What Is the Link Between Vitiligo and Autoimmune Thyroid Disease?

vitiligo and thyroid disease
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Researchers have found a clear genetic connection between the skin condition vitiligo, and other autoimmune diseases. Specifically, vitiligo is highly associated with a number of autoimmune diseases, including:

Even more, research has revealed that the prevalence of autoimmune thyroid disease in around 14 percent in people with vitiligo, and the risk of developing autoimmune thyroid disease (if you have vitiligo) increases with age.

Overview of Vitiligo

Vitiligo, also called piebald skin or acquired leukoderma, is a condition in which the pigment is lost from areas of the skin, causing whitish, smooth patches. The loss of pigment is from melanocytes, the cells that produce the pigment. The hair that grows in those affected areas may also be affected, turning white as well. In vitiligo, the skin itself suffers no damage, but some people do note skin itching or discomfort.

There are different types of vitiligo:

Non-segmental Vitiligo

This is the most common type of vitiligo. The patches are visible on both sides of the body and are typically symmetrical. The spots are most commonly found in areas commonly exposed to the sun or on skin subjected to pressure, friction, or trauma.

There are five subcategories of non-segmental vitiligo:

  • Generalized – no specific are or size where the patches occur
  • Acrofacial – mostly on fingers, toes, and face
  • Mucosal – found around mucous membranes and lips or genital mucosa
  • Universal – covers most of the body, and is very rare
  • Focal – a few scattered white patches in a small area, typically found in children

Segmental Vitiligo

This form of vitiligo spreads rapidly but is more stable than non-segmental. It's also much less common than non-segmental.

Mixed Vitiligo

Mixed vitiligo means a person has evidence of both segmental and nonsegmental vitiligo. 

Vitiligo minor or Hypochromic Vitiligo

This type of vitiligo is characterized by a few scattered white patches on the trunk and scalp, found in dark-skinned people

Cause of Vitiligo

There is no clear-cut reason why the melanocytes die. Some of the reasons thought to cause vitiligo are:

  • An autoimmune attack, where the immune system inappropriately attacks and destroys the melanocytes in the skin
  • Imbalances in the body’s oxidative stress that may be genetic in nature
  • Viruses

A number of factors are considered trigger events for vitiligo, including:

  • Stressful events or chronic stress
  • Severe sunburn
  • Exposure to harsh chemicals

Diagnosis of Vitiligo

A doctor will diagnose vitiligo by evaluating your family and medical history, as well as undergo a physical exam. Your doctor may order blood tests to evaluate your thyroid function, given the link between vitiligo and autoimmune thyroid disease.

Your doctor will typically ask questions, including:

  • Do you have other family members with vitiligo?
  • Do you have a family history of autoimmune diseases?
  • Did you have a serious rash or sunburn prior to the white patches showing up?
  • Are you under physical or mental stress?
  • Did your hair turn grey before age 35?
  • Are you sensitive to the sun?

Treatment of Vitiligo

Most likely, you will need to see a dermatologist to properly diagnose vitiligo. The doctor can help you start a course of treatment to help restore the skin pigmentation. While there are many treatment options for vitiligo, there is no cure.

Treatment depends on your age, overall health, personal preferences, and the location of the vitiligo on your body. Some people choose not to treat their vitiligo.

The treatments for vitiligo include the following:

The affected area is exposed to UVB light. This treatment can be done at home, and because it can be done daily at home, is considered one of the more effective treatments.

T his treatment uses UVA light to treat exposed areas and is typically done in a doctor’s office.

Skin camouflage/ makeup 

The affected areas can be covered with cosmetic tinted creams and makeup.

If the affected area is large, as in more than 50 percent of the body, the rest of the body can be depigmented in order to match the areas affected by the vitiligo.

Topical steroids 

Sometimes topical steroids applied to the affected areas can stop the spread of the disease. This treatment is typically not done on vitiligo located on the face.

Nutrition, herbs, and complementary approaches 

Vitiligo Support International has a good overview of various nutritional, herbal and complementary approaches for vitiligo

Two newer options are also showing promise in treating vitiligo.

PC-KUS 

PC-KUS is a topical treatment developed in Europe. In one study of almost 2,500 patients with vitiligo, the majority were able to restore pigmentation in their skin and hair with PC-KUS treatment.

Tofacitinib 

Tofacitinib, a Janus kinase inhibiting drug, has been found to stimulate repigmentation in some vitiligo patients. More extensive studies are needed to confirm that the drug is both safe and effective in treating vitiligo.

A Word From Verywell

While vitiligo is not a life-threatening disease, it can take a toll on a person's mental health. Gaining knowledge about vitiligo, seeking out proper care from a dermatologist, and connecting with others with vitiligo is key to coping well.

Lastly, if you or a loved one has vitiligo, it's sensible to discuss with your doctor obtaining a TSH blood test and a test for thyroid antibodies.

View Article Sources
  • American Academy of Dermatology. Vitiligo. 
  • Baldini E et al. Vitiligo and Autoimmune Thyroid Disorders. Front Endocrinol (Lausanne). 2017;8:290.
  • Grimes PE. (2017). Vitiligo: Pathogenesis, clinical features, and diagnosis. Tsao H, ed. UpToDate. Waltham, MA: UpToDate Inc.
  • Liu LY, Strassner JP, Refat MA, Harris JE, King BA. Repigmentation in vitiligo using the Janus kinase inhibitor tofacitinib may require concomitant light exposure. J Am Acad Dermatol. 2017 Oct;77(4):675-82.
  • Vrijman C et al. The prevalence of thyroid disease in patients with vitiligo: a systematic review. Br J Dermatol 2012 Dec;167(6):1224-35.