Vitiligo Unit

Diagnosing vitiligo is usually straightforward and is most often performed during a dermatology consultation through a simple clinical examination.

For a more comprehensive assessment, specialists at the Vitiligo Unit frequently use Wood’s light, a type of ultraviolet radiation that helps detect skin changes that are not visible to the naked eye. This allows us to determine whether any melanin remains in the affected area or whether depigmentation is complete.

Under Wood’s light, vitiligo lesions appear as a white-bluish fluorescent colour, with the intensity depending on the presence or absence of residual melanin.

In selected cases, vitiligo specialists may also recommend a skin biopsy.

This involves taking a small sample of skin for laboratory analysis to confirm the absence of melanocytes, the cells responsible for melanin production.

If the dermatologist suspects the presence of another autoimmune condition, additional tests may be requested.

The results of these investigations help the dermatologist to design a treatment plan tailored to each patient’s specific needs. At the Grupo Pedro Jaén Vitiligo Unit, we place particular emphasis on early diagnosis for two key reasons.

Firstly, early detection and classification of vitiligo allow treatment to begin sooner, increasing the likelihood of a favourable response. Secondly, vitiligo can be confused with other dermatological conditions such as pityriasis alba, pityriasis versicolor or guttate hypomelanosis—three pigmentation disorders that also present with white or pale patches. Diagnostic inaccuracies may delay appropriate treatment, potentially worsening the patient’s prognosis.

The hallmark of vitiligo is the appearance of white patches caused by the loss of melanocytes. These depigmented areas can occur anywhere on the body, although they are more commonly seen on the backs of the hands, the distal parts of the fingers, the knees, the perioral and periocular regions, the armpits, wrists, elbows and genital area.

Based on the distribution and pattern of the lesions, several types of vitiligo can be distinguished.

Segmental vitiligo

In this form, white patches appear on only one side of the body. Segmental vitiligo tends to develop at an earlier age, sometimes during childhood, and is less common in adulthood. It is more resistant to medical treatment and typically has a sudden onset, progresses over a short period, stabilises and may eventually resolve.

Focal vitiligo

Patients with focal vitiligo have a single depigmented patch or a small number of isolated depigmented areas located anywhere on the body.

Generalised vitiligo

This is the most common form of vitiligo. Depigmented areas are distributed diffusely across the body, usually following a symmetrical pattern. Lesions frequently affect the elbows, knees, genital area, mucous membranes, neck, fingers, feet, hands, lips, armpits, navel and the areas around the mouth and eyes. Hair may also be affected, leading to premature greying of the eyebrows, eyelashes or scalp.

Acrofacial vitiligo

In this type, melanocyte loss affects the face as well as distal areas such as the hands and feet.

Universal vitiligo

Universal vitiligo is characterised by widespread and progressive destruction of melanocytes across the skin. As a result, depigmented areas become increasingly extensive and may merge, leaving only small residual areas of normally pigmented skin.

Actualmente no existe ninguna manera de prevenir el vitíligo. No obstante, se sabe que es fundamental evitar los posibles desencadenantes mencionados para frenar su evolución y evitar que surjan nuevas zonas despigmentadas o que las manchas blancas se hagan cada vez más grandes.

Although ongoing research is being conducted, there are still no reliable markers that can accurately predict how vitiligo will progress once diagnosed, or which cases are likely to be more clinically aggressive at disease onset.

Actualmente, la fototerapia es el tratamiento más efectivo para el vitíligo, ya que logra frenar o detener por completo el avance de la patología. La fototerapia puede aplicarse en monoterapia o combinarse con tratamientos orales y/o tópicos para potenciar sus beneficios.

Ultraviolet light is one of the most powerful stimuli for melanocytes to produce melanin, a pigment that colours the skin as a natural protective response against solar radiation. However, prolonged and excessive exposure to ultraviolet light significantly increases the short-term risk of burns, as well as the long-term risk of premature photoageing and skin cancer.

It should also be noted that the skin of patients with vitiligo is more susceptible to sunburn in depigmented areas, as these lack melanin. Unprotected sun exposure therefore makes these areas particularly vulnerable to damage.

Phototherapy for vitiligo involves the controlled exposure of depigmented skin to ultraviolet light, specifically narrowband UVB, which stimulates melanocyte activity while avoiding the most harmful wavelengths of sunlight. UVB therapy may be delivered in different ways depending on the case, including handheld devices, panels, cabins or laser systems.

At Grupo Pedro Jaén, we also offer supervised home-based phototherapy, an option that is both effective and convenient for patients, reducing the need for frequent clinic visits.

In addition, we have an excimer lamp for selected patients—such as children or those with localised lesions. Its mechanism is similar to conventional phototherapy, but results are often achieved more quickly and in fewer sessions. This treatment, however, must be performed in a medical setting.

Topical treatments for vitiligo aim to repigment depigmented areas through the application of creams that help control inflammation or immune activity associated with the condition.

There are also plant-based topical treatments that may be used alone—such as black pepper extract to reduce oxidative stress in vitiligo lesions, or melon extract to promote repigmentation—or combined with phototherapy to enhance results, as in the case of psoralens or Polypodium leucotomos fern extract.

Topical treatments are generally considered first-line therapy for all patients with vitiligo and are usually prescribed for several months. If no significant response or improvement is observed during this period, phototherapy may be introduced or topical treatments may be combined with other medications.

Oral treatments for vitiligo are prescribed when topical therapies do not achieve the desired response. They may be used alone or in combination with other therapeutic approaches.

These medications are used to control the inflammatory component of vitiligo and are often administered as mini-pulse regimens, in which low doses are taken on several days per week. This approach helps slow disease progression, control inflammation and reduce the risk of side effects.

Vitamin D may also be added due to its antioxidant and immunomodulatory properties, which can help mitigate oxidative damage associated with melanocyte destruction and modulate immune system activity. Phenylalanine may also be prescribed.

Phenylalanine is an amino acid involved in melanin synthesis and promotes repigmentation through three main mechanisms: it inhibits the production of antibodies that destroy melanocytes, improves the skin’s tolerance to sun exposure, and facilitates the migration of melanocytes from pigmented areas to depigmented zones. Oral vitiligo treatments containing phenylalanine aim to stimulate melanocyte activity to restore natural pigment production and are usually combined with phototherapy for improved results.

In some cases, vitiligo progresses to the point where depigmented areas greatly exceed pigmented skin, leaving only small residual areas of colour. This form of the disease, known as universal vitiligo or advanced generalised vitiligo, is managed with an approach opposite to that used in other cases. Instead of attempting to repigment white areas, treatment focuses on depigmenting the remaining pigmented skin to achieve a more uniform appearance. This is done using a phenolic compound that destroys residual melanocytes and permanently removes pigment.

Patients undergoing depigmentation therapy often report high satisfaction, primarily due to aesthetic improvement. However, candidates must be selected very carefully and receive thorough information about the nature of this treatment, as it is irreversible and may take several months to achieve definitive results. The product is applied once or twice daily and is often combined with oral or topical treatments. Close dermatological follow-up is essential to monitor for possible areas of repigmentation.

Is vitiligo contagious?

No. Vitiligo is not a contagious disease. Family members and close contacts can share spaces, clothing, utensils and physical contact without any risk of transmission.

Does vitiligo cause pain?

No. Although vitiligo is associated with certain autoimmune conditions, the loss of melanocytes itself is not painful.

Is vitiligo hereditary?

There is evidence to suggest that vitiligo has a genetic component. Individuals with a family history of the condition have a higher likelihood of developing it, although inheritance is not guaranteed.

Can stress cause vitiligo?

Emotional stress may trigger the onset of vitiligo or contribute to the enlargement of depigmented areas in individuals who are already predisposed to the condition. In this sense, stress is a triggering factor rather than the primary cause. Not everyone who experiences stress will develop vitiligo.

Should I follow a special diet if I have vitiligo?

Apart from maintaining a diet rich in antioxidants to provide additional protection for depigmented skin, there is currently no strong scientific evidence to support recommending or avoiding specific foods or diets to prevent, treat or control vitiligo.

How should I care for my skin if I have vitiligo?

Patients with vitiligo should avoid objects and clothing that cause excessive friction on the skin, such as belts, jewellery, straps or tight elastics. Care should also be taken with aesthetic or cosmetic treatments that may be irritating or overly aggressive. Consulting a specialist before undergoing such procedures is advisable to avoid skin trauma that could trigger new vitiligo patches. Sun protection is particularly important. Broad-spectrum sunscreens with the highest possible protection factor should be applied regularly, as depigmented areas lack melanin and are therefore much more vulnerable to sunburn. Maintaining good skin hydration is also essential to support the skin barrier and hydrolipidic film, which help prevent dehydration and protect against external aggressors. If make-up is used, products containing sun filters are recommended. Tattooing depigmented areas to camouflage white patches is not advisable, as it may increase the risk of new depigmented lesions developing.

When should vitiligo treatment be started?

Many patients are uncertain about the best time to begin treatment, especially when lesions are small. It is important to clarify that any patient with vitiligo is a candidate for treatment, regardless of lesion extent. Scientific evidence has demonstrated the significant psychological impact of vitiligo, independent of the size of affected areas. Early treatment is also crucial to slow disease progression. Initiating therapy when lesions are still small may be decisive in preventing their enlargement and limiting further skin involvement.

The content of this page has been prepared by the Communication Department and the Medical Team of Grupo Pedro Jaén, in line with our editorial commitment to ensuring the accuracy and up-to-date nature of the information provided.

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