Vitiligo
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Vitiligo: A Common Cause of Loss of Skin Pigment
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor:
William C. Shiel Jr., MD, FACP, FACR
 Vitiligo is a condition in which white patches develop on the skin. Any
location on the body can be affected, and most people with vitiligo have white
patches in many areas of the body.
Melanin is the pigment that gives the skin its characteristic color. Vitiligo
is caused by a loss of pigment in the skin, due to destruction of
pigment-forming cells known as melanocytes. Although vitiligo affects all races
equally, it is more noticeable in dark-skinned people. Vitiligo can cause
cosmetic problems.
Vitiligo affects 1-2% of the American population, and it is estimated that 2 to 4 million Americans have the condition. In most cases, vitiligo develops
early in life, between the ages of 10 and 30 years. Ninety-five percent of
those affected will develop the disorder before age 40. Both men and women are
equally likely to develop vitiligo. Vitiligo may run in families; those with a
family history of
vitiligo or premature graying of the hair are at increased risk for the
development of vitiligo. Other risk factors that increase one's chances of
developing vitiligo include having autoimmune diseases, such as autoimmune
thyroid disease (Hashimoto's thyroiditis).
Vitiligo symptoms include an often rapid pigment loss in
several areas of the skin. The initial appearance of the white patches can be
followed by a stable period without any progression of the condition.
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What is vitiligo, and what causes it?
Vitiligo (vit-ill-EYE-go) is a pigmentation disorder in which melanocytes
(the cells that make pigment) in the skin are destroyed. As a result, white
patches appear on the skin in different parts of the body. Similar patches also
appear on both the mucous membranes (tissues that line the inside of the mouth
and nose), and the retina (inner layer of the eyeball). The hair that grows on
areas affected by vitiligo sometimes turns white.
The cause of vitiligo is not known, but doctors and researchers have several
different theories. There is strong evidence that people with vitiligo inherit a
group of three genes that make them susceptible to depigmentation. The most
widely accepted view is that the depigmentation occurs because vitiligo is an
autoimmune disease -- a disease in which a person's immune system reacts against
the body's own organs or tissues. As such, people's bodies produce proteins
called cytokines that alter their pigment-producing cells and cause these cells
to die. Another theory is that melanocytes destroy themselves. Finally, some
people have reported that a single event such as sunburn or emotional distress
triggered vitiligo; however, these events have not been scientifically proven as
causes of vitiligo.
Who is affected by vitiligo?
About 0.5 to 1 percent of the world's population, or as many as 65 million
people, have vitiligo. In the United States, 1 to 2 million people have the
disorder. Half the people who have vitiligo develop it before age 20; most
develop it before their 40th birthday. The disorder affects both sexes and all
races equally; however, it is more noticeable in people with dark skin.
Vitiligo seems to be somewhat more common in people with certain autoimmune
diseases. These autoimmune diseases include hyperthyroidism (an overactive
thyroid gland), adrenocortical insufficiency (the adrenal gland does not produce
enough of the hormone called corticosteroid), alopecia areata (patches of
baldness), and pernicious anemia (a low level of red blood cells caused by the
failure of the body to absorb vitamin B12). Scientists do not know the reason
for the association between vitiligo and these autoimmune diseases. However,
most people with vitiligo have no other autoimmune disease.
Vitiligo may also be hereditary; that is, it can run in families. Children
whose parents have the disorder are more likely to develop vitiligo. In fact, 30
percent of people with vitiligo have a family member with the disease. However,
only 5 to 7 percent of children will get vitiligo even if a parent has it, and
most people with vitiligo do not have a family history of the disorder.
Next: What are the symptoms of vitiligo? »
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