Eczema and Vitiligo: What’s the Connection? | MyVitiligoTeam

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Eczema and Vitiligo: What’s the Connection?

Posted on July 26, 2023

Have you noticed dry, itchy, or scaly patches of skin along with your vitiligo symptoms? If so, you may also be living with eczema, an inflammatory skin condition that can affect people with vitiligo.

MyVitiligoTeam members have asked others about their experiences living with both of these conditions. “Is there a correlation between vitiligo and eczema?” asked one member. “I have vitiligo and was recently diagnosed with eczema. I constantly scratch and have pain. My doctor put me on prednisone, which helped but now that I finished it, the itching has started again. Any suggestions?”

In this article, we’ll discuss the relationship between eczema and vitiligo. These skin conditions can have overlapping symptoms — by getting an accurate diagnosis, your doctor or dermatologist (a doctor who specializes in treating skin conditions) can help make the best treatment plan for you. Fortunately, vitiligo and eczema treatments share many treatment options.

Studies Show an Association Between Eczema and Vitiligo

Eczema is a common condition, affecting an estimated 30 percent of people in the United States. Vitiligo is less common, affecting 0.5 percent to 1 percent of people around the world.

Researchers have started to look into how eczema and vitiligo are connected. An analysis of seven studies of people with atopic dermatitis (the most common type of eczema) showed that the two conditions are closely associated. The authors found that people with atopic dermatitis are more than three times more likely to have vitiligo, compared to the general population.

Another study of more than 1,600 people living with vitiligo reported that 24 percent of them also had atopic dermatitis. The researchers found that people with both vitiligo and eczema were more likely to have more vitiligo on their body and to have skin burning and itching.

Eczema and Vitiligo Are Caused by an Overactive Immune System

Eczema and vitiligo are both caused by an overactive immune system that damages your healthy skin cells. However, there are some key differences between how these two conditions develop.

Eczema is an inflammatory skin condition that researchers believe is triggered by allergies. When you have an allergy to a specific substance or allergen, your immune system overreacts to it and creates inflammation. This causes classic allergy symptoms like watery eyes and runny nose. When you have eczema, the inflammation from your overactive immune system disrupts your skin barrier, leading to dry, itchy, scaly skin.

Eczema can cause scaly, itchy patches all over the body, including the hands. (CC BY-NC-ND 3.0 NZ/DermNet)
Eczema can cause large rough or leathery patches that appear brown, purple, or gray on darker skin tones. (CC BY-NC-ND 3.0 NZ/DermNet)

Researchers also believe that genetic changes raise your risk of having eczema. Your body produces filaggrin protein, which helps your skin hold onto moisture. Some people have changes in their filaggrin gene, so they make less protein — this means their skin is more likely to become dry and itchy. These gene changes can be passed down through family members.

On the other hand, vitiligo is an autoimmune disease that develops when your immune system begins attacking your melanocytes — skin cells that make the color or pigment in your skin known as melanin. Vitiligo can be triggered by skin injuries (like scrapes, cuts, or burns), severe sunburns, or a type of skin cancer known as melanoma.

Skin affected by vitiligo can look white, pink, red, or brownish. The condition frequently affects the hands. (CC BY-NC-ND 3.0 NZ/DermNet)
Areas commonly affected by vitiligo include the face, neck, arms, knees, and feet — but it can occur anywhere on the body. (CC BY-NC-ND 3.0 NZ/DermNet)

Eczema and Vitiligo May Have Similar Symptoms

When you have more than one skin condition at a time, it can be hard to tell them apart. Some MyVitiligoTeam members have noticed their eczema and vitiligo symptoms overlap, especially when it comes to itchy skin.

“When I was much younger, I had eczema as well as vitiligo. My skin would itch terribly, especially on all of the areas with vitiligo,” shared one member.

Another noted they’ve started experiencing new symptoms that look similar to eczema: “I think I may be developing eczema on my hands in addition to my vitiligo. I’m getting a rash and it’s very itchy. It goes away for a while but then comes back.”

While itchy skin is typically an eczema symptom, it’s also common in active vitiligo (discolored patches of skin that are actively spreading). Those patches are rarely itchy once they stop spreading.

Other MyVitiligoTeam members share that areas of their skin affected by eczema are losing their color as well. One asked, “I have eczema on my legs from childhood and vitiligo on the back of my neck. Recently, I’ve noticed that my eczema spots are turning white. Any idea why?”

Researchers have found that your skin can lose its color when it’s inflamed. This symptom is common in people with eczema — especially those with darker skin color. This happens as the melanocytes are only suppressed by the inflammation, not destroyed as in vitiligo. This loss of color resulting from eczema will eventually go away on its own after a few weeks or months.

Eczema and Vitiligo Share Similar Treatments

Because eczema and vitiligo are caused by an overactive immune system, they share many treatment options that help control inflammation. Examples include topical creams with corticosteroids, Janus kinase (JAK) inhibitors, topical calcineurin inhibitors (TCIs), and phototherapy.

Corticosteroids

Corticosteroids (steroids) are medications that can reduce inflammation levels, which can help in treating eczema and vitiligo. Depending on how severe your symptoms are, your doctor or dermatologist may prescribe either a topical applied directly to your skin or a pill to take by mouth.

Dry skin and itching from eczema can be treated with over-the-counter topical hydrocortisone cream available at grocery stores and pharmacies. If you need a stronger dose, your doctor may prescribe prescription-strength corticosteroids that come as creams, ointments, lotions, or sprays. It’s important to use these according to your doctor’s directions.

Topical corticosteroids are also commonly prescribed to treat vitiligo. They help slow the spread of vitiligo symptoms and stop more white patches of skin from forming. You’ll likely need a prescription-strength corticosteroid to help control your symptoms.

If you have severe eczema and/or vitiligo, your doctor or dermatologist may prescribe corticosteroid pills. The most commonly prescribed oral corticosteroid for vitiligo is prednisone, while prednisolone and prednisone are commonly used for treating eczema.

JAK Inhibitors

JAK inhibitors are a newer class of medications used to treat skin conditions. They help block inflammatory messengers in the skin that contribute to dry, itchy skin in eczema and loss of pigment in vitiligo.

The U.S. Food and Drug Administration (FDA) initially approved the topical JAK inhibitor cream Opzelura — a formulation of ruxolitinib — for treating mild to moderate atopic dermatitis. In 2022, the FDA also approved it for treating nonsegmental vitiligo, which affects both sides of the body.

Topical Calcineurin Inhibitors

TCIs also work by blocking inflammatory messengers in your skin to treat eczema and vitiligo. There are two FDA-approved TCIs for treating atopic dermatitis — Protopic, a formulation of tacrolimus, and Elidel, a formulation of pimecrolimus — but many doctors and dermatologists prescribe them “off-label” (outside of their approved use) for vitiligo. “I was given tacrolimus ointment for eczema as well as vitiligo,” shared a MyVitiligoTeam member.

Phototherapy

A kind of light therapy known as phototherapy is used to treat both eczema and vitiligo. This treatment option uses ultraviolet light similar to sunlight to help control inflammation and skin itching in eczema.

Phototherapy can also help slow the spread of vitiligo, make discolored patches smaller, and enhance repigmentation. Your dermatologist may use phototherapy along with other topical treatments for better results.

Talk to Your Doctor About Vitiligo and Other Skin Conditions

If you’ve noticed any new symptoms or if your current treatment plan isn’t working, talk to your dermatologist or other health care provider. They can take a closer look to see if you’re living with vitiligo, eczema, and/or another skin condition and help start you on the right treatment plan. Working together with your provider, you can better manage your symptoms and improve your overall quality of life.

Talk With Others Who Understand

On MyVitiligoTeam, the social network for people with vitiligo and their loved ones, more than 12,000 members come together to ask questions, give advice, and share their stories with others who understand life with vitiligo.

Are you living with both eczema and vitiligo? What symptoms have you experienced and what treatments help you manage them? Share your thoughts 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.

References
  1. What Is Eczema? — National Eczema Association
  2. Vitiligo — MedlinePlus
  3. Association of Atopic Dermatitis With Vitiligo: A Systematic Review and Meta-Analysis — Journal of Cosmetic Dermatology
  4. Association Between Vitiligo and Atopic Disorders: A Pilot Study — JAMA Dermatology
  5. Vitiligo: Causes — American Academy of Dermatology Association
  6. Vitiligo: Signs and Symptoms — American Academy of Dermatology Association
  7. Post-Inflammatory Hypopigmentation — The Australasian College of Dermatologists
  8. Corticosteroids — Cleveland Clinic
  9. Available Eczema Treatments — National Eczema Association
  10. Topical Medication for Vitiligo — NYU Langone Health
  11. Advances in Vitiligo: An Update on Medical and Surgical Treatments — The Journal of Clinical and Aesthetic Dermatology
  12. Use of Systemic Corticosteroids for Atopic Dermatitis: International Eczema Council Consensus Statement — The British Journal of Dermatology
  13. JAK Inhibitors: What Your Dermatologist Wants You To Know — American Academy of Dermatology Association
  14. FAQ — Opzelura (Ruxolitinib) Cream — National Eczema Association
  15. FDA Approves Ruxolitinib (Opzelura) for Vitiligo Therapy: A Breakthrough in the Field of Dermatology — Annals of Medicine & Surgery
  16. Eczema Treatment: Topical Calcineurin Inhibitors (TCIs) for Children — American Academy of Dermatology Association
  17. Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo — JAMA Dermatology
  18. Prescription Phototherapy — National Eczema Association
  19. Vitiligo — Mayo Clinic
    Posted on July 26, 2023
    All updates must be accompanied by text or a picture.

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    Maggi Ahmed, M.D., Global Vitiligo Foundation is a postdoctoral clinical research fellow at the University of Massachusetts Chan Medical School. Learn more about her here
    Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here

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