Vitiligo: Information for Patients

Vitiligo is a common condition in which white patches appear due to loss of pigment in the skin. In this article, we explain, in clear language and without myths, what it is, why it can appear, how to recognize it, what safe measures you can take starting today, and what treatments are available, including what results are typically realistic. You will also find signs to know when it’s advisable to consult a dermatologist and how the clinical evaluation is usually performed.

Summary in 60 seconds

• Vitiligo is a condition in which white patches appear due to loss of pigment.
• It is not contagious or «caught». It is usually related to an immune process and can progress in outbreaks or stabilize.
• The diagnosis is usually clinical, sometimes supported by a special lamp (Wood’s lamp).
• There are treatments that can slow down activity and promote repigmentation , but the result varies between people and requires time (months).
• Sun protection is key to preventing sunburn and more pronounced contrasts. Seeking medical advice early helps in choosing safe and realistic treatment options.

What is vitiligo?

Vitiligo is an acquired disorder in which the skin (and sometimes the hair) loses color due to a decrease or absence of functional melanocytes, resulting in white macules or patches . The most common form is non-segmental vitiligo (often bilateral or symmetrical), while segmental vitiligo tends to be localized to one side of the body. It is not an infection and is not transmitted by contact. Ezzedine 2015

Why does it appear?

There is no single cause. The evidence points to a combination of:

• Immunological factors (the immune system is involved in the damage to pigment cells).
• Genetic susceptibility (higher probability in some families, without being uniquely «hereditary»).
• Triggering or aggravating factors in some people: repeated friction, wounds/scratching (Koebner phenomenon), sunburn, physical or emotional stress, among others.

Vitiligo can be associated with other autoimmune conditions (the most frequently cited in clinical practice being thyroid disease), although this does not mean that everyone with vitiligo will develop them. Guidelines recommend assessing the context and, if necessary, ordering further tests. Eleftheriadou 2022

What does it look like and what symptoms does it cause?

• Well-defined white spots , of varying size.
• Common locations: face (around eyes/mouth), hands, elbows, knees, feet, armpits, groin.
• It can affect mucous membranes (lips, genitals) and hair (localized graying).
• It generally does not hurt or cause significant physical symptoms; some people report mild itching or sensitivity, but this is not typical.
• Under Wood’s light, depigmented areas tend to be highlighted, helping to define their extent.

What can you do today? (safe and concrete measures)

• Daily sun protection : Use broad-spectrum sunscreen on exposed areas and reapply if there is direct sunlight. This reduces sunburn and helps to minimize the contrast between healthy skin and areas without pigmentation.

• Avoid sunburn : vitiligo is not «cured by the sun.» Uncontrolled exposure can worsen the contrast and cause new lesions in some people.

• Reduces friction and microtrauma : tight clothing, scratching or aggressive hair removal can act as triggers in predisposed areas.

• Cosmetic camouflage (if desired): Corrective makeup or self-tanning products can improve uniformity without interfering with medical treatments.

• Record changes : monthly photos with similar lighting help detect stability or progress and evaluate response if you start treatment.

• Take care of the emotional impact : if there is anxiety, isolation or low self-esteem, seeking support (psychology/psychiatry) is a health intervention, not «an extra».

Treating it early does not guarantee complete repigmentation, but it can improve the odds and help stop the disease from progressing.

What NOT to do? (common mistakes)

• Do not use tanning beds or «home UV therapies»: they increase the risk of burns and skin damage.

• Do not self-medicate with potent corticosteroids : they can thin the skin and cause adverse effects, especially on the face and in skin folds.

• Do not apply irritating products (acids, abrasive “remedies”, strong essential oils) seeking to “repigment”: they can inflame the skin and worsen the condition.

• Don’t assume that every white spot is vitiligo : some are superficial fungi, post-inflammatory dermatitis, or other causes that require a different approach.

When should I consult a specialist?

Consult a dermatology professional if:

• The spots appear or spread rapidly within weeks.

• There are white patches with scaling, marked itching , or atypical changes (to rule out other causes).

• There is involvement of the eyelids, lips, genitals , or highly exposed areas that worry you.

• You experience frequent sunburns in the depigmented areas.

• The emotional impact is high (anxiety, persistent sadness, social avoidance).

• You have general symptoms that suggest another associated problem (e.g., thyroid signs) and you want a comprehensive assessment.

What does a dermatologist usually do?

1. Medical history and examination : distribution pattern (segmental/non-segmental), time of evolution, recent activity, friction factors or burns.

2. Wood’s lamp : helps to confirm and delimit injuries.

3. Differential diagnoses : depending on the case, rule out tinea versicolor, post-inflammatory hypopigmentation, pityriasis alba, among others.

4. Additional tests : if the context suggests it, you may order blood tests (e.g., thyroid function tests).

5. A realistic treatment plan , which may include:

   • Topical treatments (e.g., corticosteroids in cycles or calcineurin inhibitors in sensitive areas).

   • Phototherapy (narrowband UVB or excimer) when indicated and available.

   • In some countries and patient profiles, topical JAK inhibitors (such as ruxolitinib) are used for limited areas; careful selection and follow-up are required. Rosmarin 2022

   • In stable and selected vitiligo: surgical options (grafts) or repigmentation techniques.
     The guidelines emphasize that response is usually measured in months , and that combining strategies (e.g., topical treatments + phototherapy) can improve outcomes in suitable patients. Böhm 2022

Frequently Asked Questions

Is vitiligo contagious?

• No. It is not transmitted through contact, objects, swimming pools, or sexual relations. Ezzedine 2015

Can it be cured?

• Today it is considered a chronic condition. There are treatments that can achieve partial or significant repigmentation and/or slow down activity, but there is no universal guarantee of a «cure» and relapses can occur.

Does the sun help with repigmentation?

• Uncontrolled sun exposure increases the risk of sunburn and contrast. Light is used medically and in controlled doses (phototherapy), not for tanning.

Does diet improve it?

• There is no single «vitiligo diet» with solid evidence of repigmentation. A balanced diet is reasonable for overall health. If you are considering supplements, it’s best to discuss this with your doctor.

Is it different for children?

• It can begin in childhood. The aim is an effective approach, but with special attention to safety, adherence, and emotional well-being.

Does makeup worsen vitiligo?

• Generally, no. Cosmetic camouflage can be useful and safe if suitable products are chosen and removed with gentle cleansing.

How long does it take to see a response to the treatment?

• It depends on the type of vitiligo, the affected area (the face usually responds better than hands/feet), and the treatment strategy. It is typically evaluated over several months , with adjustments based on response and tolerance.

Bibliography and sources

• Eleftheriadou V, Atkar R, Batchelor J, McDonald B, Novakovic L, Patel JV, et al. British Association of Dermatologists guidelines for the management of people with vitiligo 2021 . Br J Dermatol. 2022;186(1):18-29. doi:10.1111/bjd.20596.
• Böhm M, Schunter JA, Fritz K, Salavastru C, Dargatz S, Augustin M, et al. S1 Guideline: diagnosis and therapy of vitiligo . J Dtsch Dermatol Ges. 2022;20(3):365-378. doi:10.1111/ddg.14713.
• Taieb A, Alomar A, Böhm M, Dell’Anna ML, De Pase A, Eleftheriadou V, et al. Guidelines for the management of vitiligo: the European Dermatology Forum consensus . Br J Dermatol. 2013;168(1):5-19. doi:10.1111/j.1365-2133.2012.11197.x.
• Ezzedine K, Eleftheriadou V, Whitton M, van Geel N. Vitiligo . Lancet. 2015;386(9988):74-84. doi:10.1016/S0140-6736(14)60763-7.
• Rosmarin D, Passeron T, Pandya AG, Grimes P, Harris JE, Desai SR, et al. Two phase 3, randomized, controlled trials of ruxolitinib cream for vitiligo . N Engl J Med. 2022;387(16):1445-1455. doi:10.1056/NEJMoa2118828.
• Whitton ME, Pinart M, Batchelor J, Lushey C, Leonardi-Bee J, González U, et al. Interventions for vitiligo . Cochrane Database Syst Rev. 2015;2015(2). doi:10.1002/14651858.CD003263.pub5.
• Bergqvist C, Ezzedine K. Vitiligo: a review . Dermatology. 2020;236(6):571-592. doi:10.1159/000506103.
• American Academy of Dermatology Association. Vitiligo: diagnosis and treatment [Internet] . Rosemont (IL): American Academy of Dermatology Association; 2026 [consultado 6 jun 2026] . Available from: American Academy of Dermatology Association .
• Spanish Academy of Dermatology and Venereology. Guide for patients with [Internet] . Madrid: Spanish Academy of Dermatology and Venereology; [consultado 6 jun 2026] Available from: Spanish Academy of Dermatology and Venereology .