Vitiligo is a disease that causes a change to the color of your skin, resulting in patches of lighter skin.
The condition may also affect your hair, eye color, and areas in and around your mouth, lips, nostrils, rectum, genitals, or belly button.
Vitiligo (pronounced vit-ill-EYE-go) results from a change in your melanocytes, the cells that make pigment (coloring) in your skin and other areas of your body.
The condition affects men, women, and people of any race or ethnicity equally.
Worldwide, on average, 0.5 percent to 1 percent of the population has vitiligo, according to a 2009 report in the Journal of the American Academy of Dermatology.
It affects people of all ages too, although it usually begins when people are in their mid-20s, and it starts before age 20 in nearly half of the people who get the disease.
Vitiligo is not contagious. However, we don’t generally know the underlying cause of vitiligo, and it can be related to, or a sign of, other illnesses.
Patches of vitiligo are usually more noticeable if your normal skin color is relatively dark.
Michael Jackson, perhaps the most famous person with vitiligo, wore gloves to hide discoloration from vitiligo.
Actor Jon Hamm and U.K. talk-show host Graham Norton also have vitiligo.
Most people who have vitiligo, if it is not related to another disease, report feeling physically healthy.
The condition does not cause pain or irritation, but it often affects people’s self-image, which can be emotionally distressing.
The primary symptom of vitiligo is patches of skin that lighten or turn white. It commonly affects sun-exposed areas first, including your face, lips, arms, hands, and feet.
Other vitiligo signs include:
- Lightening of skin around your armpits and belly button (navel)
- Premature (before the age 35) whitening or graying of your hair, including the hair on top of your head, eyelashes, or facial hair (such as eyebrows and beard)
- Loss of color in your mucus membranes, including your lips or the tissues inside your mouth, nose, rectum, or genitals
- Loss of color in your eye’s retina (which may look like a change in color)
Vitiligo may also affect the pigment cells that are part of your inner-ear system, which can cause partial or total hearing loss.
Hearing loss isn’t common with vitiligo, but tell your doctor about any hearing loss or changes, especially if you are under 40 years old.
Types of Vitiligo and Symptoms
Different patterns of discoloration depend on the type of vitiligo that you have. These may be important in your diagnosis.
There are two types of vitiligo, non-segmental and segmental.
Non-segmental vitiligo is the more common type. It’s also known as bilateral vitiligo, vitiligo vulgaris, and generalized vitiligo.
- Light-colored patches that appear on both sides of the body, generally beginning on the wrists, hands, fingertips, or around the eyes and feet
- Rapid color loss that stops for a while and then starts up again. The start-stop cycle usually continues through your lifetime
Segmental vitiligo is also known as unilateral vitiligo. Symptoms include:
- Patches that appear on one side and one limb of the body, such as one side of your face, or on one leg or arm
- Loss of hair color, affecting the hair on your head, eyelashes, eyebrows, or other facial hair
- Discolorations at an early age that progress for about a year and then stop
Causes of Vitiligo
Vitiligo happens when your melanocytes (cells that create color) die, or stop producing melanin. The exact reason this occurs is unknown.
Researchers suspect vitiligo may be caused by:
- An autoimmune disease, causing your normally protective immune system to attack cells that create pigment
- Genetics: Vitiligo tends to run in families
- A triggering event, such as exposure to industrial chemicals, sunburn, or stress
Although vitiligo can exist without any other known health conditions or symptoms, it can be related to another illness, and it may cause other health problems.
People with vitiligo are more likely to have autoimmune diseases. Autoimmune illnesses occur when your body’s normal disease-fighting processes attack healthy cells.
Autoimmune thyroid disease is the most common condition related to vitiligo. If it’s related, the discoloration symptoms of vitiligo usually occur before or at the beginning of the thyroid illness.
According to a 2010 report in the journal Clinical and Experimental Dermatology, vitiligo can be a sign of thyroid problems in children, not just adults and teenagers.
The researchers also found that among the children in this study, non-segmental vitiligo was more frequently related to autoimmune thyroid disease than segmental vitiligo was.
Medical researchers have been expanding the number of potential vitiligo-related conditions they investigate, looking for links to vitiligo across a number of inherited (genetic), infectious (bacterial, fungal, and parasitic), endocrine (hormones that regulate vital body functions), and autoimmune disorders.
You should see your doctor if you have symptoms of vitiligo. At your appointment, your doctor will ask you questions about your medical history, including whether you have any family members with vitiligo or if you have an autoimmune disease.
The doctor is likely to take a blood sample to test for thyroid disease and perform an eye exam. A skin biopsy may also be done to look for other skin conditions.
If another disease is involved in your case, it is likely to be an autoimmune thyroid condition.
However, your doctor may want to do a “differential diagnosis” to rule out other conditions that can cause or be confused with vitiligo. Some of these include:
- Illnesses that cause eye inflammation
- Illnesses of the endocrine-system (hormones that regulate vital body functions) in addition to thyroid disease
- Illnesses that can affect the skin, such as autoimmune diseases (e.g., lupus, scleroderma), cancer (e.g., melanoma), or blood-circulation disorders
- Infections, such as fungal (tinea versicolor), bacterial (syphilis, yaws, and other Treponematosis infections), or parasitic (river blindness) diseases
- Inherited genetic conditions that may affect skin color, eyes, and hearing (such as piebaldness, tuberous sclerosis, and Waardenburg syndrome)
Medication, such as corticosteroids, can also cause vitiligo symptoms.
You should always tell your doctor about any traveling you’ve done in the past few years, and all medications, supplements, diets, and other treatments — including alternative medicines — that you’re taking.
There is no cure for vitiligo, but topical medications, light and laser treatments, and surgery may add pigment back to your skin to give you a more even skin tone.
Of course, if your vitiligo is related to or caused by another condition, such as thyroid disease, then you will be treated for that.
Vitiligo can affect your self-image, which may be distressing or depressing.
If you feel down or want advice for coping, it can help to get professional counseling and find a support group of other people who are living with the same condition.