What Is the Main Cause of Vitiligo?

Reviewed on 6/28/2022

A woman's back shown with vitiligo
The main cause of non-segmental vitiligo (the most common type of vitiligo) is believed to be an autoimmune response. The main cause of segmental vitiligo is believed to be due to chemicals released from the nerve endings in the skin that are poisonous to melanocyte skin cells.

Vitiligo is a condition in which white-colored or pale patches develop on the skin due to a lack of melanin, the pigment in skin. Vitiligo can affect any part of the skin, but it commonly occurs on the face, neck, hands, and in skin creases.

The types of vitiligo include:

  • Non-segmental vitiligo (also called bilateral or generalized vitiligo)
    • The most common type of vitiligo, affects about 90% of those with the condition
    • Symptoms often occur on both sides of the body as symmetrical white patches
  • Segmental vitiligo (also called unilateral or localized vitiligo)
    • Less common than non-segmental vitiligo, but more common in children
    • White patches only affect one area of the body
  • Universal or complete vitiligo
    • Rare
    • Affects the entire body

The main cause of non-segmental vitiligo (the most common type of vitiligo) is believed to be an autoimmune response. In autoimmune conditions, the body mistakenly attacks itself instead of foreign cells such as viruses. In non-segmental vitiligo, the body’s immune system attacks and destroys the melanocyte skin cells that make melanin.

Risk factors for developing non-segmental vitiligo include:

  • Family history of the condition
  • Family history of other autoimmune conditions 
  • Another co-existing autoimmune condition
  • Melanoma or non-Hodgkin lymphoma 

The main cause of segmental vitiligo is believed to be due to chemicals released from the nerve endings in the skin that are poisonous to melanocyte skin cells.

Triggers for developing vitiligo may include:

  • Stressful events, such as childbirth
  • Skin damage, such as severe sunburn or cuts (the Koebner response)
  • Exposure to certain chemicals 

What Are Symptoms of Vitiligo?

Vitiligo most commonly affects the: 

  • Mouth (inside and outside)
  • Eyes
  • Fingers and wrists
  • Armpits
  • Groin
  • Genitals
  • Hair roots, such as on the scalp

Signs and symptoms of vitiligo may include: 

  • A pale patch of skin that gradually turns completely white
    • Some people only develop a few small white patches
    • Others will get larger white patches that connect across larger areas of skin
    • Patches are usually permanent
  • Center of a patch may be white with paler skin around it
  • Patch may be slightly pink if it’s in an area with blood vessels
  • Edges of the patch may be smooth or irregular
  • Edges may be red and inflamed, or there may be brownish discoloration (hyperpigmentation)
  • Patches may itch
  • If it develops where there are hair roots, the hair in the affected area may turn white or grey

How Is Vitiligo Diagnosed?

  • Vitiligo is diagnosed with a patient history and physical examination of the affected areas of skin.
  • Sometimes the doctor will use an ultraviolet (UV) lamp called a Wood's lamp to look at the skin. Patches of vitiligo are easier to see under UV light and it can help rule out other conditions that can cause skin discoloration. 
  • Because non-segmental vitiligo is associated with other autoimmune conditions, other tests may be done to see if there is another underlying autoimmune condition.
  • Blood tests may also be needed to check thyroid function.

What Is the Treatment for Vitiligo?

The white patches caused by vitiligo are permanent, however, if the condition is severe or bothersome, treatment may be considered to reduce the appearance of the patches.

  • For small patches, skin camouflage cream can be used to cover them up.
  • Steroid creams may be used to help restore some pigment, but long-term use of topical steroids can cause stretch marks and thinning of the skin
  • If steroid creams do not work, phototherapy (treatment with light) may be used

While treatments may help restore color to the skin, the effect does not usually last and treatment will not stop the condition from spreading.

It is important to use a sunscreen with a high sun protection factor (SPF) because pale areas of skin are more vulnerable to sunburn.

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Reviewed on 6/28/2022
References
REFERENCES:

Image Source: iStock Images

https://www.nhs.uk/conditions/vitiligo/