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Types of Vitiligo

Posted on December 03, 2019


Vitiligo can be separated into two main types – generalized vitiligo and segmental vitiligo. In both types of vitiligo, the cells that create skin pigmentation are destroyed, creating patches of lighter skin. However, generalized and segmental vitiligo present differently on the body.1

Generalized Vitiligo

Generalized vitiligo is characterized by symmetrical patches of depigmentation on both sides of the body. Often, generalized vitiligo starts with patches of skin discoloration on the hands, feet, elbows, armpits, or face.2 Generalized vitiligo can also be referred to as non-segmental vitiligo, bilateral vitiligo, or vitiligo vulgaris.1

About nine in 10 people with the condition have generalized vitiligo.3 A person can develop generalized vitiligo at any age, and it frequently progresses throughout life.2

Generalized vitiligo may cause non-skin symptoms and is associated with autoimmune and thyroid conditions.4 Learn more about health conditions related to vitiligo.

Generalized vitiligo can be divided into several subtypes:

  • Acrofacial vitiligo affects the head and distal extremities such as the fingertips.5
  • Focal vitiligo involves one patch or a few small, isolated patches of depigmentation in one area that have not spread after two years.5
  • Universal vitiligo is an uncommon form of vitiligo where 80 percent or more of the skin loses pigment.6

Segmental Vitiligo

In contrast to generalized vitiligo, segmental vitiligo usually affects just one side of the body.2 Segmental vitiligo can also be referred to as unilateral vitiligo.1

Segmental vitiligo impacts about one in 10 people with vitiligo and is more prominent in children – three in 10 children with vitiligo have segmental vitiligo.3 Individuals with segmental vitiligo typically develop the condition as children or young adults. Unlike generalized vitiligo, which can advance throughout a person’s life, segmental vitiligo usually progresses for a year or two and then stays constant.2

Segmental vitiligo can manifest in specific patterns that are consistent from person to person.2 Many people with segmental vitiligo also lose some amount of hair color on the head, eyelashes, or eyebrows.1

Segmental vitiligo is less strongly associated with autoimmune conditions.7

Some researchers believe that different types of vitiligo may have different causes.8 Read more about causes and risk factors for vitiligo.

Drug-Induced Vitiligo

In some cases, people can develop vitiligo as the result of medication use. Drug-induced vitiligo (also called drug-induced leukoderma) is most commonly the result of medications that modify the immune system, including immunomodulators, biologics, and targeted therapies used to treat cancer. Vitiligo may also be induced by topical exposure to monobenzone or a similar chemical in a class known as phenols.8 Certain targeted therapies for leukemia and lymphoma and medications that treat inflammatory illnesses like rheumatoid arthritis or psoriasis are among the drugs that can cause vitiligo.8

Like other forms of vitiligo, genetic factors may make some people more prone to developing drug-induced vitiligo. Those who develop drug-induced vitiligo may also be more likely to develop other autoimmune conditions.8

Drug-induced vitiligo often develops at an older age spreads more quickly than segmental or generalized vitiligo. Small white dots are common in new areas of drug-induced vitiligo. Drug-induced vitiligo may reverse after stopping the medication that caused skin depigmentation.8

Condition Guide

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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. Vitiligo: Signs and symptoms. (n.d.). Retrieved October 31, 2019, from https://www.aad.org/diseases/a-z/vitiligo-symptoms.
  2. Nordlund, J. (2011). Vitiligo: A review of some facts lesser known about depigmentation. Indian Journal of Dermatology, 56(2), 172. doi: 10.4103/0019-5154.80413
  3. Overview: Vitiligo. (n.d.). Retrieved October 31, 2019, from https://www.nhs.uk/conditions/vitiligo/.
  4. Vitiligo Clinical Presentation: Physical Examination, Clinical Variants, Clinical Classifications of Vitiligo. (2019, October 31). Retrieved November 8, 2019, from https://emedicine.medscape.com/article/1068962-clinical#showall.
  5. Goh, B.-K., & Pandya, A. G. (2017). Presentations, Signs of Activity, and Differential Diagnosis of Vitiligo. Dermatologic Clinics, 35(2), 135–144. doi: 10.1016/j.det.2016.11.004
  6. Homan, M. W. L., Sprangers, M. A. G., Korte, J. D., Bos, J. D., & J. P. Wietze Van Der Veen. (2008). Characteristics of Patients With Universal Vitiligo and Health-Related Quality of Life. Archives of Dermatology, 144(8). doi: 10.1001/archderm.144.8.1062
  7. Geel, N. V., & Speeckaert, R. (2017). Segmental Vitiligo. Dermatologic Clinics, 35(2), 145–150. doi: 10.1016/j.det.2016.11.005
  8. Drug-induced vitiligo. (n.d.). Retrieved November 26, 2019, from https://dermnetnz.org/topics/drug-induced-vitiligo/.
All updates must be accompanied by text or a picture.
Richard H. Huggins, M.D., Treasurer of the Global Vitiligo Foundation is the author of numerous journal articles and chapters studying treatments and quality of life for people with vitiligo and other skin conditions. Learn more about him here.
Alison Channon has nearly a decade of experience writing about chronic health conditions, mental health, and women's health. Learn more about her here.

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