Vitiligo is a long-term condition in which patches of skin lose their colour and turn pale or white. It happens when the cells that make skin pigment, called melanocytes, stop working or are destroyed. Vitiligo is not contagious and is not caused by anything a person did. It is often more noticeable on darker skin, which can make it emotionally difficult, but effective treatments and support are available.
Key facts
- Vitiligo affects roughly 1 in 100 people worldwide, across all skin tones.
- It usually starts before the age of 30.
- It is thought to be an autoimmune condition, where the immune system attacks pigment cells.
- It is not infectious and does not damage general health.
- Treatment can restore colour in many people, especially on the face, but results vary.
Types of vitiligo
- Non-segmental vitiligo is the most common type. Patches often appear on both sides of the body in a similar pattern, commonly on the hands, face, around the eyes and mouth, and over joints.
- Segmental vitiligo affects one area on one side of the body. It tends to start earlier and usually stops spreading after a year or two.
Causes and triggers
The exact cause is not fully understood. Contributing factors include:
- Autoimmunity. People with vitiligo are more likely to have other autoimmune conditions, especially thyroid disease. See our guide to hypothyroidism.
- Genes. About one in three people with vitiligo has a relative with the condition.
- Triggers such as severe sunburn, skin injury, or stress may start new patches in people who are prone to it.
Symptoms
- Flat, milky-white or pale patches with clear edges
- Patches that may slowly grow or new ones that appear
- Early whitening of hair on the scalp, eyebrows, eyelashes or beard
- Pale areas inside the mouth or nose
Vitiligo is usually not itchy or painful, although patches can burn easily in the sun.
Diagnosis
A doctor or dermatologist can usually diagnose vitiligo by looking at the skin. A special ultraviolet lamp (Wood’s lamp) makes patches easier to see on lighter skin. Because vitiligo is linked to thyroid disease and diabetes, a blood test may be offered. Other causes of pale patches, such as fungal infections, need to be ruled out, since these are treated differently.
Treatment
Treatment is optional. Some people choose to leave vitiligo untreated, while others want to restore colour or stop it spreading. A dermatologist can help decide what suits you.
Treatments with good evidence
- Steroid creams or ointments, used for limited periods under medical supervision, can help colour return on small areas.
- Calcineurin inhibitor creams (tacrolimus or pimecrolimus) are often used on the face and eyelids, where steroids can thin the skin.
- Ruxolitinib cream, a JAK inhibitor, is approved in some countries for non-segmental vitiligo and can restore colour over several months.
- Narrowband UVB phototherapy, given in a clinic two or three times a week, is one of the most effective options for widespread vitiligo.
- Surgery, such as skin grafting or transferring pigment cells, may help stable patches that have not changed for at least a year.
Colour often returns first around hair follicles, as small freckle-like dots. It can take months to see a result, and patches may come back when treatment stops.
Treatments to be careful about
Herbal remedies, supplements and bleaching products are widely sold for vitiligo. There is not enough good evidence that herbs such as ginkgo biloba work, and some products contain steroids or mercury that can harm the skin and kidneys. Speak to a doctor before using any product. Avoid skin-lightening creams unless they are prescribed for extensive vitiligo by a specialist.
Caring for your skin
- Use a broad-spectrum sunscreen of SPF 30 or higher on pale patches, because they burn easily.
- Wear hats and protective clothing in strong sun.
- Cosmetic camouflage creams can cover patches if you wish, and are waterproof and long-lasting.
- Avoid tattoos on or near patches, as skin injury can trigger new ones.
Emotional wellbeing
Vitiligo can affect confidence and relationships, particularly where there is stigma or misunderstanding. It helps to know that the condition is common, harmless to general health and not contagious. Talking to a counsellor, joining a support group or connecting with others online can make a real difference.
When to see a doctor
See a doctor if you notice new pale patches, if patches are spreading quickly, or if you have symptoms of thyroid disease such as tiredness, weight change or feeling cold. A doctor can confirm the diagnosis and refer you to a dermatologist.
Frequently asked questions
Is vitiligo contagious?
No. You cannot catch vitiligo from touching someone, sharing food or any other contact.
Can vitiligo be cured?
There is no permanent cure yet, but treatment can restore colour and slow spread for many people.
Does diet cause or cure vitiligo?
No specific food causes or cures vitiligo. A balanced diet supports general health.
