Skin Health More Skin Conditions How Vitiligo Is Treated By Heather Jones facebook twitter Heather M. Jones is a freelance writer with a strong focus on health, parenting, disability,and feminism. Learn about our editorial process Heather Jones Medically reviewed by Medically reviewed by Casey Gallagher, MD on February 20, 2021 Casey Gallagher, MD, is board-certified in dermatology and works as a practicing dermatologist and clinical professor. Learn about our Medical Review Board Casey Gallagher, MD Published on February 22, 2021 Print Table of Contents View All Table of Contents Causes of Vitiligo Types of Treatment Current Research Prognosis Coping Vitiligo is a condition in which the skin in one or multiple areas becomes lighter than the rest of the skin due to a loss of pigmentation. While primarily a cosmetic issue, vitiligo is associated with other medical conditions such as hearing loss and thyroid problems. There is no cure for vitiligo, but more treatments are being researched that appear promising. LeoPatrizi / Getty Images What Is Vitiligo? Causes of Vitiligo The exact cause of vitiligo is unknown, but it is believed to be the result of one of, or a combination of, the following factors: Genetics: About 30% of people with vitiligo have a close relative who also has or has experienced vitiligo.Autoimmune disorder: At least some forms of vitiligo appear to be caused by autoimmune factors, where the body destroys its own cells, specifically melanocytes (the cells that produce pigment in skin and hair).Neurogenic factors: Nerve endings in the skin may produce a substance that is toxic to melanocytes.Self-destruction: Melanocytes may destroy themselves due to a defect within the cells.Physical or emotional stress: It is possible that vitiligo could be triggered by physical or emotional stress. How Common Is Vitiligo? Vitiligo affects approximately 1% of the population and can affect people of any ethnicity, skin color, or gender. While people of any age can develop vitiligo, it usually starts in adolescence or early adulthood, with nearly half of all people with the condition developing it by the time they turn twenty-one. Types of Treatment Many people choose not to treat their vitiligo. If your vitiligo is not related to other potentially associated health conditions—like autoimmune diseases—there is no medical need for treatment. Medication Treatment for vitiligo often includes topical or oral medications or a combination of both. Corticosteroids Come in topical or oral formTarget inflammation that can lead to fewer pigment cellsCan take up to three months to see resultsMay cause skin atrophy (when skin becomes very thin and dry), or striae (stretch marks) when used long-termIncludes steroids such as clobetasol, betamethasone, and fluocinonideAbout 45% of people using potent or super potent topical corticosteroids regain at least some skin pigmentation by four to six months Topical medications are usually prescribed for use on small areas and work best for people with darkly pigmented skin. These medications work better on some areas of the body than others. They are not very effective on the hands and feet but are more effective on the face. It is important to note that some of these medications should not be used on the face, or other specific body parts, because of the potential for harm. Always check with your healthcare provider before use. Other topical medications include: Topical vitamin D analogs Used to stimulate melanocytesIncludes calcipotriol and tacalcitolStudies indicate a mixed efficacySerious side effects are rareMild side effects can include dry skin, stinging, and burning, and can subside with continued useTypically used in combination with other treatments such as corticosteroids Protopic and Elidel Available by prescription only in the United StatesImmunomodulators that suppress the immune system where appliedAllows melanocytes to returnMore effective on the face, less effective on hands and feetStudies show very little systemic absorption, less than seen in topical steroidsSide effects such as sensations of itching, stinging, burning, or soreness of the affected skin usually occur within the first few days of treatment and are typically mild or moderateLess common, but more serious side effects can occur, so it is important to discuss risks versus benefits with your healthcare providerBlack box warning from the FDA concerning the extremely rare possibility of developing some form of lymphoma from the use of these medicationsDrinking alcohol may cause flushing in the face (redness, feeling hot), which is not dangerous Light Treatment Phototherapy (light therapy) uses narrow band ultraviolet B (UVB) light to restore lost color to the skinMost effective on face, least effective on hands and feetCan be administered via a lightbox (for widespread areas affected by vitiligo) or excimer lasers (for targeted treatment of smaller areas)Requires two to three treatments per week for several weeks to monthsEffective for many people, with about 70% of people seeing results from treatment with excimer lasersResults are not always permanent with about 44% experiencing a loss of regained color one year after stopping treatment, and about 86% after four yearsCan be used on its own or in combination with medications PUVA Light Therapy Uses a combination of UVA light and the medication psoralen to restore color to the skinPsoralen can be administered topically or orally (in pill form)Can be used for widespread vitiligoAbout 50 to 75% effective for the face, trunk, upper arms, and upper legs, but less effective on hands and feetRequires twice a week treatment at a hospital or PUVA center for about 1 yearRequires an eye exam before and after finishing treatment as psoralen can affect the eyesPeople undergoing PUVA therapy are monitored closely to prevent serious side effects Surgery Surgery for vitiligo involves taking unaffected skin from one area of the body and using it to replace an area of skin affected by vitiligo. It can also be done by transplanting skin cells into areas devoid of pigment due to vitiligo. Usually performed after other treatments have been ineffectiveVitiligo must have been stable (unchanged) for at least six months to a year before surgery can be performedPeople who scar easily or develop keloids (scars that rise above the skin) should avoid this treatmentEffective for up to 95% of peopleRisks include failure to work, cobblestone-like skin, and infection Micropigmentation (a type of tattooing on a small area, sometimes called permanent makeup) is occasionally performed, usually on the lips. It is not recommended for larger areas. People with vitiligo and other autoimmune disorders should be careful about getting tattoos because they can cause or worsen skin issues. Depigmentation During depigmentation, the drug monobenzone is applied to skin uneffected by vitiligo to remove its pigment in order to match the skin that is unpigmented due to vitiligo. Not commonly usedUsually only used when the majority of a person's skin has lost pigment already from vitiligoAfter depigmentation, a person has completely white skinCan take one to four years to completeSpots of pigment may reappear after being in the sun. The treatment cream can be applied to these spots to once again remove pigment. Vitiligo Treatments For Children Not all treatments for vitiligo are safe for children. Always check with your child's healthcare provider before starting them on any treatment. Current Research While not yet in use, research into a class of medications called JAK inhibitors show promise for their use as a treatment for vitiligo. JAK inhibitors target a type of immune communication pathway that has not previously been targeted in vitiligo. It is believed that JAK inhibitors work by: Reducing levels of inflammatory chemicals that lead to disease progressionStimulating regrowth of melanocytes Studies involving two types of JAK inhibitors—tofacitinib and ruxolitinib—showed promising results for the treatment of vitiligo when a JAK inhibitor is used in combination with UVB phototherapy. More research needs to be conducted before an FDA approval is reached, but preliminary data of larger studies show encouraging results of repigmentation, particularly on the face. JAK inhibitors are currently considered off-label as a treatment for vitiligo and can be expensive as they are rarely covered by insurance for the use of vitiligo treatment. A Note About "Unconventional" Treatments There are some treatments, such as certain herbal remedies, that claim to treat vitiligo. Most of these treatments are unregulated and unproven, which could make them unsafe. Prognosis Because vitiligo and vitiligo treatment affects each individual differently, it is not possible to give a guaranteed predicted outcome. About 10 to 20% of people with vitiligo fully regain their pigment, while others see some regained pigment. Vitiligo is not life-threatening, and it is not contagious. Coping In addition to medical treatments, there are things that can be done to make living with vitiligo more manageable. Practice sun safety: People with vitiligo can burn easily, particularly those who have undergone depigmentation. In addition to the risk of sunburn, tanned skin around depigmented areas can make vitiligo more noticeable. Use lots of broad-spectrum, SPF 30+ sunscreen, seek shade, and wear protective clothing.Avoid tanning beds and sun lamps: These are unsafe sun alternatives for everyone, including people with vitiligo.Add safe, artificial color to your skin: Self-tanner, dyes, and cosmetics such as concealers or makeup can add color to depigmented skin. Self-tanners and dyes give longer-lasting coverage.Join a support group: You can find both online support groups, and groups in your area through places like the Global Vitiligo Foundation. Vitiligo and Mental Health Vitiligo can have an effect on mental health, including self-image and self-esteem.If you are struggling with your experiences of having vitiligo, reach out to a mental health professional. A Word From Verywell While vitiligo can be life-altering, on its own it is not dangerous to your health. Because it can be associated with other conditions that can be more serious to your health, it is important to see a healthcare provider if you spot signs of vitiligo. You can start by booking an appointment with your primary care provider. From there, they may suggest, or you can request, a referral to a dermatologist for more specialized treatment. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. American Academy of Dermatology. Is vitiligo a medical condition? Harvard Medical School. Vitiligo: more than skin deep. Updated September 26, 2019. Cleveland Clinic. Vitiligo. Updated January 13, 2020. American Academy of Dematology. Vitiligo: who gets and causes. Cleveland Clinic. Vitiligo: management and treatment. Updated January 13, 2020. Vitiligo Support International. Topical therapies. American Academy of Dermatology. Vitiligo: diagnosis and treatment. Cleveland Clinic. Micropigmentation. Updated July 2, 2020. Solimani F, Meier K, Ghoreschi K. Emerging topical and systemic jak inhibitors in dermatology. Front Immunol. 2019;10. doi:10.3389/fimmu.2019.02847 Cleveland Clinic. Vitiligo: outlook/prognosis. Updated January 13, 2020. American Academy of Dermatology. Vitiligo: tips for managing.