It is believed that the word “vitiligo” comes from Latin. The first part of the word, “viti” is from the Latin word “vitium” meaning a mark or blemish. The suffix, “ligo” is a common Latin ending meaning to bind or cause.

Vitiligo is NOT contagious. It is a genetic disease, caused by inheritance of multiple causal genes simultaneously, possibly in different combinations in different people, plus exposure to environmental risk factors that remain mostly unknown.

Most people find that their vitiligo develops in a generalized way, most often with bilateral characteristics, meaning that if a vitiligo patch appears on one elbow, it often appears on the other elbow about the same time.

Some people develop vitiligo only in one or a few limited areas of their body. This is called segmental vitiligo. People with vitiligo can have a combination of segmental and generalized vitiligo.

In many, but certainly not all cases, vitiligo does progress slowly over time, but there is really no way to tell whether your vitiligo will progress or not. It is a slow progressing condition however, and many patients report that they may go many years without new patches developing, and then may discover new patches appearing years later. Some people even report spots that spontaneously repigment, with no treatment at all. Use of new technologies however, may be able to arrest new spots in their development.

Some, though not all patients, do experience itching of the skin prior to or while depigmentation is occurring.

The course and severity of pigment loss differ with each person. In many cases, vitiligo begins in a small area. Over time, other spots may appear, while existing spots may grow larger. Some people notice that their vitiligo may stay the same for years or even decades, and then suddenly new areas of depigmentation may occur. Occasionally, vitiligo patches will repigment spontaneously, all by themselves, with no treatment whatsoever. Many people with vitiligo do notice this happening at some point in their lives.

For reasons we don’t really understand yet, there are certain parts of the body, which are commonly affected in those who have vitiligo. The face, underarms, hands, wrists, fingers, feet, elbows, knees and genitals are among these areas. There are many theories about why such sensitive areas of the body seem to be commonly affected – the presence of many nerve endings, the bony nature, sweat glands, etc.

People who develop vitiligo usually first notice white patches or spots (depigmentation) on their skin. The skin remains of normal texture, though some people experience itching in areas where depigmentation is occurring. The white patches are more obvious in sun-exposed areas, including the hands, feet, arms, legs face, and lips. Other common areas for white patches to appear are the armpits and groin and around the mouth, eyes, nostrils, navel, and genitals. Vitiligo generally appears in one of three patterns. In one pattern (focal pattern), the depigmentation is limited to one or only a few areas. Some people develop depigmented patches on only one side of their bodies (segmental vitiligo). For most people who have vitiligo, depigmentation occurs on different parts of the body, in a bilateral pattern (generalized vitiligo). In addition to white patches on the skin, some people with vitiligo may experience white hair growing in on the scalp, eyelashes, eyebrows, and beard.

Melanin is a dark brown pigment of skin and hair in animals, particularly vertebrates, derived from the amino acid tyrosine. It is synthesized by special cells called Melanocytes, which also store the melanin.

A Melanocyte is a specialized cell located in the skin, which produces melanin (pigment). Surprisingly, all humans have roughly the same number of pigment cells in their skin. Those with darker toned skin, have pigment cells that are able to store more melanin within them. In the diagram below, the cell with the tendrils, marked “I” is the melanocyte. The brown color within the cell is the melanin. The cell uses the tendrils to distribute the melanin evenly throughout the skin.

An autoimmune disorder is any of a number of conditions in which a person’s immune system reacts against the body’s own organs or tissues, and the person’s immune system produces antibodies to them. An autoimmune disorder is NOT an “immune deficiency”. In the case of vitiligo, we believe that the immune system probably sees the person’s own pigment cells as foreign bodies, and attacks them, destroying them or weakening them. Other examples of autoimmune disorders include thyroid disorders, alopecia areata, lupus, and pernicious anemia.

An autoimmune disorder is any of a number of conditions in which a person’s immune system reacts against the body’s own organs or tissues, and the person’s immune system produces antibodies to them. An autoimmune disorder is NOT an “immune deficiency”. In the case of vitiligo, we believe that the immune system probably sees the person’s own pigment cells as foreign bodies, and attacks them, destroying them or weakening them. Other examples of autoimmune disorders include thyroid disorders, alopecia areata, lupus, and pernicious anemia.

Vitiligo appears as uneven white patches on the skin, that may vary from lighter tan to complete absence of pigment. Many people develop vitiligo bilaterally, in other words, if it appears on one elbow, it often appears on the other elbow. Researchers do not completely understand why this is. Others develop what is known as segmental vitiligo, where the patches develop in only one area or on only one side of the body.

Vitiligo is a relatively common skin disorder, in which white spots or patches appear on the skin. These spots are caused by destruction or weakening of the pigment cells in those areas, resulting in the pigment being destroyed or no longer produced. Many doctors and researchers believe that vitiligo is an autoimmune-related disorder. Although researchers are not exactly sure what causes the autoimmune response, more is being learned every year. In vitiligo, only the color of the skin is affected. The texture and other skin qualities remain normal.

Most people with vitiligo have no relatives with vitiligo. However, enough people with vitiligo do have parents, or siblings or children who develop vitiligo that a genetic factor does appear to exist.

There are definitely some medications which will pass through the placenta to your fetus. Ultraviolet light may also pose some risk. If you are pregnant, you should definitely consult with both your dermatologist and your obstetrician regarding any risks to the various types of treatments available for vitiligo.

Other than the white patches of skin, there are no other physical symptoms of vitiligo. As a secondary effect, vitiligo patches will tend to sunburn more easily, and sunscreen is often recommended. Though some websites suggest eye color and vision may be affected by vitiligo, experts indicate that any effect on eye color or the retinal pigment is extremely rare, and any impairment of vision, even rarer.

In addition to the phenol type chemicals listed in the previous paragraph, there are other things and activities which people with vitiligo should avoid. Unfortunately, the list of activities, products and chemicals to avoid varies, depending on who you talk to. Our Main Message Board has numerous topics about this subject, however, we will be updating this section shortly, with a list of some of the things many people agree may make vitiligo worse.

Some chemicals, particularly photography chemicals such as Phenols, can trigger vitiligo in those who are susceptible. Phenols can also be found in many types of hair colorings, household stains, and similar products. There are other industrial chemicals and substances which may also trigger the onset of vitiligo.

This is one theory about what may cause or contribute to the onset or exacerbation of vitiligo. Oxidative stress is an over-accumulation of hydrogen peroxide in the skin. Every person develops hydrogen peroxide in the skin, as a result of natural biological processes. An enzyme called “catalase” normally breaks down the hydrogen peroxide in the skin into water and oxygen. However, some people with vitiligo may have a problem manufacturing, using or delivering catalase to the skin.

This is a common thought for those with vitiligo. Why should we attempt to treat at all, and spend the money, if the permanence of our new pigment is not guaranteed? There are several reasons. First, for many people, simply making some attempt to repigment, in of itself, is a powerful emotional tool in dealing with their vitiligo. Second, it is clear that the larger an area of vitiligo, or the more extensive vitiligo is on a person, the harder it may be, and the longer it may take to repigment. Better treatments for vitiligo are almost sure to come eventually. There is more research and investigation about vitiligo taking place now that ever before in history. Clearly, if within the next three, five or even ten years, something revolutionary is developed in the field of vitiligo, the more pigment a person has at that point, the better.

Right now, the products available for treating vitiligo, seem to be addressing the symptom of vitiligo (the spots), and not the underlying cause, which we still don’t completely understand. Once a spot has been repigmented, some people report that the new pigment lasts a long time, and many do not report any relapse of that spot. Some patients feel that if you can get a spot to “close,” meaning, to be repigmented completely to the naked eye, that it will have a better chance of staying repigmented. Still, a significant number of people report that after repigmenting, and then stopping treatment, that over time, from a few months to a decade or longer, the areas start to lose pigment again. The underlying cause of vitiligo is still not well understood. But whatever the cause, treating the spots is treating a symptom. Therefore, watching for new areas of vitiligo is important, so that you can begin treatment as soon as possible. Many dermatologists recommend various forms of maintenance of new pigment. Maintenance could include occasional light therapy treatments, or other options. This is also something important to consider. As research advances, we may one day soon be able to treat the CAUSE of our vitiligo, rather than just the symptoms.

As with all ointments and creams, you want to discuss this with your doctor. The greatest risk to the eyes from vitiligo treatment is UV exposure. Prior to any treatment with UV light, it is wise to have a full Ophthalmic exam. Of course, many people keep their eyes covered with goggles while getting UV therapy. Many dermatologists will allow you to remove the goggles and keep your eyes gently shut for some period of time during each treatment. You should discuss this with your dermatologist prior to any treatment.

Many experts suggest that tanning beds (also known as tanning booths and solariums) not be used in place of PUVA lamps or Narrow Band UVB lamps or even natural sunlight. The problem with tanning beds is that the lamps in these devices usually emit a much stronger, broader spectrum of UV rays, and may not be as safe or effective for people treating vitiligo, and may result in severe burning or other side effects. You should consult your dermatologist before attempting any type of light or UV therapy.

For some reason, certain parts of the body, including the hands, feet, and some areas where the hair has turned white, do seem to be harder to treat than other areas. However, many of today’s brightest experts in the treatment of vitiligo, maintain that ANY vitiligo spot can be repigmented, and even hair repigmented, with enough work and dedication.

The best way to find a doctor who treats vitiligo, as with most professionals, is from a personal referral from a friend or family member or a respected family physician. Of course, that may be easier said that done, since you may not know anyone with vitiligo other than you. One option, is the doctor search we have created on VitiligoSupport.org, and which you can click on from the left menu bar. Of course, you may live somewhere where there are no vitiligo experts. Many of our members have found that Universities and Colleges (all over the world) which have dermatology departments, are often the best place to find doctors who can treat vitiligo. Don’t be afraid to ask your doctor if his office uses specific therapies, such as Narrow Band UVB. Many of our members have found their dermatologists extremely willing to try different approaches, and excited to hear about new research.

Depigmentation involves fading the rest of the skin on the body to match the already white areas. For people who have vitiligo on more than 50 percent of their body, depigmentation may be the best treatment option. Patients apply the drug monobenzylether of hydroquinone (monobenzone or Benoquin) twice a day to pigmented areas until they match the already depigmented areas. Patients must avoid direct skin-to-skin contact with other people for at least 2 hours after applying the drug. The major side effect of depigmentation therapy is inflammation (redness and swelling) of the skin. Patients may experience itching or dry skin. Depigmentation is generally permanent and cannot be reversed. In addition, a person who undergoes depigmentation will always be unusually sensitive to sunlight.

Novitil (the company is called Dermabest) is a natural topical product that some people use, which contains sources of vitamins, phytonutrients and antioxidants. Some people report that Sinvitil is helping them repigment but results are mixed. Sinvitil is a formulated gel that contains an extract of proteolipids (oils). It purports to help stimulate the pigmentation process.

Melagenina (now Melagenina Plus) was developed in Cuba about 20 years ago, using human placenta tissue. They may now use other animal placental tissues. The company in Cuba that markets it claims high success rates, but these cannot be substantiated, and many people have claimed no results at all. The product instructions indicate that application of the cream should be several times a day, followed by 15 minutes of natural sunlight. In 1998, Melagenina Plus was announced, which unlike the previous treatment requires only once daily application and does not require exposure to the sun. The company claims that the calcium chloride contained in the product strengthens the skin?s pigmentation. The product is not available in the U.S. or Canada, and is not approved by the FDA for use on vitiligo.

In this procedure, the doctor takes a sample of the patient’s normally pigmented skin and places it in a laboratory dish containing a special cell culture solution to grow melanocytes. When the melanocytes in the culture solution have multiplied, the doctor transplants them to the patient’s depigmented skin patches. A fairly new technology, this procedure is still in the experimental stages.

In an autologous (use of a person?s own tissues) skin graft, the doctor removes skin from one area of a patient’s body and attaches it to another area. This type of skin grafting is sometimes used for patients with small patches of vitiligo. The doctor removes sections of the normal, pigmented skin (donor sites) and places them on the depigmented areas (recipient sites). There are several possible complications of autologous skin grafting. Infections may occur at the donor or recipient sites. The recipient and donor sites may develop scarring or an uneven appearance, or may fail to repigment at all. Treatment with grafting takes time and is costly, but does work for some people.

V-Tar is a 30% Standardized water soluble coal tar product which also contains natural anti-inflammatory agents, skin conditioners, and antioxidants. V-Tar has been used successfully in many patients with vitiligo and other hypopigmentary disorders. It will not stain the skin, and its once weekly application is convenient for many patients. V-Tar is available only with a physician’s prescription.

As described above, an excimer laser is basically a highly concentrated beam of UV light, directed at vitiligo spots or patches, without affecting the pigmented skin around them. Developed by Dr. James Spencer at Mt. Sinai Hospital in New York, this treatment has the advantage of requiring no medications, and with virtually no side effects. Recently approved by the FDA, the treatment is more expensive than other methods, and often not covered by health insurance, however many dermatologists are offering excimer laser treatment in their offices.

Pseudocatalase, also called Pcat for short, is a cream, that is applied twice a day, and purported to reduce epidermal hydrogen peroxide in vitiliginous skin, found to be in higher levels in those with vitiligo. Pseudocatalase is typically used in combination with some form of UV light therapy. Pseudocatalase does not make the skin more sensitive to light. The original formula is only available from Griefswald Germany or Bradford England.

Like Protopic, these products are all immunomodulators that affect immune response. Elidel is a product called Pimecrolimus, that is similar to Protopic, but comes in a cream form. The risks and side effects of Elidel, Aldara and Imiquimod are not entirely known, and should be discussed with your doctor. A black box warning was added to Elidel in early 2005, warning that there had been several reported cases of lymphoma or skin cancer following its use. Some doctors dispute these findings, suggesting the numbers of cancer and lymphoma cases reported are no higher than would be seen in the general population.

Protopic (Tacrolimus) is a newer medication that has is prescribed by some dermatologists for vitiligo. Protopic, an ointment made by Fujisawa Pharmaceuticals in Japan, works to down-regulate (suppress) the immune response in an area of vitiligo. Studies have shown repigmentation success in some (but not all) people who use it. Protopic ointment is currently indicated for the treatment of moderate to severe atopic dermatitis (eczema). Currently, the approved label has no specific mention of vitiligo, and the Food and Drug Administration (FDA) regulatory requirements do not support the clinical investigation or use of Protopic in vitiligo at this time. The product is available in .03% strength and the stronger .1% strength . The risks and side effects of Protopic are not entirely known, and should be discussed with your doctor. A black box warning was added to Protopic in early 2006, warning that there had been several reported cases of lymphoma or skin cancer following its use. Some doctors dispute these findings, suggesting the numbers of cancer and lymphoma cases reported are no higher than would be seen in the general population.

Many experts believe that vitiligo is the result of the immune system improperly generating antibodies to one’s own pigment cells, which then attack and kill or weaken such cells. Immunomodulators may inhibit immune cells (t-cells) from attacking the pigment cells.

Topical psoralen photochemotherapy often is used for people with a small number of depigmented patches (affecting less than 20 percent of the body). It is also used for children 2 years old and older who have localized patches of vitiligo. Treatments are done in a doctor’s office under artificial UVA light once or twice a week. The doctor or nurse applies a thin coat of psoralen to the patient’s depigmented patches about 30 minutes before UVA light exposure. The patient is then exposed to an amount of UVA light that turns the affected area pink. The doctor usually increases the dose of UVA light slowly over many weeks. Eventually, the pink areas fade and a more normal skin color appears. Most patients wash off any topical residue after treatment. The two major potential side effects of topical psoralen therapy are severe sunburn and blistering and occasionally too much repigmentation or darkening of the treated area or the normal skin surrounding the vitiligo (hyperpigmentation). Hyperpigmentation is usually a temporary problem and eventually disappears when treatment is stopped.

Steroid is the Greek word for hormone. Some steroids occur naturally in the body, such as cortisol, **Profanity Removed by Administrator** hormones, bile acids. Cortisol is essential for all life. There are many kinds of steroids, Cortico, Glutico, **Profanity Removed by Administrator** Hormones and Anabolic steroids. Anabolic steroids are illegal. When synthetic steroid hormones are prescribed and used correctly, they can be helpful, and their side-effects can be reduced. But when safeguards are ignored, damage can result.

For patients who cannot go to a PUVA facility, the doctor may prescribe psoralen to be used with natural sunlight exposure. The doctor will give the patient careful instructions on carrying out treatment at home and monitor the patient during scheduled checkups.

PUVA is one of the oldest methods used for treating vitiligo. Oral PUVA therapy is used for people with more extensive vitiligo (affecting greater than 20 percent of the body) or for people who do not respond to topical PUVA therapy. Oral psoralen is not recommended for children under 10 years of age because of an increased risk of damage to the eyes, such as cataracts. For oral PUVA therapy, the patient takes a prescribed dose of psoralen by mouth about 2 hours before exposure to artificial UVA light or sunlight. The doctor adjusts the dose of light until the skin areas being treated become pink. Treatments are usually given two or three times a week, but never 2 days in a row. The person must avoid sunlight after treatment for 12-24 hours, and must wear wrap around sunglasses to protect their eyes. The most common side effects of PUVA are sunburn, and stomach upset due to the psoralen pills. Many patients find that eating something starchy before taking psoralen pills, greatly reduces or eliminates an stomach upset.

More research and development than ever before is being conducted about vitiligo and treating it. Even the mapping of the human genome, and the advent of gene sequencing computers, may show potential.

Results from the treatments available vary by person. Some people will see results from treatment within 3 to 6 months. Others may not see results for 8 months. With immunomodulators, some people are reporting some repigmentation with 4 to 8 weeks. For others it is taking longer. The rule of thumb, is that you will need to allow at least 3 to 6 months before you begin to see results from ANY treatment. Additionally, you should expect to treat for up to two years or longer, in order to see good results. If you try a treatment for 3 months, and then quit because you saw no results, you did not wait long enough.

No. While it’s true that vitiligo is not fatal, and that it has no other physical symptoms other than white patches, the emotional and social effects of vitiligo on people are well-documented.

Vitiligo is difficult to treat – that much is true. But in the past few years, new treatments have been developed that are working better. And there are more options. Vitiligo can be treated, though results can take time. Even though treatment can take from 6 months up to two years or longer to see results, there are many new treatments available. Where you don’t see good results with one treatment, another may work better.

Vitiligo Support International is a global community organization committed to supporting those affected by vitiligo, raising awareness, promoting research, and discussing effective treatments until a cure is found.. You can help support our efforts with a tax deductible contribution on our donation page.

There is probably more research being conducted today in the area of vitiligo, than ever before. From the genetic basis of autoimmune disorders, to the structure of the skin, and understanding the immune system, studies are now being conducted which may yield more information about the nature and causes of vitiligo, and how to treat it more effectively.

It is always a good idea for people with vitiligo to use sunscreen, whenever they will be spending more than a few minutes in the sun. Besides the need to protect the skin from severe sunburn, sunscreen will keep non-vitiligo affected areas from tanning, thus helping you to avoid the contrast that results between tanned areas, and vitiligo spots. However, there are an increasing number of medical doctors who believe that SOME sun exposure, usually 5 to 15 minutes of sun exposure a few times a week, may be useful in healing vitiligo. If you are interested in this addition to your treatment, you should consult with your dermatologist to see if it is right for you.

Experts recommend that if you have vitiligo, you should avoid hair colorings and bleaches. Chemicals in these products called Phenols may cause the onset or further spreading of vitiligo. Natural colorings which do not contain phenols or phenol derivatives, are generally accepted as safe. When in doubt, you should consult with your physician.

Yes! Some members of Vitiligo Support have created their own safe homemade skin stain, made entirely out of rubbing alcohol (isopropyl) and ordinary Food Coloring. By mixing the ingredients together, a brownish color results, and the tone can easily be adjusted to match your skin.

Because people are different, and because there are thought to be many different causes of vitiligo, different treatments work better for different people. It is important to be willing to try new therapies if others are not working. Just because one treatment did not work for you, does not mean something else won’t. As biotechnology improves, and as understanding of the human genome advances, and with ever more powerful computers to assist researchers, it seems almost certain that treatment therapies will continue to improve in convenience and effectiveness.

Vitiligo Support International is a global community organization committed to supporting those affected by vitiligo, raising awareness, promoting research, and discussing effective treatments until a cure is found.. You can help support our efforts with a tax deductible contribution on our donation page.

There is probably more research being conducted today in the area of vitiligo, than ever before. From the genetic basis of autoimmune disorders, to the structure of the skin, and understanding the immune system, studies are now being conducted which may yield more information about the nature and causes of vitiligo, and how to treat it more effectively.

Don’t avoid the beach or swimming pools just because of your vitiligo. Do not allow vitiligo to interfere with the joy of living. From a physical aspect, it may make sense to go swimming and to the beach in the later afternoons, when the sun is not as strong. If it makes you feel better, wear stain or waterproof makeup cover. And if people ask about the vitiligo, you should explain it to them just as indicated above.

Under various laws, most Americans (and people in many other countries) are protected from discrimination in their work or from being fired based on medical conditions or illness. If you feel that you have been discriminated against because of your vitiligo, then you should consult an attorney specializing in labor and employment law.

Children usually cope best with vitiligo when their parent(s) is/are prepared to talk about the condition as openly and truthfully as possible. To pretend you haven’t noticed something so obvious may make it difficult for your child to talk to you about it. Because this is often so difficult for parents to cope with, especially as relates to other children, it is important to talk with teachers, and counselors, and to be conscious if your child is being teased or bullied. Support your child, and encourage them to get involve with activities and hobbies. Teach them that it is OK to be different, and that it doesn’t make them any less important. A wonderful book for children to read, is Lori Mitchell’s Different Just Like Me which teaches children that there are many different people in the world, and that they really are very much alike, despite their obvious differences.

We suggest that you be honest and open, and explain to people that vitiligo is a genetic condition, in which the body’s immune system sees pigment cells as foreign bodies, and attacks them. Explain that it is a rather common condition, that it does not hurt or itch, and that it is not contagious. Finally, explain to them that treatment technology for the condition is improving, and that genetic advances may one day solve the condition. No matter who they are, everyone can identify with genetic ailments, such as cancer, leukemia, multiple sclerosis, Parkinson?s, and other conditions. When they realize that this is a condition just like every other miserable condition humans inherit, they are less likely to be afraid of it.

Sun protective clothing can be a good addition or alternative to using sunscreens. Since sun protective clothing is an easy way to protect your skin from the sun without using chemicals such as those found in sunscreens, it is becoming more popular. This clothing is rated by a UPF (ultraviolet protection factor) rather than a SPF (sun protection factor), as it protects from both UVA and UVB rays. A garment with a UPF of 50 would block 98% of all UVA and UVB rays. Sun protective clothing can be found for men, women, and children, along with hats and sun protective swimwear.

It is always a good idea for people with vitiligo to use sunscreen, whenever they will be spending more than a few minutes in the sun. Besides the need to protect the skin from severe sunburn, sunscreen will keep non-vitiligo affected areas from tanning, thus helping you to avoid the contrast that results between tanned areas, and vitiligo spots. However, there are an increasing number of medical doctors who believe that SOME sun exposure, usually 5 to 15 minutes of sun exposure a few times a week, may be useful in healing vitiligo. If you are interested in this addition to your treatment, you should consult with your dermatologist to see if it is right for you.

Experts recommend that if you have vitiligo, you should avoid hair colorings and bleaches. Chemicals in these products called Phenols may cause the onset or further spreading of vitiligo. Natural colorings which do not contain phenols or phenol derivatives, are generally accepted as safe. When in doubt, you should consult with your physician.

Yes! Some members of Vitiligo Support have created their own safe homemade skin stain, made entirely out of rubbing alcohol (isopropyl) and ordinary Food Coloring. By mixing the ingredients together, a brownish color results, and the tone can easily be adjusted to match your skin.