Vitiligo: Causes
Vitiligo runs in families
While having a close blood relative with vitiligo increases your risk of developing it, not everyone who has vitiligo in their family develops this disease.
What causes vitiligo?
Vitiligo is an autoimmune disease. This type of disease develops when your immune system attacks part of your own body.
If you have vitiligo, your immune system attacks cells in your body called melanocytes. These are cells that make pigment.
Depending on where in your body the immune system destroys these pigment-making cells, you will have:
Lighter patches and spots on your skin
Loss of color inside your mouth or nose, which may spread and cause loss of color on your lips, around your mouth, or outside your nose
Hair on your head turn prematurely gray or develop a white streak
Part (or all) of an eyebrow or eyelash turn white, or hair covering a patch of vitiligo turn white.
Loss of color in part of an eye
Hearing loss, as the inner ear contains melanocytes
If the body continues to attack melanocytes, the patches will grow, and new spots and patches can appear in other areas.
Who gets vitiligo?
People of all races and skin colors can get vitiligo, and the disease occurs about equally in people of all races.
About half the people who develop vitiligo get it before they turn 20 years of age. For many of these people, vitiligo begins when they’re a child. Children who develop vitiligo often have a relative with this condition.
Is vitiligo hereditary?
While vitiligo can run in a family, having a close blood relative with vitiligo doesn’t guarantee that you will get vitiligo. A number of genes are involved. Vitiligo develops when changes occur in these genes, and the changes happen in the right combination.
Inheriting certain genes may increase the risk of something triggering (causing it to happen) vitiligo.
Known vitiligo triggers include:
A severe sunburn
Injured skin (cut, scrape, burn)
Getting a strong chemical like phenol on your skin
What increases the risk of getting vitiligo?
Some people have an increased risk of developing a type of vitiligo called non-segmental vitiligo. This is the most common type of vitiligo.
Your risk increases if:
Blood relatives have vitiligo.
Blood relatives have certain other autoimmune diseases (develops when your immune system attacks part of your own body), especially one that affects the thyroid (gland in your throat) or alopecia areata (type of hair loss).
You have melanoma (the most serious type of skin cancer) or non-Hodgkin lymphoma (cancer of the lymphatic system).
You are being treated for melanoma with immunotherapy.
Developing vitiligo while treating melanoma with immunotherapy is considered a good sign. Studies indicate that patients who develop vitiligo while undergoing this treatment have higher survival rates.
Vitiligo also appears more often in people who have moles on their skin called halo nevi. This type of mole has a white ring around it.
If you see white patches and spots on your skin, it’s important to find out if you have vitiligo. This disease increases the risk of having some other autoimmune diseases like thyroid disease and alopecia areata. Some people develop hearing loss or a problem with their vision.
If you have vitiligo, a dermatologist can treat the condition. Your dermatologist can also monitor you for other diseases and refer you to other doctors if necessary. This can help you help you feel your best.
To find out what’s involved in seeing a dermatologist to find out if you have vitiligo, go to Vitiligo: Diagnosis and treatment.
Related AAD resources
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References
Alikhan A, Felsten LM, et al. “Vitiligo: A comprehensive overview Part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work-up.” J Am Acad Dermatol. 2011 Sep;65(3):473-91.
Dahir AM, Thomsen SF. “Comorbidities in vitiligo: comprehensive review.” Int J Dermatol. 2018 Oct;57(10):1157-1164.
Failla CM, Carbone ML, et al. “Melanoma and vitiligo: In good company.” Int J Mol Sci. 2019 Nov 15;20(22):5731.
Gill L, Zarbo A, et al. “Comorbid autoimmune diseases in patients with vitiligo: A cross-sectional study.” J Am Acad Dermatol. 2016 Feb;74(2):295-302.
Grimes PE. “Vitiligo.” In: Taylor and Kelly’s Dermatology for Skin of Color. (second edition). McGraw Hill, USA, 2016:341-8.
Passeron T, Ortonne JP. “Vitiligo and other disorders of hypopigmentation.” In: Bolognia JL, et al. Dermatology. (fourth edition). Mosby Elsevier, China, 2018: 1087-96.
Written by:
Paula Ludmann, MS
Reviewed by:
Kesha Buster MD, FAAD
Sandy Marchese Johnson, MD, FAAD
Bassel Hamdy Mahmoud, MD, PhD, FAAD
Last updated: 6/29/22