Coronavirus and vitiligo

Many are asking me whether individuals with vitiligo are at higher risk for contracting the novel coronavirus, COVID-19, which is responsible for an ongoing pandemic. In general, the answer is no. I figured that I would take the time to write this blog while I and my family are “socially distancing” ourselves in order to slow the spread of the pandemic in our little part of the world. So, we’re stuck in our house and thinking about everyone out there who is worried about what this pandemic means for them and their loved ones.

Vitiligo is an autoimmune disease of the skin, which means that someone with vitiligo has an immune system that is malfunctioning in a small way. The normal role of the immune system is to protect you from infections and cancer. Just like any trait that you may have (height, weight, hair color, etc), your genetic makeup can influence the quality and strength of your immune response. In vitiligo the immune cells are attacking the melanocytes, or pigment cells, even though the cells are not dangerous.

So just like some people are very tall, some are very short, and most are somewhere in the middle, some people have an immune system that is very strong in one area, very weak in an area, or somewhere in the middle. Individuals with vitiligo have an immune response that is too strong against their melanocytes, which results in these normal cells being killed and white spots appearing where that happened, because they can’t make pigment anymore. This is actually good from one perspective, because it means they have a lower risk of developing melanoma and other skin cancers (that’s what that part of the immune response is supposed to be doing – protecting from melanoma). So that “malfunctioning” immune system is causing white spots on your skin, but also decreasing your chances of getting skin cancer – I guess whether this is “good” or “bad” depends on your perspective. 

But in any way you look at it, it doesn’t mean that your immune system is weak because you have vitiligo. It actually means that it’s a little too strong, so you are most likely NOT more susceptible to coronavirus or any other virus. Some of my patients report that they get fewer infections than their friends and family, and this may reflect the fact that the immune system is a little overactive. But just because the immune system is overactive in one small aspect (against the melanocytes), it doesn’t necessarily mean that it’s strong in every aspect, so everyone is probably a little different. But overall the take home message is that having vitiligo does not mean your immune system is weak, or that you are more likely to get an infection.