Vitiligo and Psoriasis: Is There a Connection? - Verywell Health

Vitiligo and psoriasis are both autoimmune skin diseases. Sometimes they occur together. 

The reasons for that aren't fully understood, but researchers suspect genetic differences point to a common underlying problem with the immune system.

This article explores connections between vitiligo and psoriasis, what research has uncovered, plus prevention and treatment for both conditions.

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Vitiligo vs. Psoriasis

About 1% of the population has vitiligo, which causes skin patches to lose all of their melanin (pigment). That leaves white blotches, especially on the following parts of the body:

• Face, especially around the mouth and eyes
• Inside the mouth
• Neck
• Armpits
• Hands and wrists
• Groin and genitals

It can also affect the hair. Vitiligo is especially noticeable in people with darker skin.

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Psoriasis is more common, affecting about 3% of the population. Psoriasis involves skin cells that multiply too fast, causing them to build up. That leads to thick, discolored skin with silver scales.

Patches can be anywhere, but are most common on the:

• Face
• Back
• Elbows
• Palms
• Knees
• Feet

Both vitiligo and psoriasis are autoimmune skin diseases. That means the immune system mistakenly attacks cells in a part of your body as if they were a threat like a bacteria or virus.

The exact triggers of these disorders (and autoimmune diseases in general) aren't yet understood. Researchers believe they involve a genetic predisposition that makes you vulnerable. Then, if you encounter the right set of environmental triggers, the disease develops.

It's common to have more than one autoimmune disease. Vitiligo and psoriasis sometimes occur together.

Recap

Vitiligo and psoriasis are both autoimmune diseases. Vitiligo causes the destruction of pigment and creates white patches of skin. Psoriasis causes the buildup of dead cells and leads to discolored patches with silvery scales. Due to common genetics and immune dysfunction, some people have both conditions.

What Research Says

Little is known about the relationship between vitiligo and psoriasis. However, research is ongoing.

A small 2021 study looked at a group of 436 vitiligo patients and found that 74 of them (about one-fifth of the participants) had a history of psoriasis either currently or in the past. More than 50% of the people with both conditions were diagnosed with psoriasis first.

In 12 people, psoriasis patches occurred in the same places as the vitiligo white spots. This has been seen in other studies, as well.

The risk appears to go both ways: People with psoriasis have an increased risk of developing vitiligo, and people with vitiligo have an increased risk of developing psoriasis.

The connection appears to be in the immune system. Both conditions involve an autoimmune response to melanocytes (pigment cells) or proteins derived from melanocytes.

Vitiligo and psoriasis are associated with other autoimmune and skin diseases, as well.

Recap

Vitiligo and psoriasis both increase your risk of developing the other skin condition. Psoriasis plaques are sometimes confined to the white vitiligo patches. Experts believe this is due to similarities in the immune system, especially in regard to actions taken against melanocytes (pigment cells).

Prevention

So far, experts know of no way to prevent either vitiligo or psoriasis. They also can't be cured.

Lifestyle factors that may help with prevention include:

• Eating a healthy diet with lots of leafy greens and antioxidants
• Learning to manage stress
• Preventing skin damage from the sun, insect bites, scratches, tattoos, etc.
• Avoiding infections

Psoriasis White Patches

Sometimes, psoriasis lesions can cause depigmentation of the skin. That leaves white patches behind when the lesion heals. It can be hard to tell vitiligo from psoriasis white patches.

Treatment

Treatment may slow or stop the progression of these diseases, as well as ease symptoms. Fortunately for those who have both, some treatments are the same or similar.

Vitiligo

Treatments for vitiligo focus on repigmenting the skin. They include:

• Topical medication: Strong corticosteroids applied to the skin
• Light treatment: Lasers, light boxes, or UVA light combined with the drug psoralen 
• Surgery: Skin grafting of pigmented skin into depigmented areas
• Supplements: Ginkgo biloba has some clinical evidence; others haven't been studied

Nutritional deficiencies may play a role in vitiligo. These include:

Ask your healthcare provider if you should make any dietary changes. They may want to test your blood for deficiencies.

Some healthcare providers prescribe supplements to stabilize the immune system, such as:

During treatment or if treatment isn't effective, many people try to conceal the blotches. Options include:

• Camouflage: It's common to cover white patches with makeup or self-tanner.
• Depigmentation: In rare cases, a skin cream is used to remove all remaining melanin from the skin, leaving all of the skin white. This takes between one and four years to accomplish.

Psoriasis

Psoriasis treatments include:

• Topical medication: Steroid creams, medicated lotions and shampoos
• Light treatment: Lasers, light boxes, or UVA light combined with the drug psoralen 
• Medications: Retinoids, and in severe cases, methotrexate or cyclosporine
  

JAK Inhibitors

A newer class of drugs called Janus kinase (JAK) inhibitors has shown promise in studies as a treatment for vitiligo and psoriasis. It's being researched in both oral and topical forms. JAK inhibitors reverse overactivity in the immune system.

Summary

Vitiligo and psoriasis are autoimmune diseases with related genetic predispositions. Vitiligo destroys pigment and creates white patches of skin. Psoriasis causes discolored patches with silvery scales. Some people have both of them, and sometimes, psoriasis only appears in vitiligo patches.

Having one of these disorders increases your risk of the other. Both involve immune reactions to melanocytes.

Treatments for these conditions have some overlap, such as corticosteroid creams and light therapy. Other vitiligo treatments include supplements or surgery to place pigmented skin in white patches. Other psoriasis treatments include medications such as anthralin or methotrexate.

A Word From Verywell

Having one skin condition is hard enough on your self-esteem. Having two is especially difficult.

Rest assured, effective treatments are available for vitiligo and psoriasis. Some of them will even help both conditions.

Talk to your healthcare provider about your options and start working toward better skin.

Frequently Asked Questions

• Vitiligo is pronounced vih-tuh-LYE-go.

• Yes, it is an autoimmune disease. The immune system misidentifies melanin (pigment) cells called melanocytes as a danger. It then sets out to destroy them. That's what causes the white patches, also called depigmentation.

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