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White patches on skin
White spots on skin
Skin losing color
Parts of skin looking lighter
Patches of white hair on body
Early graying of hair
Not seeing your symptoms? No worries!
Destruction of pigment cells in the skin causes white patches to appear due to an autoimmune disease, where the body's immune system attacks its own pigment cells.
Your doctor may ask these questions to check for this disease:
There is no cure for vitiligo. Some treatments to slow or reverse color change include cosmetic products, creams, oral medications, and ultraviolet therapy. Sun protection can reduce sun damage to light areas and decrease tanning of normal skin.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Yukiko Ueda, MD (Dermatology)
Dr. Ueda graduated from the Niigata University School of Medicine and trained at the University of Tokyo Medical School. She is currently a clinical assistant professor at the Department of Dermatology, Jichi Medical University, and holds several posts in the dermatology departments at Kyoto Prefectural University of Medicine, Komagome Hospital, University of Tokyo, and the Medical Center of Japan Red Cross Society.
Content updated on Jan 29, 2025
Following the Medical Content Editorial Policy
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Q.
Is it Vitiligo? Why your skin is losing pigment & medical next steps
A.
Skin losing pigment may be vitiligo, an autoimmune attack on melanocytes that causes sharply bordered, often symmetrical white patches, but infections or post-inflammatory changes can look similar. Diagnosis is clinical with a Wood's lamp and sometimes blood tests for related autoimmune disease, and next steps include early dermatology evaluation, strict sun protection, and evidence-based treatments such as topical steroids or calcineurin inhibitors, phototherapy or excimer laser, and newer topical JAK inhibitors, with urgent care if pigment loss is rapid or you have systemic symptoms. There are several factors to consider; see below for key signs, look-alikes, testing, treatments, and when to seek urgent care.
References:
* Srivastava, A., & Kumar, M. (2021). Vitiligo: A Review of Pathophysiology, Diagnosis, and Treatment. *Journal of Clinical and Aesthetic Dermatology*, *14*(3), 22–32. https://pubmed.ncbi.nlm.nih.gov/33976865/
* Rodrigues, M., Ezzedine, K., Hamzavi, I., Pandya, A. G., & Harris, J. E. (2017). New insights in the pathogenesis and treatment of vitiligo. *Journal of the American Academy of Dermatology*, *77*(1), 1–13. https://pubmed.ncbi.nlm.nih.gov/28623023/
* Mohan, P. M., & Parsad, D. (2020). Management of Vitiligo. *Indian Dermatology Online Journal*, *11*(4), 493–508. https://pubmed.ncbi.nlm.nih.gov/32904323/
* Goulart, L. B., & Ramos, E. B. (2017). An overview of pigmentary disorders: an update. *International Journal of Dermatology*, *56*(7), 701–710. https://pubmed.ncbi.nlm.nih.gov/28543789/
* Speeckaert, R., & van Geel, N. (2017). Vitiligo: an update on pathophysiology and treatment. *Expert Review of Clinical Immunology*, *13*(2), 167–177. https://pubmed.ncbi.nlm.nih.gov/27852156/
Q.
Vanishing Pigment? Why Your Skin Is Fading and the Medically Proven Next Steps
A.
Fading or sharply defined white patches are most often due to vitiligo, an autoimmune loss of pigment, though infections like tinea versicolor, postinflammatory hypopigmentation, chemical exposures, and rare disorders can also cause skin to lighten. There are several factors to consider. Proven next steps include early dermatologist evaluation, sun protection, and evidence-based treatments such as topical steroids or calcineurin inhibitors, phototherapy, newer JAK inhibitors, and screening for related autoimmune disease. See the complete guidance below to understand timing, risks, and which options may best fit your situation.
References:
* Ezzedine K, Eleftheriadou V, Kasbari C, van Geel N. Vitiligo: Pathogenesis, clinical features, and management. J Am Acad Dermatol. 2023 Feb;88(2):297-307. doi: 10.1016/j.jaad.2022.09.006. Epub 2022 Sep 9. PMID: 36087754.
* Goel N, Gupta P, Kumari N, Singh I. Postinflammatory hypopigmentation: a review of the etiology, clinical features, and treatment options. J Dermatolog Treat. 2023 Dec;34(1):2217688. doi: 10.1080/09546634.2023.2217688. PMID: 37944062.
* Kim M, Yeom Y, Cho D, Heo EP, Cho SH, Kim HO, Park KC, Kim WS. Idiopathic guttate hypomelanosis: A comprehensive review. J Am Acad Dermatol. 2021 Mar;84(3):711-722. doi: 10.1016/j.jaad.2020.07.031. Epub 2020 Jul 15. PMID: 32682333.
* Ghasemi F, Haghani I, Saeedi S, Zarei R, Ahmadi B, Mahmoudi S. Tinea Versicolor: A Comprehensive Review. J Fungi (Basel). 2023 Mar 14;9(3):351. doi: 10.3390/jof9030351. PMID: 36983750; PMCID: PMC10057069.
* Wang M, Guo R, Chen Z, Liu Y, Li C, Fu M, Chen X, Yang F, Liu Y. Contact leukoderma: A comprehensive review. J Am Acad Dermatol. 2022 Nov;87(5):1111-1120. doi: 10.1016/j.jaad.2022.04.053. Epub 2022 Apr 21. PMID: 35460867.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Ahmed jan N, Masood S. Vitiligo. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing
https://www.ncbi.nlm.nih.gov/books/NBK559149/Allam M, Riad H. Concise review of recent studies in vitiligo. Qatar Med J. 2013 Dec 23;2013(2):1-19. doi: 10.5339/qmj.2013.10. PMID: 25003059; PMCID: PMC4080492.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4080492/Nordlund, J.J., Le Caroline, I.P., Boissy, R.E. (2008). Vitiligo Vulgaris. In: Gaspari, A.A., Tyring, S.K. (eds) Clinical and Basic Immunodermatology. Springer, London.
https://link.springer.com/chapter/10.1007/978-1-84800-165-7_38