Pigment
Vitiligo
Vitiligo is a common skin condition in which the immune system stops pigment cells from working, leaving lighter or white patches. It is not contagious and it is not dangerous, but it can be hard emotionally.
Reviewed by Raashid Haque, MD, board-certified dermatologist
For education only. This guide does not diagnose or treat any condition.
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Camouflage makeup evens out pale patches and has been studied for lifting confidence in children with vitiligo.
Look for
- Products made for cover-up, often sold as camouflage or corrective makeup
- A shade range that matches your skin tone in daylight
- Waterproof, long-wearing formulas with setting powder
Full details, cautions and sourcesAvoid
- Heavy cover-up over open, weeping or infected skin
- Sharing applicators
- Going to sleep with it on
These are products Dr. Haque has reviewed and recommends for different reasons. Unless a product is clearly marked 'Affiliate link,' it is not one. Most are not.
Food and lifestyle may play a part in Vitiligo too
Anti-inflammatory eating and lifestyleLearn about Vitiligo
Vitiligo happens when melanocytes, the cells that make skin color, are lost or stop working. Experts think it is mainly an autoimmune condition, meaning the body's defense system mistakenly attacks these cells. Genes play a part, and it often runs in families, but most people with vitiligo have no clear cause.
Who gets it: Vitiligo affects people of every background and skin tone, roughly 1 in 100 people. It often starts before age 40, but it can begin at any age.
How it looks: Patches are lighter than the surrounding skin, often milky white, with clear edges. Hair in the patch may turn white too. The most common type, called nonsegmental vitiligo, tends to appear on both sides of the body, such as the hands, around the eyes and mouth, knees, elbows, and feet. A less common type, segmental vitiligo, stays on one area or one side. On fair skin the patches can be easy to miss until the surrounding skin tans. On brown and Black skin the contrast is usually obvious year-round.
Course: It is unpredictable. Patches may stay the same for years, slowly grow, or sometimes show a little natural return of color.
Thyroid and other conditions: Vitiligo is linked with other autoimmune conditions, most often thyroid disease. Many people never develop any of them, but your clinician may check for them.
What it is not: It is not contagious, not caused by anything you ate or did, not leprosy, and not a sign of poor hygiene.
Self-care
What it is
Shade, protective clothing, and broad-spectrum sunscreen to protect skin that no longer has pigment.
Often considered when
Considered for essentially everyone with vitiligo, since depigmented skin can burn quickly and burns may worsen patches.
Less suitable or needs caution when
There is little reason to avoid it. People with sensitive skin or allergies may need to try different sunscreen types, such as mineral ones.
What to watch for
Redness or burning in patches after short sun time; stinging from some sunscreen ingredients.
How long to judge it
This is a habit rather than a treatment, so it is ongoing.
Questions to ask
- How much sun is safe for my patches?
- Which sunscreen types do you suggest for my skin?
- Should I do anything different for my face and hands?
What it is
Make-up, body cosmetics, and self-tanning or staining products that blend patches with the surrounding skin. Some are made for vitiligo.
Often considered when
Often considered by people who want a quick, non-medical way to even out color, or while waiting to see if a treatment helps.
Less suitable or needs caution when
Less suitable if a product irritates your skin or you have had allergic reactions to cosmetics. Self-tanners may not match the patch evenly.
What to watch for
Itching, rash, or stinging after use. Color can rub off on clothing, and some products need to be reapplied.
How long to judge it
Results are immediate but temporary, lasting from hours to several days depending on the product.
Questions to ask
- Which camouflage products work best for my skin tone?
- Can I test a product first to check for allergy?
- Can a trained skin-camouflage specialist help me?
Prescription creams and gels
What it is
Anti-inflammatory creams or ointments that calm the immune attack on pigment cells in the skin.
Often considered when
Often considered for small, newer patches or in younger people, usually for a limited stretch of time under a clinician's guidance.
Less suitable or needs caution when
Less suitable on thin skin such as the eyelids, groin, and underarms, or for long continuous use. Use in children and during pregnancy is usually decided with a clinician.
What to watch for
Skin thinning, stretch marks, visible tiny blood vessels, and extra hair growth with long use. Clinicians often schedule check-ins to watch for these.
How long to judge it
Many clinicians judge response after about 3 to 4 months. If nothing is changing, they usually reassess.
Questions to ask
- Is my patch a good candidate for a steroid?
- How will we watch for skin thinning?
- What is the plan if it does not work?
What it is
Non-steroid creams or ointments, such as tacrolimus and pimecrolimus, that calm the immune response in the skin without thinning it.
Often considered when
Often considered for the face, eyelids, neck, underarms, and groin, where steroids are riskier, or for longer-term use.
Less suitable or needs caution when
Less suitable when the skin is broken or infected. Sun protection matters more with these medicines, and use in pregnancy or in young children is usually decided with a clinician.
What to watch for
Burning or stinging at first, which often fades. Clinicians also watch for cold-sore flares and sun exposure of treated skin.
How long to judge it
Slow. Many clinicians judge it over several months, since color can return gradually.
Questions to ask
- Is this a better fit than a steroid for my face?
- Should I use sun protection differently with this?
- How long before we decide if it works?
What it is
A prescription cream that blocks certain immune signals (JAK pathways). Ruxolitinib cream is approved by the U.S. FDA for nonsegmental vitiligo in people 12 and older, for limited areas of skin.
Often considered when
Often discussed when vitiligo is nonsegmental, affects a limited area, and other creams have not been enough or are not a good fit, including for the face.
Less suitable or needs caution when
Less suitable for people under 12 (safety and effectiveness are not established), during pregnancy or breastfeeding, or with certain infections or health histories. It is a prescription medicine only.
What to watch for
Acne where it is applied, itching, redness, and local irritation. The label carries a boxed warning about serious infections, death, cancer, heart events, and blood clots seen with JAK medicines taken by mouth, so clinicians review your health history first.
How long to judge it
Color change is usually slow. Many clinicians judge response after about 6 months, and color may fade if treatment stops.
Questions to ask
- Is this approved and appropriate for my age and patch size?
- What safety checks should I have first?
- What happens to the color if I stop?
What it is
A class of prescription topical agents that permanently remove the remaining color so the whole skin becomes one even light tone.
Often considered when
Sometimes discussed when vitiligo covers most of the body, repigmentation has not worked or is unlikely, and the person prefers an even tone.
Less suitable or needs caution when
Less suitable for anyone who is unsure, since the change is permanent and the skin will need lifelong sun protection. Not for people who want their natural color back.
What to watch for
Irritation or contact allergy, and lightening of skin you did not treat. Many people have strong feelings about identity and appearance, so counseling can help.
How long to judge it
Very slow, often taking one to several years to reach an even tone.
Questions to ask
- Is this choice reversible, and what are the alternatives?
- How will I protect my skin from the sun afterward?
- Can I speak with someone who has chosen this?
Procedures
What it is
Controlled ultraviolet light, usually narrowband UVB, given in a clinic, with a home unit or targeted excimer laser or lamp for small areas.
Often considered when
Often considered when vitiligo is widespread or active, or when creams are not enough, and sometimes combined with a cream.
Less suitable or needs caution when
Less suitable for people who cannot commit to many visits, who burn very easily, or who have a history of skin cancer or light-sensitive conditions. Eye protection is needed.
What to watch for
Redness, itching, or sunburn-like reactions, dry skin, and darkening of the normal skin around patches. Long-term skin cancer risk is a topic clinicians weigh.
How long to judge it
Slow. Treatment usually continues for months, and many clinicians judge response after about 3 to 6 months, with better results on the face and neck than the hands and feet.
Questions to ask
- Is clinic or home phototherapy realistic for me?
- How will you protect my eyes and the normal skin?
- What if I only see color return on part of my body?
What it is
Procedures that move pigment-making cells from healthy skin to a patch, using skin grafts, tiny punch grafts, blister grafts, or a suspension of cells.
Often considered when
Often considered only for stable vitiligo, meaning no new or growing patches for a long period, usually 6 to 12 months or more, especially for small patches or segmental vitiligo.
Less suitable or needs caution when
Less suitable for active, spreading vitiligo or for people who scar thickly (keloids). These procedures need an experienced team.
What to watch for
Scarring, uneven color such as a cobblestone look, color not matching, infection, and new patches at the donor site.
How long to judge it
Color usually shows over several months, and many clinicians judge results at about 6 to 12 months.
Questions to ask
- Is my vitiligo stable enough for surgery?
- How experienced is your team with this procedure?
- What if the color does not match?
Nobody fully knows what sets vitiligo off, and most people cannot point to one trigger. Things that may be linked to new or spreading patches include:
- Skin injury or friction. New patches can appear where skin was cut, scraped, burned, rubbed by tight clothing, or irritated by shaving. This is called the Koebner phenomenon.
- Sunburn. Burned skin may be more likely to develop new patches.
- Strong chemical exposure. Some workplace or hobby chemicals have been linked to patches.
- Stress or illness. Many people report flares after a hard period, though the evidence is limited.
- Family history and other autoimmune conditions. These raise the chance but do not make it certain.
Sun also makes patches more noticeable, because the surrounding skin tans and the patches do not.
| Topic | Evidence | What it means |
|---|---|---|
| Emotional health and support | Established | Vitiligo can affect confidence, relationships, and mood, and stigma is real. Counseling and peer support groups are well accepted ways to cope, even though research on which approach is best is still limited. |
| Stress | Early | Many people link flares to stress, and some studies suggest a connection, but it is not proven. Stress care is worthwhile for your wellbeing even if it does not change the patches. |
| Vitamin D and antioxidant supplements | Early | Low vitamin D is seen in some people with vitiligo, and antioxidant supplements are sometimes promoted, but good proof that they bring color back is lacking. Ask your clinician before taking supplements, and a blood test can tell whether vitamin D is actually low. |
| Diet | Anecdotal | No diet has been shown to cause or cure vitiligo. Online claims about cutting out foods are mostly based on personal stories. Very restrictive diets can lead to missing nutrients, so a balanced diet is the safer approach. |
Read: Anti-inflammatory eating
Avoid very restrictive diets, especially for children, unless a clinician is guiding you.
Vitiligo ·
When to get care soon
- Patches that are spreading quickly or new patches appearing over a few weeks.
- Symptoms that could point to a thyroid or other autoimmune problem, such as unusual tiredness, weight change, feeling too hot or too cold, heart racing, or heavy thirst.
- Patches that are red, painful, scaly, itchy, crusted, or that do not look like typical vitiligo, since other conditions can look similar.
- Skin that has blistered or burned badly in a patch, or signs of infection such as warmth, swelling, pus, or fever.
- Changes in vision, eye pain, or eye redness, especially with hearing changes, since rare conditions can affect pigment cells in the eye and ear.
- A patch in a child, so growth and other conditions can be checked early.
- Feeling very sad, hopeless, anxious, or avoiding daily life because of how your skin looks. If you ever think about harming yourself, call or text 988 in the United States right away.
About the reviewer
Raashid Haque, MD
Board Certified Dermatologist · Charlotte, NC
- 25+ years of clinical experience
- Dermatology at University of Oklahoma - Chief Resident
- Internship at Baylor College of Medicine
- LSU School of Medicine Shreveport - Valedictorian, AOA