Vitiligo ICD-10: L80

Pigmentation disorder / Autoimmune

Often searched as: white patches on skin, skin losing color, white spots on hands and face, why do I have white patches, white spots that spread, vitiligo photos, smooth white patches skin, skin turning white…

Clinical urgency level

lowmediumhigh

Systems Affected

skinmucous membraneseyes (ocular depigmentation in some cases)inner ear (rarely)

Severity Levels

mild

Localized — one or few depigmented patches, stable, in non-visible areas.

moderate

Segmental or generalized, involving visible areas (face, hands), slowly progressive, with notable cosmetic impact.

severe

Universal vitiligo — near-total or total skin depigmentation; significant psychological and social impact; high likelihood of associated autoimmune conditions.

Red Flags

Rapid spread of new patches within weeks
Vitiligo appearing around the eyes or on mucous membranes
Associated symptoms of thyroid disease (fatigue, weight change, hair loss)
Eye discomfort or vision changes (rare ocular involvement)
New patches in a child — warrants earlier evaluation for associated conditions
Significant psychological distress, depression, or social withdrawal

Clinical Presentation

Vitiligo depigmentation on the back of the hand — typical presentation

Source: Wikimedia Commons (CC BY-SA 3.0)

Vitiligo on the face and neck

Source: Wikimedia Commons (Public domain )

When to See a Doctor

See a dermatologist if you notice new white or pale patches on your skin, especially if they are growing or appearing on the face, hands, or genitals. Also seek evaluation if you have a family history of vitiligo or other autoimmune diseases, as screening for thyroid and other conditions is recommended.

Differential Diagnosis

Pityriasis versicolor (hypopigmented variant)
Post-inflammatory hypopigmentation
Chemical leukoderma (occupational)
Discoid lupus erythematosus (depigmented scars)
Pityriasis alba (common in children)
Idiopathic guttate hypomelanosis
Tinea versicolor
Nevus depigmentosus

Comorbidities

Thyroid disease (Hashimoto's thyroiditis, Graves' disease) — most common
Alopecia areata
Type 1 diabetes
Rheumatoid arthritis
Addison's disease
Psoriasis
Depression and anxiety (significant psychological burden)

Prognosis

Vitiligo is a chronic condition and spontaneous complete repigmentation is rare. However, the disease can remain stable for years. Treatment with topical corticosteroids, calcineurin inhibitors, narrowband UVB phototherapy, or the newer JAK inhibitor ruxolitinib (approved 2022) can achieve significant repigmentation in many patients. Segmental vitiligo tends to stabilize earlier but responds less predictably to treatment. Early intervention offers better outcomes.

Detailed Overview

Causes, Symptoms, and When to Take Action Vitiligo is a chronic condition in which patches of the skin lose their pigment, resulting in lighter or white areas. It occurs when the cells that produce pigment (melanocytes) are destroyed or stop functioning. How It Looks Texture: Same as surrounding skin (no raised scale or change in texture) Color: White or very pale patches contrasted with normal skin tone Shape: Irregular or well-defined patches; they may gradually expand Location: Frequently appears on the hands, face, arms, feet, and around body orifices; also can affect mucous membranes Affected hair, eyebrows, eyelashes, or scalp hair in patch areas may turn white. Why Does It Appear? Vitiligo is believed to be an autoimmune condition: the immune system attacks melanocytes Genetic predisposition contributes — people with family members who have vitiligo or other autoimmune diseases are at higher risk Environmental triggers such as stress, skin injury, or sunburn may stimulate onset or spread The loss of melanocytes in affected areas leads to depigmented patches Should You Be Concerned? Vitiligo is not life-threatening, but there are reasons to consult a dermatologist: If new patches appear or existing ones expand If the condition affects visible areas and impacts emotional well-being To assess for associated autoimmune conditions (e.g., thyroid disease) To explore options for restoring pigment or even skin tone Can You Prevent It? There is currently no proven way to prevent vitiligo, but you can take steps to reduce risk of worsening and protect your skin: Avoid strong sun exposure or sunburns Use sunscreen on depigmented areas Minimize skin trauma (cuts, friction) that may trigger new patches 👉 How Piel AI Can Help Piel AI can help you document and monitor appearance, size, and number of vitiligo patches over time. While it does not diagnose, it supports tracking progression or stability and aids in discussions with dermatologists. Summary Vitiligo is a pigment-loss disorder caused by destruction or dysfunction of melanocytes. It presents as white patches with normal skin texture. The cause is chiefly autoimmune, with genetic and environmental influences. Though benign, its cosmetic and psychological impact is significant. Monitoring, skin protection, and early professional consultation are essential.

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