Treatment guidelineTriggers

Treatment guideline

On the outside, severe sunburn, physical skin damage, prolonged contact with certain chemicals containing:

  • p-phenylenediamine (also known as para-phenylene diamine or PPD)
  • para-tertiary butylphenol (PTBP)
  • monobenzylether of hydroquinone (MBH)

may induce or worsen vitiligo. Industrial items with PPD or PTBP include permanent hair dyes, fabric and leather colorants, printing inks, motor oil additives, fiberglass products, plywood, masonry sealant, insecticides and commercial disinfectants. Medical items with PTBP include hearing aids, prosthesis and athletic tape. Skin lighting creams and soaps in certain countries may contain MBH in excessive concentrations.

On the inside, psychological stress is the most frequent trigger for vitiligo. Hormonal changes during pregnancy, delivery and menopause may also be the culprit, as can excessive pressure and friction from lingerie, shoes, or sporting equipment. Parasites and chronic gastritis that impair absorption of vital elements by the digestive system may also precipitate vitiligo.