In vitiligo, a faulty immune reaction kills off pigment cells called melanocytes and leaves patches of white skin. Considered an autoimmune disorder, vitiligo often emerges in adolescence or later, occurring in an estimated 1 percent of the world’s population and affecting all ethnic groups equally — although the depigmentation is more obvious on darker skin and carries greater social stigma in certain cultures. More than 50 separate gene changes have been linked to a greater risk of developing vitiligo, but what actually triggers it is unclear. (Some areas of the body, such as the face, are more likely to be affected, as are areas of the skin that have had trauma.)
In some small percentage of people, the patches clear up spontaneously, but most linger for life. That can take a psychological and emotional toll: Surveys show that the majority of people with vitiligo experience shame and insecurity; for some such feelings can bloom into clinical depression. And as with other kinds of immune activity gone awry, it can be hard on other parts of the body as well.
Studies suggest between 15 percent and 25 percent of those with vitiligo have at least one additional autoimmune disorder, including thyroid disease, inflammatory bowel disease and lupus. And because melanocytes also populate the inner ear, various tissues of the eyeball and even a layer of the brain’s protective coating, individuals with vitiligo can experience hearing loss, vision impairments and occasional neurological abnormalities.
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