The main symptom of vitiligo is white spots or patches on the skin. Initially, the vitiligo may start as a patch that is slightly paler than the rest of your skin but will gradually become completely white. The edges of the patch may be smooth or irregular and may have an inflamed red border.
Typically, vitiligo produces symmetrical depigmented areas of skin that otherwise appear perfectly normal – what is known as generalized vitiligo. A less common type is segmental vitiligo in which asymmetrical, focal or one-sided depigmentation develops. In addition to white patches on the skin, people with vitiligo may have premature graying of the scalp, hair, eyelashes, eyebrows, and beard. People with dark skin may also notice a loss of color inside their mouth.
The initial appearance of the white patches can be followed by a stable period without any expansion. Later on, periodic cycles of disease progression and stability may be observed. There is no way to predict if generalized vitiligo will spread further, while segmental vitiligo remains localized to one part of the body and does not spread.
Vitiligo does not cause physical discomfort to your skin, such as dryness, but patches may occasionally be itchy. Vitiligo commonly affects areas on the skin that are exposed to sun, body folds (such as armpits), previous sites of skin injury, and areas around body openings - genitals also may be affected. Vitiligo is not contagious - you cannot catch it from other people or pass it on.
Diagnosis of vitiligo is made based on a physical examination, medical history, and, occasionally, laboratory tests. Important factors in the diagnosis include a family history of vitiligo, skin trauma that occurred at the site of vitiligo two to three months before depigmentation started, stress or physical illness, and graying of the hair before the age of 35.
Early signs of vitiligo can be diagnosed under ultraviolet (UV) light when the naked eye cannot yet distinguish affected areas from normal skin. Doctors use the so-called Wood's Lamp (photo, right) in a dark room, to check for the subtle vitiligo lesion appearance or change of existing ones. Actively depigmenting areas may appear larger under UV illumination than with visible light, whereas areas showing repigmentation can appear larger or smaller with UV than with visible light.
Not all white patches on your skin are vitiligo. Fungal infection, healed eczema, sun allergy and guttate hypomelanosis are common conditions that mimic early-stage vitiligo. To help confirm the diagnosis in difficult cases, your doctor may take a small sample (biopsy) of the affected skin to examine under a microscope.
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