Vitiligo
Taylor Erickson, MD and Brandi Kenner-Bell, MD

What is vitiligo and what causes it?

Vitiligo is a skin condition that causes white patches to develop on the skin. The white patches are caused by the loss of pigment-producing cells in the skin, which are called melanocytes.^1,2 It occurs in all races, however it may have a more devastating impact on people with darker skin tones. ^1,2 The average age when people develop vitiligo is 20 years, but it also occurs in children and older adults. ^1,2,3 Vitiligo is believed to be an autoimmune condition, meaning the person’s own immune system is destroying their melanocytes.

Where does vitiligo occur?

Vitiligo is common on the face, tops of the hands and feet, armpits, lower back, anal and genital regions, groin, and nipples. Vitiligo may also occur in areas on the body where there is more friction or trauma (elbows/knees). Vitiligo can cause whitening of the hair on the scalp or the body. ^1,2 There are several different types of vitiligo which can present in different patterns on the body. It can affect small areas of the body or become more widespread. 

How do I know if I have vitiligo?

If you notice areas of your skin that have lost the pigment, that appear “chalky-white” as compared to your normal skin tone, you should see a dermatologist. 

What other diseases are associated with vitiligo?

Most patients with vitiligo are otherwise healthy. However vitiligo, especially when involving a larger proportion of the skin, may be associated with other autoimmune diseases including those affecting the thyroid or those causing hair loss like alopecia areata ^1,2

What treatments are available for vitiligo?

There are a number of treatment options for vitiligo including phototherapy (ultraviolet light therapy), lasers, topical steroid and anti-inflammatory creams, some surgical procedures, oral steroids, and other oral anti-inflammatory medications.^1,2,3 Consultation with your dermatologist will help determine which option is right for you. In some cases, vitiligo can be progressive despite treatment. Depigmentation therapy (where the remaining pigment is permanently removed from the skin using a medicated cream) is another option for patients with extensive involvement. ^2,3

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References

1. Bergqvist C, Ezzedine K: Vitiligo: A Review. Dermatology 2020;236:571-592.
2. Ortonne, JP, Passeron, T. Vitiligo and Other Disorders of Hypopigmentation. Bolognia, JL, Schaffer, JV, Cerroni, L. Dermatology: Fourth edition. 1023-1030
3. Rodrigues M, Ezzedine K, Hamzavi I, Pandya AG, Harris JE; Vitiligo Working Group. Current and emerging treatments for vitiligo. J Am Acad Dermatol. 2017 Jul;77(1):17–29.