Vitiligo

Vitiligo – an acquired depigmenting skin disorder caused by loss of melanocytes – can affect the skin, hair, and mucous membranes.^1,2

The condition affects approximately 0.5–2% of the global population, with onset often before age 30.³ It has a substantial psychosocial impact, affecting self-esteem, emotional wellbeing, and quality of life.⁴

What causes vitiligo?

In vitiligo, autoreactive CD8+ T cells target and destroy melanocytes, leading to depigmentation.⁵

The disorder is multifactorial, involving:⁵

• Genetic susceptibility
• Immune dysregulation
• Environmental factors

Risk factors include family history and coexistence of other autoimmune diseases, particularly autoimmune thyroid disease.⁶

What are the symptoms of vitiligo?

Vitiligo is characterized by depigmented macules and patches.^1,7 Common clinical features include:^1,7

• Well-defined white patches of skin
• Symmetrical involvement in non-segmental vitiligo
• Depigmentation of facial, acral, and periorificial areas
• Leukotrichia

Additional manifestations include:^1,7

• Mucosal depigmentation
• Segmental or localized patterns of disease
• Progressive expansion of existing lesions
• Significant psychosocial and quality-of-life burden

How is vitiligo diagnosed?

Diagnosis of vitiligo is primarily clinical.^1,2 Wood's lamp examination can help assess disease extent.⁸

Laboratory investigations may be performed to evaluate associated autoimmune conditions, particularly thyroid disease.⁹ Skin biopsy is generally reserved for atypical presentations or when the diagnosis is uncertain.³

What are the treatments for vitiligo?

Management of vitiligo requires a multidisciplinary approach that addresses both physical manifestations and psychosocial wellbeing.⁴

Treatment aims to stabilize disease activity, promote repigmentation, and improve quality of life.¹⁰ Common treatments include:^9,10

• Topical corticosteroids
• Topical calcineurin inhibitors
• Narrowband ultraviolet B (NB-UVB) phototherapy

Targeted therapies such as topical ruxolitinib have expanded treatment options for eligible patients.^9,10

Surgical interventions such as cellular grafting procedures may be considered for selected patients with stable disease.¹⁰ Depigmentation therapy may be an option in extensive cases where repigmentation is unlikely to achieve satisfactory results.¹⁰

Developed by EPG Health for Medthority, independently of any sponsor.

References

1. AL-smadi, 2023. Vitiligo: A review of aetiology, pathogenesis, treatment, and psychosocial impact. https://www.mdpi.com/2079-9284/10/3/84
2. Alkhateeb, 2003. Epidemiology of vitiligo and associated autoimmune diseases in caucasian probands and their families. https://www.doi.org/10.1034/j.1600-0749.2003.00032.x
3. Joge, 2022. Vitiligo: A narrative review. https://www.doi.org/10.7759/cureus.29307
4. Salama, 2023. Unveiling the unseen struggles: A comprehensive review of vitiligo's psychological, social, and quality of life impacts. https://www.doi.org/10.7759/cureus.45030
5. Upadhya, 2025. Genetic and immune dysregulation in vitiligo: Insights into autoimmune mechanisms and disease pathogenesis. https://www.doi.org/10.1016/j.autrev.2025.103841
6. Baldini, 2017. Vitiligo and autoimmune thyroid disorders. https://www.doi.org/10.3389/fendo.2017.00290
7. Srivastava, 2026. Vitiligo. https://www.ncbi.nlm.nih.gov/books/NBK559149/
8. Dyer, 2022. Revealing the unseen: A review of Wood's lamp in dermatology. https://pmc.ncbi.nlm.nih.gov/articles/PMC9239119/
9. van Geel, 2023. Worldwide expert recommendations for the diagnosis and management of vitiligo: Position statement from the International Vitiligo Task Force Part 1: towards a new management algorithm. https://www.doi.org/10.1111/jdv.19451
10. Seneschal, 2023. Vitiligo: Current therapies and future treatments. https://www.doi.org/10.5826/dpc.1304S2a313S