Vitiligo: Signs and symptoms
Where does vitiligo appear on the body?
Vitiligo can develop anywhere on a person's skin. When vitiligo begins, the patches usually appear on the:
Face
Arms
Hands
Feet
In time, the spots and patches can grow, and vitiligo can appear on other areas of a person’s body. Some people lose color in areas called mucous membranes, which includes the inside of the mouth or nose and the genitals.
Vitiligo can also affect the hair, causing white or prematurely gray hair.
Some people lose some of their eye color and see light spots on the colored part of an eye. Vitiligo can also develop inside your ear and may affect your hearing.
What are the signs and symptoms of vitiligo?
The most noticeable sign of vitiligo is one or more areas of lighter skin. For many people, that’s the only sign of vitiligo. However, other signs and symptoms can develop. The following explains what you may notice.
Spots and patches of lighter skin
When a person has vitiligo, cells that make pigment are damaged. Because these cells give the skin its color, spots and patches of lighter skin appear. Vitiligo can appear anywhere on a person’s skin, including the genitals.
Patches turn white
When vitiligo is actively destroying cells that give a person’s skin its color, the patches tend to be pink or tricolor (causing a zone of tan skin between a person’s natural skin color and the white vitiligo). Once vitiligo is no longer active, the patches turn completely white, as shown here.
Lighter patches inside your mouth or nose
Vitiligo can cause loss of color in the mouth, on the lips, around the mouth, around the nose, or inside the nose.
Patches and spots sunburn easily
Skin that’s lost pigment is more sensitive to sunlight, so it sunburns quickly. Sunburns can also trigger vitiligo, causing it to spread. That’s why sun protection is so important.
Patches itch
When vitiligo is actively spreading, patches may feel itchy. Otherwise, the spots and patches rarely cause discomfort.
Hair turns white or gray
Vitiligo can cause a person’s hair to lose its color. When vitiligo appears on the skin, the hair in that area can turn white, as shown in picture A. Vitiligo can also cause a person’s hair to turn prematurely gray, as shown in picture B.
Eyelash, eyebrow, or section of hair on the scalp turns white
Some people develop loss of color on part (or all) of an eyelash or eyebrow. Others see a streak of white hair on their head.
Hearing loss develops
Melanocytes are the cells that give skin, hair, and eyes their color. The inner ear also contains these cells. When a person has vitiligo, the body attacks melanocytes. If the body attacks melanocytes in the inner ear, a person can have hearing loss.
Eye color changes
If vitiligo affects the eyes, your eye color could change. This happens quickly. While rare, vitiligo can also affect a person’s eyesight.
Vitiligo can affect your quality of life
Vitiligo can change your appearance, which leaves some people feeling:
Self-conscious
Anxious
Depressed
Angry
Embarrassed
Frustrated
If vitiligo affects the way you feel about yourself, you’re not alone. In talking with their patients, dermatologists have learned that vitiligo often changes how people feel about themselves.
Many patients want to hide vitiligo. One woman confided that she wanted to wear a short-sleeved dress to a wedding but didn’t. She was too worried about what others would think when they saw the light patches on her skin.
If vitiligo affects the way you feel about yourself and life, tell your dermatologist. With help, many people feel better. Help can range from treatment that may restore lost skin color to learning how to get natural-looking results from camouflage makeup. For some patients, joining a support group or seeing a psychologist helps build their self-confidence.
Learning more about this disease can also be helpful. Some people say it helps them feel more in control. To learn why some people get vitiligo, go to Vitiligo: Causes.
Related AAD resources
Images
Image 1: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Images 2,3,4,5,8,9: Getty Images.
Image 6: Used with permission of the Journal of the American Academy of Dermatology. J Am & Acad Dermatol. 2016;74:1178-84.
Image 7: Used with permission of the Journal of the American Academy of Dermatology. J Am & Acad Dermatol. 2017;77:17-29.
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.
Ezzedine K, Eleftheriadou V, et al. “Psychosocial effects of vitiligo: A systematic literature review. Am J Clin Dermatol. 2021;22(6):757-74.
Grimes PE. “Vitiligo.” In: Taylor and Kelly’s Dermatology for Skin of Color. (second edition). McGraw Hill, USA, 2016:341-8.
Kussainova A, Kassym, et al.” Vitiligo and anxiety: A systematic review and meta-analysis.” PLOS One. 2020 Nov 10;15(11):e0241445.
Linthorst Homan MW, Spuls PI, et al. “The burden of vitiligo: patient characteristics associated with quality of life.” J Am Acad Dermatol. 2009 Sep;61(3):411-20.
Passeron T, Ortonne JP. “Vitiligo and other disorders of hypopigmentation.” In: Bolognia JL, et al. Dermatology. (fourth edition). Mosby Elsevier, China, 2018: 1087-96.
Silvan M. “The psychological aspects of vitiligo.” Cutis. 2004 Mar;73(3):163-7.
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