Vitiligo: Causes and Risk Factors - Verywell Health

Vitiligo is a chronic skin pigmentation condition that causes white or light patches to form on the body. The discoloration occurs when the cells that give the skin, hair, and eyes color (melanocytes) stop functioning.

Vitiligo is generally considered to be an autoimmune disease, though it's not entirely clear what triggers the immune system to mistakenly attack its own healthy skin pigment cells.

Experts think that a combination of factors, including genetics, autoimmunity, stress, skin damage, and chemical exposure, likely contribute to a person's risk of vitiligo.

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Common Causes

Vitiligo affects people of all ethnicities and skin types. While the exact cause is unknown, research has suggested that a variety of factors are at play.

Genetic Mutations

Variations in multiple genes have been linked to an increased risk of developing vitiligo. Roughly 30% of vitiligo cases run in families, and about one-fifth of people with vitiligo have at least one close relative who also has the condition.

While a family history of vitiligo can make someone more likely to have the condition, researchers agree that it's not the only cause.

Autoimmune Conditions

Studies show a clear genetic link between vitiligo and other autoimmune diseases, including those that specifically affect the thyroid gland.

While the exact circumstances are still being studied, it could be because vitiligo patients' immune systems develop antibodies that destroy the skin pigmentation cells.

Roughly 15% to 25% of people with vitiligo have at least one other autoimmune disease.

People who have an existing autoimmune disease, such as psoriasis, lupus, Hashimoto's disease, rheumatoid arthritis, type 1 diabetes, and hypothyroidism, are at an increased risk of developing vitiligo.

Environmental Triggers

Environmental circumstances, such as stress, a bad sunburn, skin trauma, or exposure to a strong chemical, seem to prompt vitiligo development in people who are genetically predisposed to the condition.

Triggers may also cause existing vitiligo patches to spread or progress in people who already have the condition. For example, the first signs of skin pigmentation loss may show up on an area of skin that has come in contact with chemicals or experienced skin damage.

Vitiligo may get worse after a person experiences intense emotional or physical stress.

Genetics

Researchers have found variations in more than 30 genes that have been linked to a higher risk of developing vitiligo. Many of the genes are involved in the body's immune system or melanocyte function, and it's possible that each contributes to a portion of the vitiligo risk.

Genes that are thought to play a role in vitiligo development include:

• NLRP1 gene: This gene provides instructions for making a protein that's involved in the immune system. Specifically, it helps to regulate the process of inflammation.
• PTPN22 gene: This gene helps control the activity of the immune system cells.

Certain variations in both genes may make it more difficult for the body to control inflammation and prevent the immune system from attacking its own healthy cells.

Changes in these genes have also been associated with an increased likelihood of developing other autoimmune diseases.

Although researchers know that some people have a higher risk of developing vitiligo as a result of having certain genetic mutations, the reasons why these changes occur aren't completely clear and underscore why there are likely other contributing factors at work.

Vitiligo can run in the family, though that's not always the case. Roughly 30% of people with vitiligo have a close relative who also has vitiligo, but only 5% to 7% of children with a parent who has vitiligo will develop the condition.

Lifestyle Risk Factors

There's no way to know for sure whether a person will develop vitiligo. However, experts have identified several risk factors that are thought to increase the chances—particularly if the person has a genetic predisposition to the condition.

Skin Damage or Trauma

Research has shown that vitiligo development might be more likely in areas where there has been frequent sun exposure and severe sunburns (commonly on the face, neck, and hands).

Areas of the skin that have been affected by trauma, such as a deep cut or repeated rubbing, friction, scratching, or pressure, may also be more likely sites for vitiligo to occur.

Stress

Studies have shown that stressful events or chronic emotional and physical stress may trigger both the development and progression of vitiligo, particularly in patients who are predisposed because of their genes.

It's thought that the skin changes are prompted, at least in part, by the hormonal changes that happen when a person experiences extreme stress. Evidence has also shown that trauma and significant life stressors are linked to autoimmune disease.

Chemical Exposure

Contact with or exposure to certain chemicals might be another environmental risk factor for developing vitiligo. Some experts have hypothesized that the chemicals accelerate stress pathways that are already present in melanocytes, leading to autoimmune inflammation.

In addition, genetic influences may increase cellular stress in melanocytes or set a lower threshold for stress that the immune system can handle.

One of the chemicals that has been studied is monobenzone, which is found in certain products like rubber, leather, and cosmetic dyes. Research has found that monobenzone can prompt skin depigmentation to develop and worsen in people who already have vitiligo.

Another category of chemicals that might play a role in vitiligo is phenols, which are thought to disrupt melanocyte function. These chemicals are often ingredients in products such as adhesives, disinfectants, paints, insecticides, and more.

A Word From Verywell

Vitiligo is not life-threatening or contagious, but it can have a profound impact on a person's self-esteem, emotional well-being, and overall quality of life. It can also be frustrating because there is no way to prevent the condition or predict if, or when, a person will develop it.

Several risk factors that can increase your chances of developing vitiligo have been identified, but some of them are not in your control, such as your genetics. Among the millions of people around the world who have vitiligo, each person's causes and risk factors will be different.

There are several options for treating the skin pigmentation loss that comes with vitiligo, but you may also choose not to treat the condition.

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