The 3 Stages of Vitiligo

Vitiligo affects everyone differently. The condition usually begins with small white patches in a localized area. If the vitiligo progresses it can gradually spread across the body over time.

This article discusses the stages of vitiligo, types, and signs you could expect over time.

Young man with vitiligo looking at city view

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What is Vitiligo?

Vitiligo is a skin disease that leads to the development of smooth white areas where the skin loses its color. Those areas, called macules or patches depending on their size, occur due to a lack of melanin, or pigment. Vitiligo typically occurs on the hands, face, and neck although it can occur anywhere on the skin. 

Vitiligo is an autoimmune disease that develops when antibodies destroy melanocytes, which are the cells that produce melanin in the skin.

Autoimmune Disease

With an autoimmune disease, your body’s immune system malfunctions and, instead of fighting viruses and infections, it attacks itself. 

Of those who have vitiligo, nearly half contracted the disease before they were 21 years old. Because the skin disease is non-life-threatening and not contagious, it’s possible to live a long life with vitiligo. 

Vitiligo Stages

The first appearance of vitiligo is through small white skin patches that usually appear on the hands, arms, face, or feet although they may appear anywhere on the body. If vitiligo progresses, small skin patches may expand and spread across the body. However, for many people who have vitiligo, the skin patches can stay localized to the area where they first appear.

Vitiligo does not affect everyone the same. It's not uncommon to have a rapid loss of color in patches, and then the disease goes dormant for a period of time.

Types of Vitiligo

There are two main types of vitiligo: non-segmental and segmental. There are also several subtypes.

Non-segmental

With non-segmental vitiligo, the disease shows up as symmetrical white patches on both sides of the body. The most common type of vitiligo, it can affect the arms, elbows, back of the hands, knees, feet, and skin around the eyes or other body openings.

When the condition starts, there’s usually a rapid loss of skin color. While it usually stops for a while, it can become active again. Non-segmental vitiligo generally continues with a start-and-stop cycle for the duration of the condition. 

Segmental

This type of vitiligo affects just one area of the body. Although not the dominant type of vitiligo, segmental vitiligo is more common in children than adults. This type of vitiligo stays localized to the affected area.

About 20% to 35% of patients with vitiligo are children, according to the Global Vitiligo Foundation.


Subtypes

The amount of vitiligo on the body determines the subtype of the disease. The different subtypes include:

  • Localized: Skin patches are found on limited areas of the body. 
  • Generalized: Skin patches are scattered around the body. 
  • Mucosal: Vitiligo affects the mucous membranes found in the mouth and/or genitals. 
  • Focal: Skin patches remain in a small area of the body without spreading in the first two years. 
  • Trichome: Instead of a smooth white depigmented patch, skin patches contain a white mixed with lighter hypopigmented patches.
  • Universal: Pigment loss is widespread across the body. This is the rarest subtype of vitiligo. 

Vitiligo affects everyone differently, so the growth rate of skin patches depends on who you are and your medical condition.

Early Signs

Early signs of vitiligo are the loss of skin color in patches on the body. Initially, the skin may become pale before turning white. However, if blood vessels are just beneath the skin, the skin patch may look like pale pink instead of white. Loss of color may also appear in the hair, which may turn prematurely gray or white. 

Summary 

A non-life-threatening skin disease, vitiligo is a condition where the loss of pigment leads to smooth white patches on the skin. It often appears on the hands, arms, face, and feet. Skin patches may start to appear rapidly at the onset of the disease but stop for long periods of time before they resume. Although there is no cure for vitiligo, there are treatments available to help even out skin tone. 

A Word From Verywell

When all is said and done, vitiligo is a relatively safe skin disease that does not hurt. While it won’t physically interfere with day-to-day activities, it could have an impact on self-esteem and an individual’s outlook on life and social interactions. If this occurs, it’s important to speak with a counselor or therapist to address those concerns. 

Frequently Asked Questions

  • How does vitiligo start?

    Vitiligo starts with small skin patches that start to turn pale before becoming completely white as the pigment is destroyed.

  • Is vitiligo hereditary?

    Yes, about one-fifth of people with vitiligo have a family member who is also affected by the condition.

5 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. Strassner JP, Harris JE. Understanding mechanisms of autoimmunity through translational research in vitiligoCurr Opin Immunol. 2016 Dec; 43:81-11. doi: 10.1016/j.coi.2016.09.008

  2. American Academy of Dermatology Association. Vitiligo: Who Gets and Causes.

  3. Mu EW, Cohen BE, Orlow SJ. Early-onset childhood vitiligo is associated with a more extensive and progressive courseJ Am Acad Dermatol. 2015;73(3):467-470. doi:10.1016/j.jaad.2015.05.038

  4. Global Vitiligo Foundation. Vitiligo facts.

  5. MedlinePlus. Vitiligo.

By Karon Warren
Karon Warren has been a freelance writer for more than two decades, covering a range of lifestyle and business topics for print and online lifestyle and consumer publications.