Symptoms of Vitiligo

The primary symptom of vitiligo is the noticeable loss of skin coloring in patches. The patches are white or lightened areas of skin that can occur anywhere on the body. Sometimes, the pattern progresses to a widespread loss of color.

In addition to skin pigmentation loss, vitiligo can cause other symptoms such as pain and itching, as well as vision and hearing changes. People with the condition may also experience anxiety and depression. Vitiligo can lead to complications related to thyroid disease and autoimmune diseases.

Not everyone who has the condition experiences the same symptoms in the same way. Here's an overview of the signs and symptoms of vitiligo.

Frequent Symptoms

Vitiligo is considered to be an autoimmune disease. The condition occurs when the body's immune system mistakenly attacks the cells that give the skin and hair their color (melanocytes).

When melanocytes are destroyed, the primary symptom of vitiligo can appear: the patchy or widespread loss of skin pigmentation.

White or light patches start to form on the skin, commonly on the face, hands, arms, feet, and genitals, though the patches can appear virtually anywhere on the body, including the insides of the nose, mouth, ears, and eyes.

These patches may come on suddenly or spread gradually. They may get bigger over time or remain the same size. The amount of skin affected varies. Some people experience just a few patches of pigmentation loss, while others see a more expansive loss of color across the body.

Aside from the noticeable loss of skin color, there are other symptoms of vitiligo that affect the skin and hair. People with vitiligo may develop:

• A premature white streak of hair: A lock or streak of hair may turn white prematurely in the area where there is a loss of pigment, including the hair on the scalp, eyelashes, eyebrows, and beard.
• Painful sunburns: The patches of skin that have lost pigment can burn more easily after sun exposure, causing pain, itching, blistering, and swelling of the skin.
• Skin discomfort: Some vitiligo patients experience occasional pain, soreness, itchiness, or irritation of the skin in the affected areas.

Vitiligo is considered a long-term skin condition and it will look different for everyone. Some people with vitiligo will only notice the loss of skin pigmentation, while others develop one or more of the additional signs of the disease.

Conditions with Similar Symptoms

There are several other conditions that also affect skin pigmentation and might be confused with vitiligo, such as pityriasis alba (a white facial patch commonly seen in children) and tinea versicolor (a fungal skin infection that develops into patches of discolored skin).

Sometimes, vitiligo is mistaken for albinism, a group of inherited skin disorders that result in little or no pigment in a person's skin, eyes, and hair.

If you have these symptoms, you'll need to see a dermatologist (a doctor who specializes in skin, hair, and nails). They can make sure that you get an accurate diagnosis.

Rare Symptoms

Less commonly, vitiligo produces symptoms that affect more than the skin and pigmentation. Rare symptoms associated with vitiligo include:

• Hearing loss: If the melanocytes located in the inner ear are affected by vitiligo, it's possible for a person to develop hearing loss. However, more research is needed to explore the link. Some experts have suggested that preventive hearing evaluation tests for vitiligo patients might be helpful as these tests would allow doctors to recognize and monitor any hearing changes.
• Vision changes: If the pigment cells in the inner part of the eye (the retina) are affected by vitiligo, a person's vision may be altered. For example, they might need a prescription for glasses or even experience a change in the color of the retina. Routine eye exams might be useful for people with vitiligo.
• Tear production changes: Vitiligo may cause a decrease in tear production, particularly if there is a loss of pigmentation on the face. Some vitiligo patients might be more susceptible to dry eye syndrome and an eye inflammation condition known as uveitis. This condition can usually be treated with over-the-counter (OTC) or prescription eye drops and medication.

Complications/Subgroup Indications

Vitiligo can have medical and psychological complications. Studies show that roughly 20% of people with vitiligo have at least one autoimmune disease. In addition, vitiligo often has a major impact on quality of life and mental health.

There are several complications and comorbidities (conditions that occur at the same time but are usually not related to vitiligo) that affect different body systems in people with vitiligo. Some of the conditions associated with vitiligo include:

• Autoimmune thyroid diseases, such as Graves' disease and Hashimoto's disease, are prevalent in people with vitiligo. However, more research is needed to understand the exact roles that the immune system, oxidative stress (an imbalance of antioxidants and free radicals in the body), and specific genes play.
• Autoimmune diseases, including inflammatory bowel disease (IBD), psoriasis, rheumatoid arthritis (RA), lupus, type 1 diabetes, alopecia areata, and pernicious anemia, occur at higher rates in people with vitiligo compared to the general U.S. population. Increased screenings at routine doctor's appointments is one recommendation for identifying and monitoring these conditions in people with vitiligo.
• Mental and emotional health is also a consideration for people with vitiligo. A person's self-esteem, levels of anxiety and depression, and overall quality of life can be affected. Studies have noted there is substantial social stigma linked to the condition's visible skin patches. Experts are pushing for increased awareness and understanding of the detrimental psychological effects of visible vitiligo symptoms.

Pregnancy

Each person's body will react differently to pregnancy and vitiligo. In general, research has shown that vitiligo symptoms and progression seem to remain stable during pregnancy. However, some pregnant people have reported vitiligo symptoms worsening during gestation, while others have reported that symptoms get better.

Autoimmune diseases like lupus and rheumatoid arthritis are linked to a higher risk of pregnancy complications; therefore, experts recommend that vitiligo patients with autoimmune disease discuss the potential risks with their doctor.

Your dermatologist can also likely provide some reassuring advice. For example, some studies indicate that vitiligo itself is not linked to adverse pregnancy, labor, and birth outcomes. Still, more research is needed to confirm these findings.

When to See a Doctor

Vitiligo is not an urgent medical emergency. However, if you have skin pigment changes—even if they are not causing pain or bothering you—it's important to see your doctor, who can refer you to a dermatologist.

Early diagnosis and treatment are important, as you might develop other symptoms or conditions that are associated with vitiligo and will need to be managed, such as:

• Hearing loss
• Vision problems
• Tear production changes
• Thyroid-related symptoms (including weight changes, fatigue, and a visibly enlarged neck)
• Autoimmune-related symptoms (such as joint and muscle pain, swelling, fatigue, and low-grade fever)
• Anxiety or depression symptoms

Your doctor can refer you to an ophthalmologist or audiologist if you are having symptoms related to your vision and hearing.

While there is no cure for vitiligo, its symptoms can be managed. The treatment that is right for you will depend on your overall health, the severity of your symptoms, your age, and your preferences. Some people choose not to pursue treatment for loss of skin pigmentation, and that's completely fine.

A Word From Verywell

Vitiligo is a chronic skin condition that is linked to other conditions, like autoimmune diseases, and may impact a person's self-esteem. You will need to see a dermatologist to be diagnosed with vitiligo and decide on treatment.

After you have been diagnosed, you might find it helpful to reach out to virtual and in-person support groups through organizations like the Global Vitiligo Foundation and Vitiligo Support International. These resources can help you learn more about the condition and living with it.