Loss of skin pigmentation is the hallmark symptom of vitiligo, but how quickly it progresses can vary between people and subtypes of the condition.

Vitiligo is an autoimmune disorder. The exact cause of vitiligo isn’t well understood, but the condition occurs when your body’s immune system attacks melanocytes, the cells that produce pigment. This causes patches of skin to lose color.

As the most common cause of skin depigmentation, vitiligo affects up to 2% of people globally and can appear at any age. Various classification systems exist, but vitiligo is generally categorized into two types: non-segmental (affecting both sides of the body) and segmental (affecting one side of the body).

Vitiligo can occur anywhere on the face and body. Some people may develop vitiligo in mucous membranes, such as inside the mouth or nose and the genitals. Vitiligo may also cause a person’s hair, eyelashes, or eyebrows to lose color and turn white.

Most cases of vitiligo start small, and you may not be too concerned about a few insignificant, lighter areas of skin. If left untreated, however, this condition can progress, and noticeable, widespread discoloration is possible.

Vitiligo is progressive, but there’s no way to know how quickly your vitiligo will spread or how much skin pigmentation you’ll lose.

Non-segmental vitiligo tends to develop slowly. People may develop new patches of depigmented skin on and off throughout their lives.

Segmental vitiligo tends to advance more quickly than non-segmental at first, causing rapid depigmentation during the first 6 months to a year.

You likely won’t continue to lose skin color indefinitely in this type of vitiligo, however. After a period of rapid loss, depigmentation stabilizes, and you may never develop new patches.

“The progression of vitiligo can vary,” says Dr. Steven Line, a cosmetic medical physician in Philadelphia, Pennsylvania and board member of the American Cosmetic Association. “Some may experience a slow progression with only a few small patches developing over many years, while others may see rapid progression occurring within months.”

He adds that some people might experience periods of pigmentation stability or even notice pigment returning during the course of vitiligo.

There’s currently no cure for vitiligo. But treatments are available that can help restore skin color and slow depigmentation — though results vary.

Vitiligo can be progressive, but it’s an unpredictable condition.

You may experience noticeable, advancing depigmentation or slow changes over a long period of time. Some types of vitiligo eventually stabilize.

“Larger patches may continue to broaden and spread, although they often remain in the same location for years, explains Dr. Anna Chacon, a board certified dermatologist and author from Miami, Florida. “The position of smaller macules [flat, discolored areas of skin] fluctuates and changes over time as specific areas of skin lose and regain color.”

If you developed this condition early in life, there’s a higher chance that more of your body will eventually be affected and your rate of vitiligo progression will be faster compared with people who develop it later in life.

Vitiligo doesn’t necessarily follow a path of progression, but it can be classified by the amount of your body affected by depigmentation and where skin coloration has been lost.

According to Chacon, vitiligo can be classified as:

  • Localized: Skin patches are limited to specific areas of the body.
  • Generalized: Skin patches can be seen all over the body.
  • Mucosal: The mucous membranes of the mouth or genitalia are
    affected by vitiligo.
  • Focal: Loss of pigmentation is seen in a few spots in a single area.

Treatments for vitiligo are available, but responses can vary. You may need to try several different approaches before you notice results. Even then, not everyone can successfully manage skin depigmentation or restore lost skin color.

Line indicates topical corticosteroids are the most common treatment for vitiligo. “They help reduce inflammation and promote the growth of new skin cells. They work best for small patches of vitiligo,” he says.

Other treatments a doctor or dermatologist may recommend include:

  • Oral prednisone: A short-term steroid taken by mouth to help suppress your immune response and slow skin depigmentation.
  • Topical calcineurin inhibitors: An “off-label” treatment for vitiligo that inhibits the pro-inflammatory protein calcineurin, reducing inflammation and promoting repigmentation.
  • JAK inhibitor: Ruxolitinib (Opzelura) is a topical JAK inhibitor approved for the treatment of non-segmental vitiligo. JAK inhibitors target specific pathways involved in the immune response and may help stop the destruction of melanocytes.
  • Melanocyte transplant: An outpatient procedure in which melanocytes are transplanted from unaffected areas of your body to vitiligo locations.
  • Skin graft: A surgeon transplants pigmented skin from one area of your body to an area of skin with vitiligo.
  • Phototherapy: During phototherapy, your skin is exposed to ultraviolet light to help stimulate the production of skin pigment.
  • Micropigmentation cosmetic tattooing: This cosmetic procedure involves implanting pigment into the skin with a tattoo needle.
  • Depigmentation: A treatment for severe, widespread vitiligo that involves removing pigmentation from unaffected areas of skin to match vitiligo patches.

Ultraviolet light therapy doesn’t mean sun exposure

Exposing yourself to the sun won’t improve vitiligo, even though it seems like “getting a tan” would encourage your skin to produce pigmentation.

Ultraviolet light is a therapy for vitiligo — but it’s a targeted therapy done with specialized equipment. It’s only used on areas of your skin that have lost pigmentation.

When you expose your body to the sun, your pigmented areas will get darker, and this can actually make vitiligo stand out even more.

Vitiligo patches are also more vulnerable to sunburn, and getting burned may make vitiligo worse.

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Vitiligo is an unpredictable autoimmune disorder that causes your skin to lose pigmentation. It can develop in anyone of any age and is the most common cause of skin depigmentation.

Vitiligo progression isn’t linear. It doesn’t always start in the same place or advance at a uniform rate. There’s no way to know how quickly vitiligo will affect you or how much pigment you’ll lose.

Most cases of vitiligo start small, and while there’s currently no cure, prompt treatment can improve your chances of slowing vitiligo progression and regaining skin pigmentation.