The World Vitiligo Day, observed on June 25, is an initiative aimed to build global awareness about vitiligo which causes a change of color in the skin creating a variety of patterns on the skin from the loss of pigment.
Vitiligo is often called a disease instead of a disorder and that can have a significant negative social and/or psychological impact on patients, in part because of numerous misconceptions still present in large parts of the world.
A message issued in the public interest by the Indian Association of Dermatologists, Venereologists & Leprologists (IADVL), aiming to raise awareness and eliminate the stigma surrounding vitiligo tells about Vitiligo.
Vitiligo is a condition that is often misunderstood, but it is important to be informed with the right facts. Vitiligo is not contagious and should not be a cause for social stigma. It is a treatable condition that results from the destruction or deficiency of melanin in the skin.
People living with vitiligo must not face discrimination. They are encouraged to consult a qualified dermatologist for appropriate diagnosis and management. It is crucial to understand that vitiligo is not a psychiatric disorder and is not caused by the food one consumes.
Moreover, not every white spot on the skin is vitiligo, highlighting the need for medical evaluation rather than assumptions.
For a detailed understanding, Dr Gautam Mazumder, MD (Prof. & head Dermatology, Tripura Medical college. Secretary NEIADVL) shared a document prepared by Indian association of Dermatologists, Venereologists & Leprologists (IADVL) in public interest in association of North East States Branch of IADVL on the occasion of World Vitiligo Day 2025.
Synopsis: **Vitiligo is a common autoimmune skin disorder** characterized by white patches due to the destruction or malfunction of melanocytes, the cells that produce melanin. It affects about 1% of the global population, often appearing before the age of 40.
**Vitiligo is not contagious or infectious**, and cannot spread through physical contact, fluids, or sharing items. The primary **symptom is depigmented patches** on sun-exposed and other areas of the body, which can appear in three main patterns: focal, segmental (on one side), and generalized (symmetrical). Some may also experience premature whitening of hair.
The disorder occurs when the **immune system mistakenly attacks pigment cells**, possibly due to oxidative stress. While **exact causes are unknown**, factors such as genetics, autoimmune history, infections, emotional trauma, pesticide exposure, and lifestyle factors may contribute.
**Non-segmental vitiligo**, the most common type (90%), involves symmetrical patches and may progress unpredictably. **Segmental vitiligo** (10%) typically appears early in life, remains localized to one side, and is often stable. **Universal vitiligo** affects over 80% of the skin, while **confetti vitiligo** is a rapidly progressing form with small, scattered lesions. **Mixed vitiligo** involves features of both segmental and non-segmental types.
**Vitiligo cannot be prevented**, but cosmetic camouflage and micropigmentation may help improve appearance. Diagnosis involves clinical assessment, skin biopsy, and tests like Wood’s lamp, ANA, thyroid panels, and metabolic evaluations.
The condition is **not life-threatening** and not linked to specific food combinations. Although **sunburn doesn’t directly cause vitiligo**, it can trigger or worsen it in susceptible individuals. **Not all white patches are vitiligo**—similar symptoms can occur in other conditions like fungal infections or leprosy.
**Vitiligo differs from albinism**, as individuals with vitiligo are born with normal pigmentation. A genetic link exists, but **most cases have no family history**. People with vitiligo can **donate blood** if deemed healthy by a professional.
While **allopathy offers treatment**, results vary. Medications include corticosteroids, calcineurin inhibitors, prostaglandins, and JAK inhibitors like tofacitinib. The **Vitiligo Extent Score (VES)** is used to quantify body surface involvement.
**Vitiligo is associated with mental health issues**, including anxiety, depression, and other psychiatric conditions. Larger and more visible patches, particularly in younger individuals, can lead to **low self-esteem and depression**, which in turn may slow recovery. **Management may involve psychiatric therapy, medication, counseling, and lifestyle changes** such as diet, exercise, and meditation.
**Anxiety in vitiligo patients** may stem from new or facial lesions, social stigma, bullying, job stress, or rejection. Women are more vulnerable due to societal pressures. Treatment includes psychiatric care, lifestyle changes, and medications.
**Surgical options** like punch grafting, blister grafting, and skin cell suspensions are available for stable cases. **Narrowband UVB phototherapy** is widely used and effective for non-segmental vitiligo. **Laser therapies** (e.g., Excimer 308 nm) target localized patches and stimulate pigment cell activity.
In severe cases, **depigmentation therapy** may be used to lighten remaining pigmented skin, creating a uniform tone. This approach is irreversible and leaves the skin highly sun-sensitive. Monobenzyl ether of hydroquinone (MBEH) is the only FDA-approved depigmentation agent in the U.S.
**Leucoderma**, often confused with vitiligo, refers to post-traumatic depigmentation and is different in origin.
**World Vitiligo Day**, observed on **June 25**, honors the memory of Michael Jackson and promotes global awareness. Vitiligo has historical mentions dating back over 3,500 years in Egyptian, Indian, Greek, Roman, and Asian literature. Ancient treatments included **psoralen-containing herbs combined with sun exposure**, a practice similar to modern phototherapy.
Finally, vitiligo may **coexist with other autoimmune diseases**, including thyroid disorders, Type 1 diabetes, alopecia areata, Addison’s disease, and pernicious anemia.
1) What is vitiligo?
Vitiligo is a common autoimmune disorder in which white spots or patches appear on the skin. These white spots are caused by destruction of pigment cells (melanocytes) by white blood cells, resulting in the pigment (melanin) being destroyed or no longer produced.
About 1% of the world’s population is affected by vitiligo. Approximately 50% of them experience it before the age of 20, while the rest develop it before the age of 40.
2) Is vitiligo contagious?
Vitiligo is neither infectious nor contagious. It is an autoimmune disorder, it cannot be passed through contact or transmitted via touch, saliva, blood transfusion, inhalation, sexual association, or the sharing of personal items.
3) What are the symptoms of vitiligo?
The most common symptom of vitiligo is the appearance of white patches or spots (depigmentation) on the skin. The skin texture remains normal. These white patches are more noticeable on sun-exposed areas, including the hands, feet, arms, legs, face, and lips. Other commonly affected areas include the armpits, groin, around the mouth, eyes, nostrils, abdomen and genitals.
Vitiligo generally appears in one of three patterns:
• Focal vitiligo: Depigmentation is limited to one or only a few areas.
• Segmental vitiligo: White patches appear on only one side of the body.
• Generalized vitiligo: The most common type, with symmetrical white patches on multiple parts of the body.
In addition, some individuals may experience white or gray hair (leukotrichia) on the scalp, eyelashes, eyebrows, or beard.
4) Why do white patches appear in vitiligo?
The immune system mistakenly destroys the melanocytes (the cells responsible for pigmentation) in the skin, which results in the emergence of white patches on different parts of the body. Another mechanism is that melanocytes are destroyed due to oxidative stress produced during metabolic processes.
5)What causes vitiligo?
There is no known specific cause of vitiligo. It has been closely linked to genetics. People with a family history of the same condition or other autoimmune diseases (such as hyper or hypothyroidism, alopecia areata, and pernicious anemia) often develop vitiligo.
Vitiligo can be triggered by hormonal changes, recurrent episodes of jaundice or typhoid fever, prolonged antibiotic treatments, and acute emotional trauma. Intake of insecticide/pesticide-treated vegetables, usage of heavy immunosuppressant drugs, regular junk food consumption , and negligence in hygiene can also cause vitiligo.
6) What is non-segmental vitiligo?
Non-segmental vitiligo is characterized by progressive, depigmented lesions of the skin, mucosa, and hair. The total area of affected skin varies between individuals, and it is always hard to predict whether the patches will spread, and by how much. The spread might take weeks or remain stable for months or years. In most cases, the skin affected by non-segmental vitiligo remains depigmented for the rest of the affected person’s life. Since the condition is photosensitive, affected areas are more sensitive to sunlight. Of all vitiligo cases, about 90% are non-segmental.
7) What is segmental vitiligo?
In segmental vitiligo, the affected area of the skin usually does not expand with time. About 10% of vitiligo cases are segmental. Segmental vitiligo typically appears on one side of an individual’s body. The spots often emerge on areas of skin that are exposed to the sun (commonly hands, face, neck, and legs). These spots range in size from millimeters to centimeters. Segmental vitiligo has an early onset usually seen in young children. The total area of affected skin varies from person to person.
8) What is Universal Vitiligo?
Universal vitiligo is a subset of vitiligo in which more than 80% of the skin color is replaced by white, milky lesions. Characterized by the wide distribution of the patches, it leaves the human body with only a few isolated islands of normal pigmentation (frequently over the malar area of the face and dorsal areas of forearms).
9) What is Confetti Vitiligo?
Confetti vitiligo is a term given to describe the confetti-like distribution of vitiligo patches. It is an extremely rapidly progressing type of vitiligo that reflects acute damage to mature melanin-forming cells in the skin.
10) Can vitiligo be prevented?
Since the exact cause of vitiligo is not known, it cannot be prevented. The appearance of the affected skin can be improved with cosmetics and tattooing (micropigmentation).
11) How is vitiligo diagnosed?
There are no specific diagnostic tests for detecting vitiligo, so a skin biopsy confirms the diagnosis. A detailed family history and the individual’s current and past medications history can be taken into account. Bedside tests like Wood’s lamp test , Dermatoscopy can be done . Other tests to determine the exact cause of vitiligo include ANA (Antinuclear Antibody), Thyroid peroxidase antibody (TPOAb), comprehensive metabolic panel, thyroid panel including Free T3, T4 and TSH, Blood glucose /HbA1c , serum cortisol & ACTH (if Addison’s disease is suspected).
12) Is vitiligo life-threatening?
Vitiligo is a cosmetic problem,not a life-threatening problem.
13) Is vitiligo caused by eating certain combinations of foods?
Vitiligo is an autoimmune disorder and has no direct relation to food. No scientific study has been conducted to confirm that consuming fish and milk can cause vitiligo.
14) Does sunburn trigger vitiligo?
Sunburn doesn’t cause vitiligo in everyone, but it can trigger or worsen it in predisposed individuals. Vitiligo spots often become noticeable in areas that were exposed to the sun. It is advised to apply broad spectrum sunscreen (SPF>/=30) to protect patches under the sun.
15) Are all white patches vitiligo?
All white patches are not vitiligo. There are many other skin conditions (like Chemical Leukoderma, Congenital Leukoderma, Post inflammatory hypopigmentation, Fungal Infections, and Leprosy) that can cause white spotson the skin.
16) Is vitiligo related to albinism?
Vitiligo is not associated with albinism. In albinism, an individual is born with no melanin. As a result, one has white skin all over the body since birth. On the other hand, people with vitiligo have normal pigmentation at the time of birth. Once they develop an abnormal immune response toward melanocytes, white patches start emerging.
17) Do children of people with vitiligo ultimately develop vitiligo?
Vitiligo is an autoimmune disorder, it may have a genetic predisposition. Among people with vitiligo, only 15–20% have one or more affected first-degree relatives. 80–85% of vitiligo cases are not linked to family history.
18) Are people with vitiligo eligible for blood donation?
Unless an individual with vitiligo has been declared unfit by a health professional, he/she is eligible for blood donation. Because vitiligo is not transmitted by blood fluids, it does not put the receiver at risk.
19) Can vitiligo be treated with allopathy?
Since the exact cause of the chronic skin disorder is not known, there is no effective treatment to cure vitiligo. The results of allopathy treatment for vitiligo may vary from one individual to another. While many people recover completely from white patches during the early stage, some report no sign of improvement. Many people experience temporary improvement and, once the treatment is stopped, vitiligo comes back.
Corticosteroid cream, ointments containing tacrolimus or pimecrolimus (calcineurin inhibitors), Prostaglandin E2, and Tofacitinib can be prescribed for vitiligo treatment.
20) What is Vitiligo Extent Score?
The Vitiligo Extent Score (VES) is a clinical rating scale for the overall vitiligo involvement of the body (extent). The measurement instrument is made up of evaluation of body surface area (BSA).
The pictures that reflect an individual’s extent of the vitiligo lesions can be selected by this instrument/tool. Based on the pictures, the VES template provides a score that can be expressed in percentage of an individual’s body surface area.
21) Is vitiligo linked to mental health disorders?
Vitiligo is associated with an increase in mental health conditions like anxiety, depression, schizophrenia, conduct disorder, adjustment disorders, personality disorder, suicidal risk, ADD/ADHD, childhood and adolescent psychiatric illnesses, alcohol-related disorders, impulse control disorders&developmental disorders.
22) Why is depression common among people with vitiligo?
Psychiatric morbidity is found more frequently in young individuals with vitiligo and is higher in people who have big, white lesions on exposed body areas.
If an individual experienceslow self esteem, hopelessness, worthlessness, suicidal thoughts, low mood (that lasts longer than two weeks), juggling thoughts (about him/her, or the world), and sleep disorders, he/she should be tested for depression in vitiligo. Depression can worsen the vitiligo spread and has the potential to slow down the treatment.
23) How can depression be treated in vitiligo?
One treatment is not suitable for everyone as different people with vitiligo experience different symptoms of depression. A Psychiatrist consultation is usually advised in symptomatic patients. Many recover through medications, while others may need counselling to come out of the depression. At times, a healthy diet and meditation are prescribed alongside medicines and therapy.
24) Are anxiety disorders common among people with vitiligo?
Low self-esteem and deteriorating self-image in vitiligo can contribute to feeling fearful and nervous. If these feelings are extreme and last for more than six weeks, it can be designated as a chronic anxiety disorder (which can radiate in the form of amplified heart rate, irregular breathing, restlessness, trouble concentrating, and difficulty remaining or falling asleep).
Anxiety disorders can affect anyone at any stage of vitiligo. Women with vitiligo are more prone to anxiety disorders due to societal pressure and the patriarchal system in some cultures.
25) What causes anxiety in vitiligo?
Anxiety can be due to the emergence of a new white patch (particularly in the facial area), strange stares, unwanted remarks, stressful job, bullying at school due to dual skin appearance, mismanaged emotions, unpredictable course of vitiligo, difficulty in finding love, or rejections in situations due to vitiligo.
26) How is anxiety treated in vitiligo?
A Psychiatrist can prescribe the right line of treatment once the anxiety triggers are identified. Based on the diagnosis, counselling and antidepressants (or a combination of both) can be prescribed.
Exercising regularly, dietary changes (including omega-3 rich foods in the diet), and a daily routine of yoga poses should also be maintained alongside treatment to quiet aggressive anxiety.
27) What is mixed vitiligo?
Mixed vitiligo is derived from non-segmental and segmental vitiligo. In some cases, both non-segmental and segmental vitiligo can co-exist in a single individual. This is known as mixed vitiligo in common language.
28) Can vitiligo be corrected surgically?
Depending on the stability and extent of vitiligo, surgical methods can be considered. During surgery, good patches of the person’s pigmented skin are removed and grafted to the affected area to cover vitiligo.
Some of the widely performed surgeries are:
• Miniature Punch Grafting
• Suction Blister Grafting
• Split-thickness Skin Grafting
• Autologous Non-Cultured Epidermal Cell Suspensions
29) How is vitiligo treated with Narrowband UVB phototherapy?
Narrowband UVB phototherapy is a potent melanocyte stimulant and currently being seen as the phototherapy of choice for treating non-segmental vitiligo. The medical procedure involves exposing vitiligo lesions to fluorescent lamps which emit ultraviolet light of 311–313 nanometers.
The phototherapy also stops the progression of vitiligo by suppressing the immune system (which is destroying the pigment-producing melanocytes) in the region to which it is applied.
The degree of repigmentation achieved by the phototherapy depends on the vitiligo-affected area and the age of the skin disorder.
Reported side effects include dryness, itchiness, and redness, which generally resolve after the application of topical emollients.
30) How does laser treatment work for vitiligo?
Vitiligo can be corrected with any of the 308 nm Excimer Laser, Low-Energy 632.8 nm Helium-Neon Laser, Ablative Fractional Laser, Gain-Switched 311-Nm Ti-sapphire Laser, and 355-Nm Ultraviolet A1 Laser, depending on the diagnosis and prognosis of vitiligo. Due to the optimal wavelength, small vitiligo patches recover faster with laser treatments compared to traditional phototherapies.
308 nm Excimer Laser is the most widely used laser treatment for correcting localized vitiligo. The procedure emits monochromatic light, using smaller, 308 nm wavelengths. The laser’s deep penetration enables the radiation to reach surviving melanocytes in the vitiliginous area. Thisattempts to stimulate melanocyte migration and proliferation from the niche located in hair follicles.
31) What is Depigmentation therapy?
Depigmentation is a method to reduce the skin color of unaffected skin by means of applying strong topical lotions or ointments and laser. If vitiligo has affected 50% or more of an individual’s body, depigmentation therapy can be considered as an option to achieve an even skin tone. It typically takes 2–3 months to see effects, while complete transition may take at least 12 months. The treatment leaves the skin without pigment, which in turn becomes very vulnerable to sun exposure.
Among all bleaching solutions used for depigmentation, only Monobenzyl Ether of Hydroquinone (MBEH) is FDA-approved in the USA. Most prescribed physical therapies for depigmentation include Q-switched ruby, alexandrite lasers, and cryotherapy.
32) What is Leucoderma?
Leucoderma is the depigmentation of the skin, which often initiates after a scratch, cut, or burn. This scar formation results in the gradual development of a white patch. Leucoderma is often, although incorrectly, used interchangeably with vitiligo.
33) What is World Vitiligo Day?
The World Vitiligo Day (WVD) is observed on June 25 every year to build global awareness about vitiligo. The purpose of the day is to debunk myths associated with vitiligo. The first World Vitiligo Day was observed in 2011.
The choice of June 25 as WVD is a memorial to Michael Jackson, who suffered from vitiligo from the early 1980s until his death on June 25, 2009.
34) Is vitiligo mentioned in history?
The first description of vitiligo dates back more than 3500 years in ancient Egypt. It has been mentioned as Sweta Kushtha in Indian texts such as the Atharva Veda (1400 BC), the Ashtanga Hridaya, the Manu Smriti, and the Charaka Samhita (100 CE).
It has also been mentioned in Japanese, Greek, Roman, Arabic, and Korean texts. However, vitiligo was not widely discussed until the 1990s, when Michael Jackson publicly confirmed he had the chronic skin disorder.
35) How was vitiligo treated in antiquity?
According to many historical accounts, the ancients used phototherapy as vitiligo treatment. Both ancient Indian and Egyptian writings confirm that psoralen-containing plants (such as Ammi majus and Psoralea corylifolia) were applied to pale macules and then exposed to sunlight to induce repigmentation.
36) Is vitiligo related to other autoimmune diseases?
Vitiligo may coexist with other autoimmune diseases like autoimmune thyroid diseases, Type 1 Diabetes mellitus,Pernicious anaemia, Addison’s disease,Alopecia areata, etc.
