You know vitiligo is active by observing new or growing white patches, itchy spots, fuzzy borders, tiny "confetti-like" spots, or the Koebner phenomenon (new spots appearing after skin injury), indicating rapid depigmentation, which contrasts with stable vitiligo where spots are fixed and fully white. Doctors also look for signs like inflammatory pink borders (inflammatory vitiligo) and use tools like Wood's lamps to confirm activity, as active disease often requires more aggressive treatment, says MoleChex and UMass Chan Medical School.
What are the signs and symptoms of vitiligo?
Smooth white or light areas called macules or patches appear on your skin. It generally starts on your hands, forearms, feet and face. Globally, about 1% of the population has vitiligo. Treatment isn't necessary, but it's available if you don't like the changes to your skin tone.
What is known is that the risk of developing vitiligo increases in kids with a family or personal history of thyroid disease, diabetes, and certain conditions like alopecia (an autoimmune disease that causes hair loss). Vitiligo is never contagious — kids can't "catch" it from someone else.
It may be related to: A disorder of the immune system (autoimmune condition) Family history (heredity) A trigger event, such as stress, severe sunburn or skin trauma, such as contact with a chemical.
How is vitiligo diagnosed in children? Vitiligo can usually be diagnosed based on a doctor's skin exam alone, without the need for any blood tests or a skin biopsy. Shining a special light, called a “Wood lamp,” on the vitiligo spots can help diagnose the condition.
Repigmentation – If the white patches on the body start regaining color, it indicates that the pigment cells have started producing melanin again. Stable patches – If the white patches on your skin haven't gotten any bigger in a few months, it may be a sign that the vitiligo is stable and not progressing.
Pityriasis alba is a common skin condition in children and adolescents. The condition is not contagious or hereditary, though does demonstrate a higher prevalence in children with a history of eczema or other allergic conditions. These spots are generally located on the face and upper trunk.
Vitiligo can be triggered by various environmental factors — such as stress — in people who have other genetic risk factors associated with the condition. In these susceptible people, an environmental factor triggers them to have an autoimmune response, one in which their immune system mistakenly attacks melanocytes.
You may be referred to a doctor who specialises in treating skin conditions (dermatologist) if further treatment is needed.
Limited studies show that the herb Ginkgo biloba may return skin color in people with vitiligo. Other small studies show that alpha-lipoic acid, folic acid, vitamin C and vitamin B-12 plus phototherapy may restore skin color for some people.
Currently, there is nothing in the medical world that will 100% cure vitiligo, but at Stanford Medicine Children's Health Pediatric Dermatology, we do have treatments that help bring color back (see below).
Patterns of pigment return
Once we start treating the vitiligo spots, the pigment comes back, thereby reversing the disease. If there are pigmented hair follicles within the spots that we're treating, after about 3 months of treatment we see little brown spots appearing around each hair.
Vitiligo produces a wide range of skin pigmentation appearances. In fact, there are three types of vitiligo: focal, generalized, and segmental. Focal vitiligo is characterized by a few spots in a concentrated area. These spots are often stable and dormant for years at a time.
Natural Ways To Increase Melanin
Antioxidants may help protect melanocytes by fighting oxidative stress such as from UV rays, boosting pigmentation and bringing back your skin's color. Examples of extracts and antioxidants used to treat vitiligo include: Vitamins A, D, and E. Coenzyme Q10.
While vitiligo cannot always be fully stopped, these science-backed strategies can help slow its spread and improve skin health.
Vitiligo often starts as a pale patch of skin that gradually turns completely white. The centre of a patch may be white, with paler skin around it. If there are blood vessels under the skin, the patch may be slightly pink, rather than white. The edges of the patch may be smooth or irregular.
White spots on skin are often harmless, but they can sometimes signal an underlying health condition that requires medical attention. Consider consulting a dermatology provider if you notice the following: Persistent White Spots: Spots that do not fade or worsen over time.
Stable vitiligo was defined as having no new lesions and no progression of existing lesions for at least 2 years, while unstable vitiligo was defined as new lesions or progression of existing lesions over the past 6 weeks.
Vitiligo may flare or spread due to: Stress. Sunburn, cuts, or other skin damage. Chemical exposure.
Genetics play a key role—children with a family history of autoimmune conditions, such as thyroid disease or type 1 diabetes, have a slightly higher risk of developing vitiligo. Environmental triggers may also contribute, including sunburn, stress, or exposure to certain chemicals.
Generally, a discolored patch on skin isn't cause for concern. Skin discoloration can be triggered by a number of causes, including: Atopic dermatitis (eczema). Sometimes a small area of skin becomes irritated, which results in a patch of skin that's lighter in pigment than is the skin around it (pityriasis alba).
Diagnostic Tools
Our dermatologists often diagnose vitiligo based solely on a physical examination. If doctors need more information about how the condition affects your skin cells, they may suggest a skin biopsy or blood test.