What It Is

example of vitiligo on a person's handsVitiligo is an autoimmune skin condition which causes white patches on the body due to the loss of cells that produce the pigment melanin, responsible for skin, hair and eye colour.

While not a dangerous or life-threatening condition, vitiligo can have negative psychological effects and result in embarrassment, a loss of self-esteem and social isolation.

Risk Factors

An estimated 0.5 to 2% per cent of the general population has vitiligo. While the condition is seen in both sexes and all races, it is more noticeable in people with deeper skin tones (e.g. brown and black). Vitiligo can start at any age, but about half of those with the condition develop it before age 20, and about 95 per cent before age 40.

Genetics are believed to play a role in the development of vitiligo, so if you have the condition, there is a chance some, or all, of your children will as well. About 1/3 of all vitiligo cases cluster in the same family groups.

Signs & Symptoms
  • Milky-white, irregularly shaped patches on the skin, especially on sun-exposed areas (face, hands, feet, arms, legs).
  • Patches can also commonly occur or spread to the armpit, groin, around the mouth, eyes, nostrils, navel, and genital and rectal areas.
  • Premature whitening or greying of hair on the scalp, eyelashes, eyebrows or beard.
  • Colour loss in the mucus membranes inside the mouth and nose.

While the spread of vitiligo may stop for several months or years, it can reoccur at any time, with this cycle repeating throughout a person’s lifetime. Sometimes some areas of skin may regain pigment spontaneously.


Vitiligo is believed to be caused by a combination of genetic and environmental factors. It occurs most often in people with certain autoimmune diseases such as hyper- or hypo-thyroidism (having an over- or underactive thyroid gland), adrenocortical insufficiency (underproduction of the corticosteroid hormone by the adrenal gland), rheumatoid arthritis, type 1 diabetes, psoriasis, systemic lupus erythematosus, and pernicious anemia (subnormal red blood cell level caused by an inability to absorb vitamin B12).

In some circumstances a skin biopsy (sample) may be taken to confirm the diagnosis. Blood tests can be taken to check for other autoimmune disorders.


Vitiligo can affect all skin tones and is not more dangerous in darker skin, however, people with darker skin tones or those facing cultural biases may experience unique challenges in coping with vitiligo. The psychological impact of the condition can be more significant when it is more noticeable.

Vitiligo affects the skin, hair and mucus membranes and in some cases can cause changes in vision and tear production. Some people can also develop other autoimmune diseases.


Although there is no cure for vitiligo, there are several approaches that can mask or lessen its effect. Treatments are available to help to restore white patches to their original colour (repigmentation) or destroy the remaining colour to match the white patches (depigmentation).

Commonly used treatments include:

Topical corticosteroid therapy
Corticosteroid creams or ointments applied directly to the skin can help restore skin color. This is the most common treatment given to vitiligo patients. Corticosteroids can be used along with a topical vitamin D derivative, and results may be seen as early as three months. In some cases, corticosteroids may be given orally when the disease is active early on, but this is not recommended as a long-term treatment.

Topical immunomodulator therapy
Another treatment for vitiligo uses non-steroid topical immunomodulators such as tacrolimus and pimecrolimus to regulate the local immune system activities resulting in the loss of pigment. These prescription medications have been shown to be more effective when used on vitiligo that affects the face. They can be used for longer periods without the side effects of corticosteroids.

Narrow-band UVB light is administered up to three times a week without pre-application of psoralen. This treatment is simpler and may be safer than previous forms of ultraviolet therapies. Treatment is usually given for a trial period of 3–4 months. If repigmentation is observed, treatment continues until repigmentation is complete, or for a maximum of 1–2 years.

Depigmentation treatments
Depigmentation involves fading normal skin to match the white areas caused by vitiligo. This is often considered in dark-skinned individuals when vitiligo affects more than 50 per cent of the body. Monobenzyl ether of hydroquinone (monobenzone) is applied twice daily to pigmented areas until they match depigmented areas.

JAK inhibitors
A new class of drugs known as Janus kinase inhibitors are showing great promise as a potential new treatment for vitiligo when applied to the skin as a cream. This class is also not a steroid and can be used safely in all areas for prolonged periods of time.

Transplant Surgery
A small percentage of vitiligo patients may be eligible for skin transplant surgery but is only performed at a few centres across Canada. Three options for surgical treatment are available:

  • “Minipunch” skin transfer: This method uses the person’s own tissue to treat small patches.
  • Blister grafting: This process uses heat, cold or suction to produce blisters over pigmented and depigmented skin. The tops of the pigmented blisters are removed and transplanted to the depigmented skin areas.
  • Autologous melanocyte transplant: In this procedure, a sample of normal pigmented skin is isolated in a laboratory dish containing a special cell suspension solution. Once enough normal cells have been isolated, they are transplanted to depigmented areas of the skin.

Tattooing (micropigmentation)
For brown and black-skinned individuals, directly inserting pigment into the skin can be considered to treat vitiligo of the lips. Matching natural skin colour can be challenging and any tattooing fades with time. Tattoos used for micropigmentation cannot be safely removed by laser technology. This approach is only recommended in certain situations.

Take Home Message

Vitiligo is not contagious. You cannot develop vitiligo by touching or being close to somebody with the condition or sharing their utensils or food.