Skin injuries like sunburn or cuts can trigger vitiligo in individuals who are genetically predisposed to the skin condition. Melanocytes are the cells in the body responsible for producing melanin (skin pigment). Scientists believe exposure to stressors like severe sunburns, cuts, repeated pressure, rubbing, or scratching can cause oxidative stress to these skin pigment cells. Oxidative stress is a process that destroys cells in the body. In vitiligo, oxidative stress attacks and destroys melanocytes, leading to skin pigment loss.

This article will explain how sunburns and other skin injuries can trigger vitiligo or cause new white patches of skin to develop.

What Causes Vitiligo?

The specific cause of vitiligo remains unknown. However, health experts believe the condition is caused by multiple factors, such as:

• Abnormal autoimmune response to melanocytes
• Genetics
• Environmental exposures
• Trauma to the skin

Researchers have found that sunburn or skin injury is related to the onset of vitiligo in between 21 percent and 62 percent of people with the condition.

Vitiligo Triggered by Sunburns

Many MyVitiligoTeam members report having a sunburn that triggered vitiligo. One member shared the first time they noticed their vitiligo develop: “I used to live in Arizona and go to the lake a lot. One day, I got a bad sunburn on my forehead. After a couple days my sunburn began to turn white.”

Studies have found that sunburns are a risk factor for vitiligo. One study found that white women with a childhood or adolescent history of sunburns with blisters after two hours of sun exposure had an increased risk of developing vitiligo. Large population-based studies have also found that people who sunburn but also have a high ability to tan have a higher risk of developing vitiligo.

Excessive sun exposure and ultraviolet (UV) damage increases the number of free radicals in the body and stress response within the skin. Free radicals are unstable molecules that can damage the body. They are naturally produced in the body, but they can also come from toxins in the environment, specifically UV rays. People living with vitiligo have an imbalance of free radicals and antioxidants — compounds that protect our cells against free radicals. This imbalance gives rise to oxidative stress, triggering an immune system response against melanocytes.

Excessive sun exposure and UV damage also increases stress protein levels, specifically HSP70i, which has been shown to play a central role in vitiligo development.

Vitiligo Triggered by Skin Injuries

Repeated skin trauma can induce an inflammatory response that triggers vitiligo. Examples of skin trauma include:

• Physical wounds, scratches, or cuts
• Chemical burns
• Sunburns
• Repeated pressure, friction, or rubbing

Getting a tattoo can also potentially worsen vitiligo.

Vitiligo appearing at the areas of trauma is known as the Koebner phenomenon (KP) or isomorphic response. A new patch of vitiligo can appear about 10 to 14 days after skin injury.

The Koebner phenomenon occurs in some types of vitiligo more often than others. There is evidence that the KP is more common among children and adults with generalized vitiligo compared to segmental vitiligo. It is found in the commonly affected areas of the body, such as the fingers, knees, and elbows. The Koebner phenomenon also appears on parts of the body with long-term friction, pressure, or repeating movement caused by a belt or tight clothing.

However, it remains unclear whether or not the same type of trauma will cause KP in all areas of skin. Additionally, experts are still uncertain if the risk of KP in vitiligo is linked to ethnicity or skin color.

Ways To Protect Your Skin

There are steps you can take to avoid or reduce damage to your skin, whether from sunburn or other injury. There is no guarantee that protecting your skin from damage will prevent vitiligo, but there are no downsides to preventing sunburn or reducing the chances of burns or cuts.

Sun Protection

Using daily sun protection is one of the best ways to avoid damaging your skin. Sun protection is important for anyone with vitiligo, regardless of skin tone.

Following are some ways to protect yourself from sun damage:

• Wear UV protection factor (UPF) clothing, available as tops, bottoms, and hats. According to the Skin Cancer Foundation, you can get very good protection from a UPF of 30 to 49, while a UPF of 50 or more provides excellent protection.
• Wear a hat that protects your face, neck, and ears.
• Wear UV-protective sunglasses to protect your eyes and eyelids.
• Wear sunscreen daily with sun protection factor (SPF) 30 or more, UVA/UVB protection, and water resistance.
• Apply sunscreen on all sun-exposed areas 15 to 30 minutes before going out in the sun. Cream, lotion, or gel sunscreens are generally better at ensuring skin coverage than sprays.
• Reapply sunscreen every two hours and immediately after swimming or strenuous physical activity.
• Spend time in the shade when it is sunny outside.
• Avoid excessive sun exposure, tanning beds, or sun lamps. The wavelengths of UV light from these sources is different from that which is administered in a medical office, and they can affect the skin differently.

Get a doctor’s perspective on sun protection and vitiligo.

Avoiding Skin Injury

Avoiding all injuries to the skin is impossible, but there are some proactive steps you can take to protect your skin.

• Take care when shaving to avoid cuts. The American Academy of Dermatology provides recommendations for safe shaving.
• Wear protective gloves when handling chemical irritants.
• Wear protective gloves and clothing when participating in activities that may lead to cuts or scrapes.
• Use oven mitts and take other precautions when cooking or using hot tools like a curling iron.
• Avoid repeated friction from tight underwear, belts, or pants by choosing looser-fitting options or different fabrics.
• Consider your expectations and the possible outcomes of getting a tattoo. Talk to your dermatologist for guidance.

Vitiligo Treatment

If you have vitiligo triggered by skin injury or any other cause, there are treatment options, including oral or topical corticosteroids, light therapy, and surgery. Some people use cosmetics to camouflage their skin depigmentation. Others choose not to treat or camouflage their skin. You can talk to your doctor about what is best for you.

Talk With Others Who Understand

MyVitiligoTeam is a social network for people with vitiligo. On MyVitiligoTeam, more than 10,000 members come together to ask questions, give advice, and share their stories with others who understand life with vitiligo.

Have you ever experienced vitiligo triggered by a sunburn or skin injury? Share your experience or questions in the comments below, or start a conversation by posting on your Activities page.

In partnership with the Global Vitiligo Foundation, which strives to improve the quality of life for individuals with vitiligo through education, research, clinical care, and community support.