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What Causes Vitiligo?

Posted on December 04, 2019

The cells responsible for making skin pigment are called melanocytes.1 In vitiligo, melanocytes are destroyed, resulting in a loss of pigment and the appearance of white patches.1 There are many theories about what causes vitiligo, but most researchers agree that in most cases, vitiligo is an autoimmune condition.2 In other words, white patches and other symptoms of vitiligo are caused by the body’s immune system attacking the melanocytes.2 Different types of vitiligo may have different causes.1

While researchers have established that both hereditary and environmental factors influence a person’s risk for developing vitiligo, no one has identified why some people get vitiligo and some people don’t.3 Most scientists believe vitiligo is most likely caused by a combination of inherited and environmental factors.4

In one theory, there are three processes that contribute to the development of vitiligo:5

  1. Melanocytes are exposed to stress, which may be caused by genetic or environmental factors, or both.
  2. Stressed melanocytes provoke inflammation, leading the immune system to identify them as foreign.
  3. The immune system develops cells specifically to seek out and destroy melanocytes.

Research continues to identify the risk factors that contribute to the development of vitiligo.

Risk Factors for Vitiligo

It is important to note that while science is good at finding correlations, or apparent relationships, between factors and disease, correlation does not prove that the factor causes the disease. Many risk factors for vitiligo have been identified and are being studied, but none have been pinpointed as a single cause of vitiligo.

Hereditary Factors

Vitiligo does not appear to be directly inherited from parents in any clear genetic pattern. About 6 percent of people with vitiligo have a first-degree relative with vitiligo.6 Among identical twins, if one has vitiligo, the other has a 23 percent risk for developing the skin condition.7

More than 30 different genes, occurring in different combinations, appear to be associated with a risk for developing vitiligo.3 Some of these genes influence how the body regulates inflammation or how melanocytes develop.3 Research suggests that the melanocytes of people with vitiligo may be more susceptible to environmental stress, or that their immune systems may have an abnormal reaction to stressed melanocytes.3

Inherited genes that raise your risk for developing vitiligo may also raise your risk for developing some other health conditions. Read more about conditions related to vitiligo.

Environmental Factors

One theory about the cause of vitiligo is that a trigger event causes stress to melanocytes in a person who is genetically predisposed to develop vitiligo.8 Researchers have identified an array of environmental factors linked to the development of vitiligo. These environmental factors may trigger vitiligo to develop in some people; in most people with vitiligo, the trigger is not known.8

  • Sunburn8
  • Trauma to the skin, which may include repeated rubbing or scratching8,9
  • Exposure to monobenzone or a similar chemical in a class known as phenols. Monobenzone is used in producing rubber, leather, and cosmetic dyes.10 Monobenzone has been shown in multiple studies to cause vitiligo to develop and to worsen vitiligo in people who already have it.10
  • Emotionally stressful events may trigger the development of vitiligo, potentially due to hormonal changes that occur when a person experiences stress.4 As in other autoimmune diseases, emotional stress can worsen vitiligo and cause it to become more severe.4

Condition Guide

Resources

External resources

Internal resources:

FAQs
Is vitiligo contagious?
No. Vitiligo is not contagious.11

Is vitiligo caused by smoking?
There is no medical evidence of a link between vitiligo and smoking.9

Is vitiligo caused by poor nutrition?
There is no medical evidence that vitiligo is related to diet.9

Can stress cause vitiligo?
Stressful events may contribute to the development of vitiligo.4 Emotional stress can make vitiligo worse.4

Can vitiligo be prevented?
Since we do not yet know what causes some people to develop vitiligo, there is no certain way to avoid developing the condition. Some risk factors, including genetic predisposition, are beyond anyone’s control.

If you are concerned that you or your child may have a high risk for developing vitiligo, focus on lowering your risk by changing the factors within your control. Protect your skin from sunburn by wearing sunscreen, hats, and long sleeves. (Although people with pale skin are more susceptible, anyone can be sunburned.12) As much as possible, avoid skin trauma such as repeated rubbing or scratching. If you must use phenol chemicals such as monobenzone, protect your skin from contact with them. Work on reducing the levels of emotional stress in your life. These changes may or may not help prevent vitiligo, but they are likely to improve your overall health.

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: Who Gets and Causes. (n.d.). Retrieved November 8, 2019, from https://www.aad.org/diseases/a-z/vitiligo-causes.
  2. Vitiligo: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved December 2019, from https://medlineplus.gov/ency/article/000831.htm.
  3. Vitiligo - Genetics Home Reference - NIH. (2019, October 29). Retrieved November 8, 2019, from https://ghr.nlm.nih.gov/condition/vitiligo#inheritance.
  4. Harris, J. E. (2017, January 17). What causes vitiligo? – Umass Vitiligo Clinic & Research Center. Retrieved November 8, 2019, from https://www.umassmed.edu/vitiligo/blog/blog-posts1/2017/01/answer-to-what-causes-vitiligo/.
  5. Harris, J. E. (2014, June 4). Vitiligo Research – Vitiligo Clinic & Research Center UMass Medical. Retrieved December 2019, from https://www.umassmed.edu/vitiligo/research/.
  6. Vitiligo. (n.d.). Retrieved January 2020, from https://rarediseases.info.nih.gov/diseases/10751/vitiligo
  7. Harris, J. E. (2014, June 21). Will my children/family get vitiligo – Speaking About Vitiligo! Blog. Retrieved December 2019, from https://www.umassmed.edu/vitiligo/blog/blog-posts1/2014/06/will-my-childrenfamily-get-vitiligo/.
  8. Manga, P., Elbuluk, N., & Orlow, S. J. (2016). Recent advances in understanding vitiligo. F1000Research, 5, 2234. doi: 10.12688/f1000research.8976.1
  9. Vitiligo. British Skin Foundation. Retrieved December 2019, from https://www.britishskinfoundation.org.uk/vitiligo.
  10. Richmond, J. M., Frisoli, M. L., & Harris, J. E. (2013). Innate immune mechanisms in vitiligo: danger from within. Current Opinion in Immunology, 25(6), 676–682. doi: 10.1016/j.coi.2013.10.010
  11. Vitiligo. (2018, March 8). Retrieved December 2019, from https://www.mayoclinic.org/diseases-conditions/vitiligo/symptoms-causes/syc-20355912.
  12. Sunburn. Skin Cancer Foundation. Retrieved December 2019, from https://skincancer.org/risk-factors/sunburn/.
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.
Kelly Crumrin is a senior editor at MyHealthTeam and leads the creation of content that educates and empowers people with chronic illnesses. Learn more about her here.

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