body. This type, called segmental vitiligo, tends to occur at a younger age, progress for a year or two, then stop.
One or only a few areas of the body. This type is called localized (focal) vitiligo.
The face and hands. With this type, called acrofacial vitiligo, the affected skin is on the face and hands, and around body openings, such as the eyes, nose and ears.
It's difficult to predict how this disease will progress. Sometimes the patches stop forming without treatment. In most cases, pigment loss spreads and eventually involves most of the skin. Occasionally, the skin gets its color back.
When to see a doctor
See your health care provider if areas of your skin, hair or mucous membranes lose coloring. Vitiligo has no cure. But treatment might stop or slow the discoloring process and return some color to your skin.
If you have light spots and patches on your skin, getting an accurate diagnosis
is important. White spots and patches develop for many reasons. You might have
vitiligo. You could also have another condition like tinea versicolor. The white
spots may also be caused by a skin injury. A board-certified dermatologist can
give you an accurate diagnosis. How do dermatologists diagnose vitiligo? A
board-certified dermatologist diagnoses vitiligo by reviewing your medical
history and examining your skin. To get a good look at your skin, your
dermatologist may use a Wood’s lamp. This specialized lamp allows a
dermatologist to clearly see areas of vitiligo.
To give patients an accurate
diagnosis, dermatologists examine a patient’s skin under different lighting In
everyday lighting (A), the vitiligo on this patient’s skin is barely visible.
When examined under different types of Wood’s lamps (B and C), the patches are
easier to see. Pictures show how vitiligo looks under (and without) a Woods lamp
If your dermatologist finds that you have vitiligo, blood tests may be
recommended. Vitiligo is an autoimmune disease. This means that your immune
system is attacking healthy cells in your body that give your skin its color.
People who have vitiligo have a higher risk of developing some other autoimmune
diseases like thyroid disease. Blood tests can find autoimmune diseases like
thyroid disease. After giving you the diagnosis, your dermatologist will also
ask whether you want to treat the vitiligo. Some people choose not to. Model
Winnie Harlow, who has vitiligo, lets the world see her skin as it is. Rather
than get medical treatment, some people prefer to cover up the light patches
with makeup, self-tanner, or skin dye. If you want to treat vitiligo,
dermatologists have treatments that can restore lost skin color. How do
dermatologists treat vitiligo? When treating vitiligo, board-certified
dermatologists create a treatment plan with these goals in mind: Restore lost
skin color Stop the patches and spots from getting bigger and new spots from
appearing There is no one best treatment for vitiligo. Before creating a
treatment plan, a dermatologist thinks about what is best for each patient. To
do this, your dermatologist considers your age, overall health, and effects the
disease has on your life. The type of vitiligo, where it appears on the body,
and how it’s progressing also play important roles. Before and after camouflage
makeup Some patients prefer to cover up vitiligo with camouflage makeup rather
than treat it. Camouflage makeup can also hide vitiligo until treatment works.
Patient with vitiligo before and after applying camouflage makeup If you decide
to treat vitiligo, it’s important to know the following: Treatment works slowly.
When treatment works, your natural skin color returns a little at a time.
Vitiligo can be stubborn. Your dermatologist will begin with the gentlest
treatment that’s suitable for you. To get desirable results, your dermatologist
may add another treatment or change your treatment. Treatment cannot cure
vitiligo. While researchers are looking for a cure, treatment cannot currently
cure this disease. Treatment can help restore lost skin color, but results may
fade over time. Many patients return for maintenance treatment to keep their
results. Here are the treatments that dermatologists consider for their patients
who have vitiligo. Medication you apply to your skin Purpose: Restore lost skin
color Several prescription medications that you apply to your skin are used to
treat vitiligo. You apply these at home. One of these medications is a
prescription corticosteroid. This medication works best for people who recently
developed vitiligo. Due to possible side effects, dermatologists prescribe a
corticosteroid for a short period of time. When used short-term, this medication
is often effective for both children and adults. Tacrolimus ointment or
pimecrolimus cream is another option for children and adults. One advantage of
these medications is that they can be used for a longer time than
corticosteroids. These work best to treat skin on the head or neck. Another
medication that may restore lost pigment is calcipotriene. While not effective
when used alone, it can be effective when used with a corticosteroid. Applying
both of these medications as directed can increase the amount of re-pigmentation
you see and shorten the time it takes to get results. Dermatologists prescribe
calcipotriene for children and adults. Light therapy Purpose: Restore lost skin
color Light therapy exposes your skin to a type of ultraviolet (UV) light that
can restore your natural skin color. If a large area of your body needs
treatment, your dermatologist may prescribe a treatment called phototherapy.
During phototherapy, you expose your skin to UV light for a specific amount of
time. A dermatologist calculates the right amount of time for each patient. The
UV light comes from a light box, which you stand in. If you need treatment
targeted to a certain part of your body, your dermatologist may prescribe laser
therapy. A laser can target a small section of skin, so there’s less effect on
skin that doesn’t need treatment. Light therapy is most effective at restoring
color to the face and neck. The lips, tips of the fingers, and toes are least
responsive to treatment with light therapy. If light therapy is an option for
you, you will need a number of treatments. Light therapy works slowly. To return
color to your skin more quickly, your dermatologist may prescribe light therapy
along with treatment that you apply to your skin. Medication you take Purpose:
Slow down the development of new spots and patches, restore skin color Vitiligo
tends to spread slowly. Occasionally, it spreads quickly. If you’re seeing new
patches and spots on your skin frequently, your dermatologist may prescribe
prednisone. This is a powerful medication that can help slow down the disease.
It comes in pill form. You take prednisone for one to two weeks. Surgery
Purpose: Restore skin color If other treatments fail to restore skin color,
surgery may be an option. Two types of surgery are used to treat vitiligo: Skin
graft: Your dermatologic surgeon removes some healthy, pigmented skin and
transplants it to one or more areas with vitiligo. Cell transplant: During this
type of surgery, your dermatologic surgeon removes some healthy, pigmented skin.
Instead of grafting the skin into an area with vitiligo, the surgeon takes cells
from the skin that was removed. These cells are then placed into skin with
vitiligo. Most re-pigmentation from these cells happens within six months of
surgery. However, dermatologists have seen patients continue to re-pigment for
up to 12 months. Surgery may be an option for people of all skin tones and for
people who have different types of vitiligo. However, it’s not an option for
everyone. Surgery usually isn’t recommended for people who have active vitiligo,
which means that over the last 12 months new spots have developed or existing
spots have grown. Surgery also may not be an option for people who developed
raised scars. Surgery could cause scarring. Before and after cell transplant
surgery Four months after cell transplant surgery, this man’s vitiligo is barely
noticeable. Patient with vitiligo before and after dermatologist performs cell
transplant surgery Makeup, self-tanner, and skin dye Purpose: Even out your skin
tone right away Getting results from treatment takes time. To help you even out
your skin tone until you get results, your dermatologist may recommend using one
of these products. Camouflage makeup Self-tanner Skin dyes These are also an
option for patients who decide not to treat vitiligo. If you’re interested in
trying these products, ask your dermatologist for a recommendation. Your
dermatologist can recommend a product that will match your skin tone and stay on
all day long. As a rule, self-tanning products are waterproof and give you
coverage for 3 to 5 days. Camouflage makeup is lightweight and waterproof, but
you need to apply it every day. To get natural-looking results from these
products, you’ll need to learn how to apply them and practice. Diet and
supplements for vitiligo Purpose: To provide your body with missing nutrients
You may have heard that certain vitamins, minerals, amino acids, or enzymes can
restore your natural skin color. Researchers are studying the effects that these
may have on vitiligo. More research is needed to know whether any diet or
supplements can effectively treat vitiligo. Depigmentation Purpose: Remove the
remaining color from your skin Depigmentation is rarely used. It’s only an
option for patients who have lost most of their natural skin color and don’t
want to continue with treatment meant to restore color to their skin.
Depigmentation removes the remaining natural color, creating an even skin tone.
To remove the remaining color from their skin, a patient applies a cream to the
areas of skin that still have pigment. The cream gradually removes the remaining
color. It can take one to four years to get rid of the remaining pigment. If
you’re considering this approach, talk with a board-certified dermatologist
about the pros and cons of depigmentation. This treatment is considered
permanent. How do dermatologists treat vitiligo in children? Vitiligo can begin
at any early age. This makes treatment options for children important. Many
treatments described above are used to treat children. Before creating a
treatment plan for your child, your dermatologist thinks about the child’s age,
how the vitiligo is spreading, other medical conditions your child has, and many
other considerations. Dermatologists are studying new vitiligo treatments
Vitiligo can be stubborn. To find better treatments, dermatologists run clinical
trials. Results from recent clinical trials are promising. A type of medication
called a Janus kinase inhibitor (JAK inhibitor for short) may be an effective
treatment for vitiligo. JAK inhibitors calm the patient’s overactive immune
system, which can stop the body from destroying melanocytes, the cells that give
skin, hair, and other parts of your body their color. When this stops, the skin
can re-pigment. Some JAK inhibitors you apply to the skin with vitiligo. Others
comes in pill form. Dermatologists are also studying a medication that when
implanted into the skin stimulates the skin cells to make pigment. Some of the
medications that are being studied as a possible treatment for vitiligo are
FDA-approved to treat other diseases. For example, one JAK inhibitor that
dermatologists are studying as a possible treatment for vitiligo is called
ruxolitinib cream. The U.S. Food and Drug Administration (FDA) has approved this
medication to treat atopic dermatitis in patients 12 years of age and older who
have a healthy immune system. Maintenance therapy often required to keep
treatment results While treatment can restore lost skin color, sometimes, the
results are temporary. Within a year of ending treatment, it’s estimated that
about 40% of patients see some color loss. Maintenance therapy helps to prevent
this color loss. To maintain results, dermatologists often prescribe a
medication that you apply to your skin a few times per week. When medication is
used along with self-care, many patients keep the color that treatment added to
their skin. To see the self-care that dermatologists recommend for their
patients who have vitiligo, go to Vitiligo: Self-care. Related AAD resources Is
vitiligo a medical condition? Hiding child’s skin condition with makeup may
boost self-esteem Vitiligo discomfort stops with sunscreen use
