Vitiligo is a chronic skin condition characterized by white patches that develop when melanocytes, the cells that give skin its natural color, are lost.

These patches can affect different parts of the body. Over time, they may enlarge, appear in new areas, or remain unchanged for long periods.

Vitiligo is not contagious. It is not an infection and cannot spread from person to person through physical contact.

A better understanding of how vitiligo develops has led to new treatment options. Early dermatologic evaluation is important for assessing disease activity and planning appropriate treatment.

What Causes Vitiligo?

The immune system’s response against melanocytes plays an important role in the development of vitiligo.

Several factors are thought to contribute, including genetic predisposition, immune mechanisms, and oxidative stress.

In some patients, new white patches develop after skin injuries, friction, or sunburn. This is known as the Koebner phenomenon.

Vitiligo is not caused solely by psychological stress. However, stress may influence the course of the condition in some patients.

What Are the Symptoms of Vitiligo?

The main sign of vitiligo is patches that appear lighter than the surrounding skin or completely white.

Commonly affected areas include:

• The face, including around the eyes and mouth
• Hands and fingers
• Elbows and knees
• Underarms and groin
• The genital area
• The trunk and other areas of skin

Hair in the affected areas may also turn white.

Vitiligo patches usually do not cause pain or itching. However, visible changes in skin color can affect quality of life and emotional well-being.

How Is Vitiligo Diagnosed?

Vitiligo is usually diagnosed through a dermatologic examination.

When needed, a Wood’s lamp can help make areas of pigment loss more visible. This examination may be particularly useful in people with fair skin and when patches are at an early stage.

The examination assesses the extent and location of the patches, whether new patches are developing, and how quickly the condition is progressing.

Vitiligo can occur alongside certain autoimmune conditions, particularly autoimmune thyroid disorders. Additional tests may therefore be considered based on the patient’s medical history and clinical findings.

Can Vitiligo Be Treated?

Yes. Appropriate treatment can help control progression and restore some of the lost skin color in certain areas.

However, treatment response varies from person to person.

Results may depend on the type, duration, and activity of vitiligo, the location of the patches, and the condition of pigment-producing cells in the hair follicles.

Patches on the face and neck may respond better, while restoring color to the fingertips, hands, and feet can be more difficult.

Treatment Options for Vitiligo

1. Topical Treatments

For suitable patients with limited areas of vitiligo, topical corticosteroids or calcineurin inhibitors such as tacrolimus may be used.

Treatment is selected based on the location of the patches, the patient’s age, and clinical findings.

2. Narrowband UVB Phototherapy

Narrowband UVB (NB-UVB) is an established light treatment for vitiligo, with effectiveness supported by scientific studies.

It may be considered particularly for widespread vitiligo. Treatment typically involves several sessions per week, and a noticeable response may take months to develop.

3. Targeted Phototherapy

A 308 nm excimer laser or lamp may be used to treat localized vitiligo patches.

These treatments deliver light directly to the affected areas of skin.

4. Newer Targeted Treatments

A better understanding of the immune mechanisms involved in vitiligo has supported the development of new medications.

One option is ruxolitinib 1.5% cream, a JAK inhibitor. Clinical studies have shown that it can help restore pigment in selected patients with nonsegmental vitiligo.

A physician should assess whether this treatment is appropriate, review its safety, and consider availability in Türkiye.

5. Surgical Treatments

Surgical techniques involving the transplantation of pigment-producing cells may be considered for selected, localized patches that have remained stable for a long time and have not responded to other treatments.

These approaches are not suitable for every patient.

How Long Does Vitiligo Treatment Take?

Vitiligo treatment requires patience and regular follow-up.

Because pigment returns gradually, treatment response is generally assessed over months rather than weeks.

Some patients may notice color returning within a few months, while others may need a longer course of treatment.

White patches can recur after treatment, so maintenance treatment and regular dermatologic follow-up may be planned when needed.

What Should People With Vitiligo Keep in Mind?

Reduced pigment in affected areas means less natural protection against sunlight.

Using an appropriate sunscreen, avoiding sunburn, and protecting the skin from injury are important.

Self-administered high-dose ultraviolet exposure and tanning beds are not recommended.

No specific diet or vitamin supplement has been proven to eliminate vitiligo. Supplements should not be taken indiscriminately when no deficiency has been identified.

Dermatologic Evaluation and Follow-Up

Vitiligo care should consider more than the appearance of white patches. Disease activity, the development of new patches, and the patient’s quality of life also need to be assessed.

At Dr. Armin Müştak’s private dermatology practice, patients with vitiligo receive a dermatologic examination. Appropriate treatment and follow-up options are discussed based on the type, extent, and activity of the condition.

Early evaluation, regular follow-up, and treatment planning based on each patient’s clinical assessment are important in vitiligo care.