Podcasts - 07 Oct `25What If Vitiligo Isn’t One Disease, But Five? (Ep. 47)

Podcast

Forget everything you thought you knew about vitiligo.

In this episode, we explore a groundbreaking new classification that shifts the focus from where vitiligo appears to how it behaves — offering doctors and patients a smarter, more predictive framework for care.

Ditch the old “segmental vs. non-segmental” divide. Meet five real-world phenotypes:

  • Highly Active Vitiligo
    Patches that spread quickly, feel itchy, and often appear after an injury or impact to the skin. This type tends to grow faster and may require urgent treatment.
  • Mild Vitiligo
    Small, steady patches that don’t change much over time. These are often easier to manage and may respond well to simple treatments.
  • Extensive Vitiligo
    Patches cover a larger area and can be long-lasting. It’s common to see white or gray hair in affected areas, and this type can be tougher to treat.
  • Koebner Type (Moderate–Severe)
    Patches appear in areas where the skin has been rubbed or irritated, similar to friction zones. Activity may be lower here, but the pattern follows where the skin has been touched or scratched.
  • Koebner Type (Mild)
    Small, localized patches that stay put and are often easier to treat with creams or topical therapies.

We explore each type, how they’re treated, and why this matters for personalized medicine, clinical trials, and patient outcomes.

🔗 Read the full breakdown: Rethinking Vitiligo – Five Distinct Faces of a Complex Disease



FAQOther Questions

  • What are risks of oral and topical corticosteroids?

    Corticosteroid drugs (like hydrocortisone, and others) are often used for treating vitiligo. By mimicing the effects of hormones your body produces naturally in your adrenal gla...

  • Will it spread?

    Vitiligo's progression and response to treatment can vary significantly among individuals, making it a particularly unpredictable skin condition. Based on the VALIANT study, her...

  • Which is better for judging vitiligo — Wood’s lamp or dermoscopy?

    A recent study out of India compared the two head-to-head. Both tools correlated fairly well with clinical criteria, but dermoscopy had a slight edge: Wood’s lamp: sensitivit...