Vitiligo most often appears as well-defined lighter patches on the skin. Symptoms can look different from person to person, but common signs include:

• White or pale patches that gradually enlarge over time
• Symmetrical patterns (for example, similar patches on both hands or both knees)
• Early involvement of the face and hands, though any area may be affected
• Premature whitening (graying) of scalp hair, eyebrows, eyelashes, or beard hair
• Color loss in mucous membranes, such as the lips or inside the mouth
• Sun sensitivity, since depigmented areas have less natural UV protection

Vitiligo is usually not painful or itchy, but the contrast between affected and unaffected skin can be more noticeable after sun exposure or tanning. For many people, the emotional impact can be significant especially when vitiligo affects visible areas like the face, neck, or hands.

Vitiligo occurs when melanocytes (the cells that make skin pigment) are damaged or stop functioning in certain areas. The exact cause can vary, but vitiligo is most commonly linked to:

• Autoimmune activity, where the immune system mistakenly targets melanocytes
• Genetics, as vitiligo can run in families
• Triggers such as significant stress, sunburn, skin injury (sometimes called the “Koebner phenomenon”), or illness
• Association with other autoimmune conditions, which may occur in some individuals

Vitiligo is not contagious, and it is not caused by poor hygiene, diet alone, or an infection.

Vitiligo is typically diagnosed through a careful skin exam and medical history. At Peak Skin Center, Dr. Knackstedt and the team may:

• Review when the color change started and how it has progressed
• Examine the pattern and distribution of pigment loss
• Use a Wood’s lamp (special UV light) to help highlight depigmented areas and better define borders
• Consider lab testing in select cases, especially if symptoms suggest an associated autoimmune condition
• Recommend a skin biopsy rarely, when another diagnosis needs to be ruled out

A clear diagnosis matters because several conditions can mimic vitiligo, and the best treatment plan depends on the type and activity level of the disease.

Treatment is individualized based on factors like location (face vs. hands/feet), how widespread vitiligo is, skin type, and how long patches have been present. Options may include:

Topical medications

• Topical corticosteroids may help encourage repigmentation, particularly when vitiligo is new or actively spreading.
• Topical calcineurin inhibitors (such as tacrolimus or pimecrolimus) are often used for sensitive areas like the face and may be used longer-term in appropriate patients.
• Topical JAK inhibitor therapy: ruxolitinib cream (Opzelura) is FDA-approved to help with repigmentation for nonsegmental vitiligo in patients 12 and older.

Light-based therapy (phototherapy)

• Narrowband UVB (NB-UVB) is a widely used option for more extensive vitiligo or when topicals alone aren’t enough, often requiring multiple sessions per week over time.
• Targeted phototherapy / excimer laser may be helpful for more localized patches.

Supportive care and camouflage

• Daily broad-spectrum sunscreen is strongly recommended to reduce burning and minimize contrast between affected and unaffected skin.
• Cosmetic camouflage products can improve appearance immediately while medical treatments work gradually.

Because vitiligo can be persistent and progress in flares, treatment often works best with a long-term plan, consistent follow-up, and adjustments based on response.