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.

If you have vitiligo, you are likely to otherwise be healthy. Vitiligo can cause emotional trauma because of the way the skin looks.

What are the different types of vitiligo?

There are 4 main types of vitiligo:

• Non-segmental vitiligo is symmetrical, meaning it usually occurs on the same area of body parts on both sides of the body.
• Segmental vitiligo usually occurs in childhood and affects only one area of skin that doesn’t cross the midline.
• Mixed vitiligo is a mixture of segmental and segmental vitiligo and is rare.
• Unclassified vitiligo has 3 subtypes: punctate follicular and hypochromic.

What are the symptoms of vitiligo?

The most obvious symptom of vitiligo is having pale or white patches of skin. The white areas of skin usually have clear borders and there is no inflammation.

The patches can develop in areas where the skin has been damaged, such as from 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.

Some people have white hairs in an area with vitiligo, and your head or facial hair might start to grey earlier than normal. The areas of vitiligo may be itchy or more sensitive.

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

If you have vitiligo, you may not have any other medical problems, and many people with vitiligo stay in good health. However, if you have vitiligo you may also develop another autoimmune condition such as Graves’ disease (an overactive thyroid) or Hashimoto’s thyroiditis (an underactive thyroid), diabetes or pernicious anaemia.

What causes vitiligo?

The cause of vitiligo is unclear, but it is thought to be an autoimmune condition, where your immune system attacks the cells that make 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. Diagnosing vitiligo is usually based on how it looks.

There are usually no specific tests you need to have. Your doctor may refer you for blood tests to check for autoimmune diseases.

How is vitiligo treated?

If you don’t have symptoms that cause physical discomfort or complications, you don’t need to treat vitiligo. If you naturally have light skin, you may not want to treat it if there isn’t an obvious colour difference.

Psychological support can be an important part of treatment if you are distressed by the way your skin looks.

There are 4 treatment options for vitiligo, but treatment can be slow and you may not be able to get the areas with vitiligo to completely match the same skin colour:

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
• medicines (such as tacrolimus, pimecrolimus or calcipotriol)
3. Re-pigmentation uses surgery to transfer your own pigment cells to the areas affected by vitiligo.
4. Depigmentation, which involves removing pigment from remaining areas of unaffected skin to create a consistent skin colour if you have widespread vitiligo.

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

Resources and support

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

To find your nearest psychology clinic or after-hours medical service, use the healthdirect Service Finder tool.

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

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.