Sexual Health With Vitiligo on the Vagina

People with vitiligo usually lose skin pigment in patches. The depigmented, white patches may spread all over the body, or they may appear only in one area. This loss of pigmentation can happen in and around the vagina.

Vitiligo is a chronic condition that causes the skin to lose melanin, the substance that determines your skin color. Researchers believe that vitiligo is an autoimmune disease—a condition that causes the body’s immune system to turn against itself and destroy healthy cells. 

Vitiligo isn’t contagious or life-threatening. However, it can lead to challenges with self-esteem, psychological distress, body image, and quality of life. This article will discuss vitiligo on the vagina, why it appears, and what helps with confidence.

What Are Vitiligo Patches?

Vitiligo causes the destruction of melanocytes—the cells that give skin its pigment. As skin loses its color, irregular milky-white patches appear on the face and body. The patches may lose color only partially, or they might appear completely white. Most people with vitiligo do not have any other symptoms, such as itching or pain.

There are two kinds of vitiligo, each of which causes a different pattern of color loss: 

• Non-segmental vitiligo, also known as generalized vitiligo, is the most common form of the condition. It causes symmetrical patches of depigmentation, often on both sides of the torso.
• Segmental vitiligo is less common. It causes depigmentation in one area or only on one side of the body.

Usually, vitiligo symptoms first appear before the age of 20. Over time, the color loss may progress and spread.

Location and Appearance

People with vitiligo can experience depigmentation anywhere. White patches are most common in the mucous membranes (such as are in the genitals, mouth, or nose), hands, feet, face, and torso. Color loss may also affect the eyes and hair. 

While anyone can get vitiligo, the white patches are often more obvious in people with darker skin tones. They may also spread more easily to areas of skin frequently exposed to the sun.

On the Vagina

Vitiligo on the vagina is sometimes called mucosal vitiligo (MV)—skin depigmentation in the mouth and/or genitals—or vulvar vitiligo (VV). White patches may appear on the vulva (the external genitalia), inside the vagina, or both.

In children, vulvar vitiligo is sometimes referred to as “figure-of-eight disease” because of the typical distribution of white patches along the vulva and perianal area (around the anus).

Sometimes, vitiligo in and around the vagina is misdiagnosed as lichen sclerosus (or vice versa). Lichen sclerosus is a chronic inflammatory skin disorder that causes itchy, white patches to develop on the external genitalia. Some people have both vitiligo and lichen sclerosus. 

Like vitiligo, lichen sclerosus is not contagious, and it can’t be sexually transmitted. However, lichen sclerosus is linked to an increased risk of vulvar cancer.

Causes of Genital Vitiligo in Women

Because vitiligo is believed to be an autoimmune disorder, it may be related to oxidative stress (an imbalance between antioxidants and free radicals in the body) and inflammation. 

Up to 25% of people with vitiligo have at least one other autoimmune disorder, such as:

• Crohn’s disease (an inflammatory bowel disease)
• Type 1 diabetes (affects the production of the blood sugar-regulating hormone insulin)
• Rheumatoid arthritis (inflammation of the joints and other body tissues)
• Psoriasis (a chronic inflammatory skin condition)
• Thyroid disease (affects the thyroid)
• Pernicious anemia (affects the absorption of vitamin B12)
• Systemic lupus erythematosus (chronic inflammation of many body organs and tissues)

Loss of pigmentation may be triggered by sunburn, illness, chemical exposure, or a skin injury. In some cases, vitiligo may be an inherited condition.

Genital vitiligo is usually diagnosed as a form of segmental vitiligo. Segmental vitiligo is more common in females than in males, and it is somewhat more likely to appear in childhood. Females are not more likely than males to have vitiligo, but they are more likely to have autoimmune disorders in general.

Why Vitiligo on the Vagina Isn't Contagious

While vitiligo symptoms may sometimes be alarming, especially in the genital area, vitiligo is not a sexually transmitted infection (STI). It is also not related to poor hygiene, sexual health, or any contagious condition.

Like other autoimmune diseases, vitiligo symptoms occur because the body’s own natural defenses “turn on themselves” and destroy healthy tissues. Vitiligo is never caused by a bacterial infection or viral illness.

Self-Esteem and Intimacy

While vitiligo is not a dangerous medical condition, it can cause significant psychological distress. Vitiligo has been linked to social stigma, self-consciousness, depression, and a diminished quality of life. 

Especially in the genital area, vitiligo can also lead to struggles with intimacy due to challenges with self-esteem, body image, and confidence. Some people may be embarrassed to talk to their partner about vitiligo. They may also worry that a sexual partner will wonder if their condition is contagious.

Recent research suggests that vitiligo-related stress can lead to sexual dysfunction, such as low arousal and difficulty reaching orgasm. A 2021 study indicated that women with vitiligo were more likely to experience sexual dissatisfaction as a result of concerns about their attractiveness to a partner.

If you have vitiligo, it’s important to build your confidence and cultivate a healthy self-image. People with vitiligo report greater levels of happiness and an improved overall sense of well-being after working to boost their self-esteem. 

Here are some ways you can approach the topic of vulvar vitiligo with your partner:

• Bring up the subject when the time feels right. Some people prefer to bring up their vitiligo symptoms up front before it’s time for sexual intimacy. Others prefer to let the subject come up organically in conversation. Do what feels most natural for you and the relationship you’re building with your partner.
• Keep an open dialogue. Let your partner know what you need from them to feel comfortable and confident, especially during physical intimacy. They may also have questions about your condition and your feelings about it. Being honest and open can help you grow closer. 
• Set healthy boundaries. While transparency and trust are important, you don’t have to answer any questions that make you feel uncomfortable. Remember that you have nothing to feel ashamed about.
• Seek help if needed. If self-consciousness about your vitiligo symptoms is affecting your relationship, you might want to seek counseling—whether together or individually. A sex therapist may help you approach intimacy in a new way.
• Find support. There are several in-person and online peer support groups for people with vitiligo where you can discuss symptoms, build connections, share tips about relationships, and more.
• Share resources. Encourage your partner and/or loved ones to educate themselves about vitiligo with helpful resources.
  

Vaginal Loss of Pigmentation Treatments

There is no known permanent cure for vitiligo. Vitiligo treatment options are focused on temporary repigmentation, preventing the spread of color loss, and covering up existing depigmentation. 

The most common treatments for vitiligo include:

• Camouflage therapy using makeup and skin dyes
• Topical creams and medications, such as corticosteroids and Janus kinase (JAK) inhibitors such as Opzelura (ruxolitinib)
• Light therapy, which involves exposure to UVB light several times a week with lasers or light boxes
• Surgery, such as skin grafting

Some healthcare providers are willing to treat vitiligo on the vagina with topical corticosteroids and UV light therapy. However, these treatments aren’t always as safe, practical, or effective for genital vitiligo.

Topical steroid creams can lead to side effects like skin atrophy (thinning of the skin). Light therapy often requires two to three sessions per week. 

Some research suggests that topical calcineurin inhibitors (TCIs), such as Elidel (pimecrolimus) and Protopic (tacrolimus) creams, may be effective in reversing color loss in children and adults with vulvar vitiligo.

Usually prescribed by a dermatologist, TCIs have anti-inflammatory, immune-boosting properties. They are also used to treat patients with eczema.

Many people choose not to seek medical treatment for vulvar vitiligo. Because vitiligo isn’t life-threatening and typically doesn’t lead to health complications, it’s not necessary to medically treat the condition.

Where to Go

If you notice white patches on your vagina, you should talk to your healthcare provider as a first step. Your healthcare provider may want to rule out other possible diagnoses, such as lichen sclerosus, other skin conditions, or vulvar cancer.

Your healthcare provider can refer you to a dermatologist (specialist in skin conditions) who focuses on female genital dermatology or a vulva-vaginal disorders specialist. A psychotherapist may also be able to help you with issues related to body image and self-esteem.

Summary

Vitiligo is a chronic condition that causes the skin to lose pigment in patches. It is believed to be an autoimmune disease. Vitiligo is not life-threatening or dangerous, but it can cause psychological distress.

Loss of pigmentation may occur anywhere on the body. Children and adults with vitiligo may experience color loss in and around the vagina.

Vitiligo patches on the vulva or in the vagina are not dangerous, and they can’t be transmitted to a sexual partner. However, many people with genital vitiligo experience self-consciousness and face challenges with body image, self-esteem, and intimacy. 

Vitiligo treatment options include topical medications, light therapy, camouflage therapy, and surgery. Many of these treatment options aren’t as safe or effective in treating genital vitiligo. However, there are some topical treatments, such as topical calcineurin inhibitors (TCIs), that can help with repigmentation in the genital area.

A dermatologist, especially one who specializes in female genital dermatology, can explain your treatment options in more detail.

A Word From Verywell

Vitiligo isn’t a dangerous medical condition, but it can lead to emotional stress and struggles with self-esteem. Talk to your primary healthcare provider or a dermatologist if you are concerned about vitiligo symptoms in your vaginal area.