Vitiligo and Lupus: What’s the Connection?

Vitiligo is an autoimmune disease, a chronic inflammatory condition that affects the skin. This inflammation can damage the cells in your skin that produce the pigments (melanin) that give it color (called melanocytes).

Because of the damage to these melanocytes, whitish patches appear on the skin. This is particularly pronounced in someone whose natural skin color is darker.

What Are Autoimmune Diseases?

In autoimmune diseases, part of the immune system becomes overly active. Instead of appropriately targeting an infection, the immune system can start to react to a normal part of the body. Sometimes this causes pain and inflammation in the affected area. 

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People who have vitiligo are also more likely to have other autoimmune disorders than people who don’t have it. It’s thought that around 20% of people with vitiligo have a different autoimmune disease as well. This may be because of similarities and overlaps in some of the genes and environmental factors that cause autoimmune diseases.

For example, even though lupus and vitiligo are different diseases, someone with vitiligo is more likely to get lupus than someone without this problem. Vitiligo can also be a symptom of lupus.

NLRP1 Gene

Scientists are still learning a lot about the complex factors that cause vitiligo. They think it probably happens due to a complicated combination of environmental effects and a person’s genes. That refers to individual differences in the DNA you inherit from your parents. 

Many of the specific genes thought to increase one’s risk of vitiligo make proteins that are involved in the immune system. One especially important gene is called NLRP1 (nuclear localization leucine-rich-repeat protein 1; also sometimes abbreviated as NALP1).

The protein made by the NLRP1 gene is a key regulator of the immune system. It is especially important in the skin, where it helps start an immune response if an infection is sensed. Certain variations of the NLRP1 gene are much more common in people with certain autoimmune diseases, including:

Vitiligo and Lupus

So, having variations in certain genes like NLRP1 might increase your risk of getting vitiligo, lupus, or both. Other unidentified environmental factors might be involved, too, but we are still learning a lot.

One study found that a person with vitiligo was 20 times more likely to have lupus than someone who did not have vitiligo. Other studies have shown increased risk as well. 

We also know that people who have lupus are at higher risk of having other autoimmune diseases as well, such as vitiligo. So if you get one, you are more likely to eventually get the other compared with someone who doesn’t have an autoimmune disorder. 

Vitiligo and Other Autoimmune Disorders

Similarly, having vitiligo increases one’s chances of having other autoimmune disorders. This might be because of NLRP1, other genes, or other environmental factors. People who have more severe vitiligo are more likely to have one or more additional autoimmune disorders.

The following are just some of the autoimmune disorders that are common in people with vitiligo:

Additionally, these autoimmune diseases seem to be more common in people with close relatives who have vitiligo.

Stay in Touch With Your Doctor

Be in close contact with your doctor about any new or unusual symptoms. These might mean that you have another new autoimmune disease that needs to be diagnosed and treated. 

Treatment

Fortunately, vitiligo itself affects just the skin and shouldn’t interfere too much with your everyday life. However, some people do experience psychological stress or embarrassment from their symptoms. 

Currently, treatment options for vitiligo are limited and often don’t work very well. Some options include:

Scientists are actively working to find more effective treatments for the condition. 

If you have another autoimmune disease, such as lupus, your potential symptoms may be more serious, and treatment is likely to be much more involved. Many of these people need to take regular oral medications to keep their symptoms in check.

For example, someone with lupus might need to take one or more of the following:

  • Plaquenil (hydroxychloroquine)
  • Glucocorticoids like prednisone
  • Otrexup (PF), Xatmep, or Trexall (all methotrexate)
  • Imuran (azathioprine)
  • CellCept (mycophenolate; MMF)

If you have more than one autoimmune disease, your clinician will carefully tailor your treatment to address both conditions.

A Word From Verywell

If you are someone with more than one autoimmune disease, you might feel angry and unlucky. Unfortunately, because of the way the immune system works, having one of these conditions does increase your risk of getting another. 

It can be challenging, but with good treatment, these conditions are usually manageable. Don’t hesitate to talk to your doctor about all your concerns and discuss any new potential symptoms. 

Frequently Asked Questions

  • Am I more likely to get an autoimmune disorder if I already have one?

    Unfortunately, yes. Having an autoimmune disorder puts you at greater risk of getting another one. This is probably due to a combination of genetics and environmental factors. Some people even have three or more different autoimmune diseases.

  • Is vitiligo a form of lupus?

    No, vitiligo is not a form of lupus. Both are autoimmune conditions that can affect your skin. If you have one, you are more likely to get the other. But they are two different diseases with two different treatments. Most people who have one will never develop the other.

  • What is the most common autoimmune disease in people with vitiligo?

    Studies vary on this. However, autoimmune thyroid disease seems to be one of the most common. This could be Hashimoto’s thyroid disease, causing hypothyroidism (too little thyroid hormone). Or it might be Graves disease, causing hyperthyroidism (too little thyroid hormone). 

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8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Boggs W for The Rheumatologist. Autoimmune diseases common in patients with vitiligo. Updated November 19, 2015.

  2. MedlinePlus. Vitiligo.

  3. Levandowski CB, Mailloux CM, Ferrara TM, et al. NLRP1 haplotypes associated with vitiligo and autoimmunity increase interleukin-1β processing via the NLRP1 inflammasome. Proc Natl Acad Sci USA. 2013 Feb 19;110(8):2952-6. doi:10.1073/pnas.1222808110

  4. Lee H, Lee MH, Lee DY, et al. Prevalence of vitiligo and associated comorbidities in Korea.Yonsei Med J. 2015;56(3):719-725. doi:10.3349/ymj.2015.56.3.719

  5. Spritz RA, Andersen GH. Genetics of vitiligoDermatol Clin. 2017;35(2):245-255.doi:10.1016/j.det.2016.11.013

  6. Migayron L, Boniface K, Seneschal J. Vitiligo, From physiopathology to emerging treatments: A reviewDermatol Ther (Heidelb). 2020;10(6):1185-1198.doi:10.1007/s13555-020-00447-y

  7. Fanouriakis A, Kostopoulou M, Alunno A, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis. 2019 Jun;78(6):736-745. doi:10.1136/annrheumdis-2019-215089

  8. Gill L, Zarbo A, Isedeh P, Jacobsen G, Lim HW, Hamzavi I. Comorbid autoimmune diseases in patients with vitiligo: A cross-sectional study. J Am Acad Dermatol. 2016 Feb;74(2):295-302. doi:10.1016/j.jaad.2015.08.063