The condition causes a loss of pigment in patches of skin—but it affects other parts of the body too.

By Amanda Gardner
Updated: April 16, 2019

The skin condition vitiligo causes people to lose pigment in patches of skin in different areas of their body. In many cases, these light or white areas of skin are the only symptom of vitiligo.

“There’s a complete loss of pigment,” Henry W. Lim, MD, former chair of dermatology at Henry Ford Hospital in Detroit, tells Health. “In patients with fair skin, it’s not going to be all that noticeable, but with dark skin it’s very noticeable—and it can be quite bothersome.”

But vitiligo can affect more than just your skin. Other vitiligo symptoms include:

  • Premature whitening or graying of your hair, eyelashes, and eyebrows
  • Whitening on the inside of your mouth and nose
  • Lightening of the retina of your eye

The bleaching is caused by destruction of melanocytes, the cells that produce melanin, which is the pigment that gives your skin and hair its color. No one knows exactly why the cells stop working, but experts believe it’s often related to autoimmunity. That’s when your immune system turns on your body’s own tissue and starts destroying it.

Many people with vitiligo also have other autoimmune diseases, commonly autoimmune thyroid disease, says Daniel J. Aires, MD, director of dermatology at the University of Kansas Health System in Kansas City.

RELATED: 5 Things That Might Cause Vitiligo

Early on, the symptoms of vitiligo begin gradually. Areas affected by vitiligo “are lighter than the surrounding skin,” says Dr. Lim, who is also a past president of the American Academy of Dermatology, “and as time goes by, it will become white.” The lighter-colored patches start as small, round areas that grow into different and bigger sizes. The centers of the patches may be white with your normal skin color around them. The borders are sometimes smooth and sometimes ragged.

How fast vitiligo progresses (and which parts of the body it affects) is highly individual. Although vitiligo symptoms can appear on any part of the body, the white patches often start on areas that have been exposed to a lot of sun—aka your hands, feet, arms, face, and lips. But signs of vitiligo can also appear on your neck, elbows, armpits, knees, and even your genitals, and once the spots appear, they almost never go away.

Very occasionally, says Dr. Lim, some people may have another vitiligo symptom: itchiness.

RELATED: How These 7 Women With Vitiligo Are Embracing Their Skin

Vitiligo symptoms also vary depending on which type you have. There are two main kinds of vitiligo: segmental, which is limited or localized, and non-segmental, which is more widespread. “Vitiligo can cover a very small percentage of the body’s surface, or it can be widespread and affect multiple different regions,” says Dr. Aires.

Almost all cases of vitiligo are non-segmental vitiligo. Usually the symptoms appear symmetrically on both sides of your body. The arms, backs of hands, elbows, knees, feet, and areas around body openings (like the eyes) are frequent locations for non-segmental vitiligo signs. “It does have a predilection for the orofacial area—eyes, nose, around the mouth,” says Dr. Aires.

With segmental vitiligo, the light patches of skin only appear on one segment of your body. But even if the vitiligo only covers a small percentage of your skin, if it’s on your face or another visible area, it can be hugely distressing.

Rarely, people have a third type of vitiligo—universal or complete vitiligo—which affects the whole body.

No matter the type of vitiligo you have, the disease can be active (meaning it is still spreading or growing) or stable (meaning there’s been no change in the course of a year). If you’re noticing any signs and symptoms of vitiligo, it’s worth bringing it up with a doctor. “I personally think if you have a loss of pigment,” says Dr. Aires, “it’s not a bad idea to see a health care provider.”

Get more on skin conditions here.