What is vitiligo?

Vitiligo is a skin condition where patches of skin become pale or white. It affects 1 to 2 in every 100 people.

There are 2 types of vitiligo.

• Common vitiligo starts as isolated pale or white spots, with more spots or patches appearing over time.
• Segmental vitiligo affects only one area of skin, generally across an area no bigger than the palm of an adult’s hand. Segmental vitiligo does not spread, is less common and usually occurs in childhood.

What are the symptoms of vitiligo?

Symptoms usually start to appear in a person’s twenties or thirties, but they can appear in childhood or in older life.

The white areas of skin usually have well-defined edges and there is no inflammation. The patches can develop in areas where the skin has been damaged, such as a cut or burn. It can appear under the arms, in the groin, between the buttocks or in other areas where the skin rubs together. It also appears around body openings and in areas that are exposed, such as the face or hands.

White hairs can occur in an area of vitiligo, and head and facial hair might start to grey earlier than normal in affected areas.

Vitiligo can progress to other parts of the body, especially during times of distress, stress, illness or pregnancy. Sometimes the vitiligo stays stable; sometimes, white patches can suddenly get their pigment back.

There are usually no other problems, and most people with vitiligo have good health. However, some people with the condition also have autoimmune conditions such as Graves’ disease (an overactive thyroid) or Hashimoto’s thyroiditis (an underactive thyroid).

What causes vitiligo?

The cause of vitiligo is unclear, though it is thought to be an autoimmune condition, where the immune system attacks the cells that form pigment.

About 1 in 10 people with vitiligo have someone else in their family with the condition. Sometimes, having an injury to the skin, emotional factors or stress may make the vitiligo worse.

How is vitiligo diagnosed?

Your doctor will talk to you and examine you. You may have blood tests to check for autoimmune diseases.

How is vitiligo treated?

Vitiligo — like many skin conditions — can be challenging to live with, mainly because of the way the skin looks. However, people with vitiligo are usually in good health and live normal lives.

If it is not associated with symptoms that cause physical discomfort or complications, the condition may be left untreated. Otherwise, there are 3 treatment options for vitiligo:

1. Camouflage using makeup and dyes to conceal affected areas.
2. Using treatments to reduce inflammation, destroy the pigment cells or encourage neighbouring cells to produce more pigment. This may be in the form of:
• cortisone creams or ointments put onto the skin
• light therapy
• creams that work when light is applied
• medications called tacrolimus, pimecrolimus or calcipotriol
3. Re-pigmentation to transfer a person’s own pigment cells to the areas affected by vitiligo. This is done with surgery.
4. Depigmentation, which involves removing pigment from remaining areas of unaffected skin to create a consistent skin colour.

A dermatologist can help you treat and manage your vitiligo if it bothers you.

Resources and support

Having vitiligo can be emotionally and psychologically challenging. If this is the case for you, then you may wish to speak with your doctor about a possible referral to a psychologist.

You can also receive support and information from the Vitiligo Association of Australia and other support groups for people with vitiligo.