Apart from the pigment loss on skin and other body parts, vitiligo generally doesn’t cause other physical complications, says Sandy Skotnicki, MD, an assistant professor of dermatology at the University of Toronto and author of Beyond Soap. But because of the changes in appearance that vitiligo causes, it can often lead to emotional distress. And because vitiligo is generally accepted to be an autoimmune disease, it can be more common in people with other autoimmune conditions and vice versa. If you have vitiligo, here are some potential complications to be aware of (and tips for dealing with them). The most common ones are:
Type 1 diabetesPsoriasisAutoimmune thyroid diseaseRheumatoid arthritisPernicious anemiaSystemic lupus erythematosusAddison’s diseaseAlopecia areata
Thyroid disease occurs among people with vitiligo 15 times as frequently as the general population in the United States. Alopecia areata is even more widespread among vitiligo patients, being 31 times more common among patients with vitiligo than the population as a whole. (2) In addition to these autoimmune diseases, there are a few rare conditions to be on the lookout for as well if you have vitiligo, including: (2)
Linear morphea, which results in hardened skinGuillain-Barré syndrome, which occurs when the immune system attacks the nervous systemMyasthenia gravis, which causes muscle weakness and fatigueInflammatory bowel disease, a chronic condition involving cramping, gas, constipation, and diarrhea (3)Sjögren’s syndrome, which results in dryness in the mouth and eyes
It’s not necessarily the case that having vitiligo causes any of these other autoimmune disorders. But experts suspect some of the reasons you have vitiligo in the first place (genetics and environmental triggers) may also put you at a higher risk for other autoimmune conditions. “Autoimmune conditions do not arise because of vitiligo,” says Hal Weitzbuch, MD, a dermatologist in private practice in Calabasas, California. “However, vitiligo is associated with other autoimmune conditions most likely since they are conditions with similar pathophysiology.” If you have vitiligo it’s smart to be aware of these links so you can be tested if you have unexpected or unexplained symptoms. Some evidence, however, suggests otherwise. A 2021 study of 13,824 individuals with vitiligo found they were actually significantly less likely to develop overall cancers. (5) Researchers suspect the very genes that put one at risk of developing vitiligo also play a role in protecting against melanoma. (6) It’s not a condition someone is born with. Having the white patches appear and spread on the skin over time can make some people feel self-conscious, and it can cause distress about one’s ethnic identity. (1) Low self-esteem and depression are potential side effects of vitiligo. (2) RELATED: How to Recognize Depression Symptoms A stigma surrounds vitiligo because people view it as not “normal,” Dr. Skotnicki says. Some people might avoid interacting with others who have vitiligo out of fear that the condition is contagious. (It’s not.) (8) “It can be devastating, especially for people of color,” Skotnicki says. That’s because vitiligo is harder to hide on dark skin. “In Caucasian skin, if you’re fair enough and you’ve got vitiligo patches, you might not even see them,” Skotnicki says. But on darker skin where there’s more contrast between the usual skin tone and the skin that’s been affected by vitiligo, the differences are more pronounced and harder to hide. RELATED: How to Maintain a Healthy Body Image The experience of living with vitiligo can be particularly difficult for children because other kids may not realize it’s a medical condition and may not be sensitive to it, inadvertently saying hurtful things or knowingly teasing other children. About 50 percent of patients with vitiligo are diagnosed before age 21, so many deal with the disease during puberty and their teenage years — when adolescents already have a lot on their plates when it comes to understanding the changes happening in their bodies and self-image. (2) One review concluded that experiencing vitiligo as a child can increase distress and worsen quality of life. (9) There’s no way to say for sure how troubling vitiligo will be emotionally, because it depends on the case and the person.
Emotional Support
Support groups and mental health professionals can be extremely helpful for people with vitiligo, says Adrienne Haughton, MD, a dermatologist and director of clinical and cosmetic services at Stony Brook Medicine in Commack, New York. You can find a support group in your area through Vitiligo Support International or chat with others online through the Vitiligo Friends community. Michele Green, MD, a New York City–based dermatologist, agrees. “Seeking counseling can help reassure you that you are not alone,” she says. Talking to a dermatologist with experience in psychotherapy is ideal, but a psychologist or other mental health professional can definitely help, too. (10) He or she might suggest cognitive behavioral therapy, mindfulness, or acceptance and commitment therapy, all of which have been shown to help patients with vitiligo increase their confidence and self-esteem. (11)
Caring for Your Skin
In addition to medications and other treatments your doctor might prescribe to help you manage and stop the spread of the physical symptoms of vitiligo, it’s also important to know that certain lifestyle habits can help make it less noticeable, such as:
Wear Sunscreen Ultraviolet (UV) light can set off a vitiligo reaction, so it’s best to use sunscreen when in the sun and to avoid tanning beds. (1) Vitiligo skin also doesn’t tan as well, so the contrast between tan skin and vitiligo patches will be more apparent. Look for broad-spectrum sunscreen with an SPF of 30 or higher. (12)Protect With Clothing You can increase the SPF of clothing by washing your clothes with a UV-protectant treatment. (12)Try a Self-Tanner Applying this to your skin can add color safely. The American Academy of Dermatology suggests choosing one with dihydroxyacetone, which the U.S. Food and Drug Administration says is the ingredient responsible for darkening the skin. (12,13)Avoid Tattoos They sometimes can trigger another vitiligo outbreak within two weeks. (11)Limit Hair Dye and Bleach These contain chemicals called phenols, exposure to which can trigger vitiligo to start or spread. Choose natural dyes instead. (9)
It’s important to talk to your doctor if you have vitiligo. You’ll want to mention any other symptoms you’ve been experiencing, including any linked to depression or anxiety, so they can help diagnose any problems or complications you do experience and connect you to the resources you need.
