Dermatology Facts—Vitiligo

Vitiligo is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin are destroyed. As a result, white patches of skin appear on different parts of the body. Common areas of involvement are on the face, lips, hands, arms, and legs; although any part of the body may be affected.

What Causes Vitiligo?

No one knows what causes vitiligo but several different theories exist. One main theory is that people develop antibodies that destroy melanocytes. Another theory is that melanocytes destroy themselves. Some people have also reported that a single event such as a sunburn or emotional distress triggered their vitiligo. However, none of these theories has been scientifically proven.

Who Gets Vitiligo?

Vitiligo affects one to two percent of the world’s population. About half the people who develop it do so before the age of 20; about one-fifth have a family member with this condition. Vitiligo affects all races and both sexes equally, although it is more noticeable on darker-skinned people. Most people with vitiligo are in good general health.

Will It Spread?

There is no way to predict if vitiligo will spread. For some people, the white patches do not spread. However, for others, the condition is progressive and the white patches spread to other parts of the body. The rate at which it may spread cannot be predicted. For some people, the spreading may occur rapidly, while for others, it may take many years.

How is Vitiligo Treated?

There is no single cure for vitiligo. However, there are treatments aimed at restoring the function of the skin and improving the patient’s appearance. Therapy for vitiligo may take a long time, up to 18 months. The therapeutic approach depends on the severity of the condition and on the patient’s preference for treatment. Each patient responds differently to treatment, and a particular treatment may not work for everyone.

Popular approaches to therapy include:

• Topical steroids—
  May aid in repigmenting the skin, especially if started early in the disorder.


• Newer immunomodulatory topical agents (e.g., Protopic and Elidel)—
  Promising but still unproven controlled trials


• PUVA—
  This treatment combines ultraviolet light (UVA) with the chemical psoralen. Effective, but required frequent trips to the dermatologist (three times a week for several weeks).