“Hypopigmentation” is a general term to describe a reduction in skin pigmentation, which can be present at birth or develop later in life from illness, injury, or certain medications. Vitiligo is an autoimmune skin pigmentation disorder that develops when the immune system destroys melanocytes. It is associated with smooth, chalky-white patches on the skin.
Though the two may appear similar, hypopigmentation and vitiligo are different. Read on to learn more.
Symptoms
Vitiligo and hypopigmentation involve the loss of skin pigmentation in spots or patches. These patches may be limited to one area of the skin or occur all over the body.
Hypopigmentation Symptoms
Hypopigmentation does not typically cause symptoms beyond the appearance of light patches or spots on one area or several parts of the body. If an underlying health issue is causing hypopigmentation, you may have signs and symptoms of that particular condition.
Vitiligo Symptoms
The primary symptom of vitiligo is the appearance of smooth, flat white spots or patches on the skin. Patches can develop anywhere on the body but are commonly found on the hands, feet, and face.
Other vitiligo symptoms include:
Whitening of hair, particularly on the scalp, eyebrows, eyelashes, and beard Loss of color in the inner layer of the eye (retina) Itchy skin on affected areas Loss of color on the inside of the nose & mouth (mucous membranes)
Causes
The most significant difference between hypopigmentation and vitiligo is the causes. Hypopigmentation occurs on its own or with other skin disorders, infections, or injuries. Vitiligo is an autoimmune disorder.
What Causes Hypopigmentation?
There are various causes of hypopigmentation. It may be present at birth or develop later in life.
Causes of hypopigmentation include:
Localized: Single or multiple depigmented patches on one area or multiple areas on the skin
Genetics, like albinism Skin disorders like pityriasis alba, tinea versicolor, lichen sclerosus, psoriasis, and dermatitis Infections Injuries, like a burn or cut Certain medications, like topical steroids, retinoic acid, EGFR (estimated glomerular filtration rate) inhibitors, chloroquine Vascular changes
What Causes Vitiligo?
Vitiligo occurs when the immune system develops antibodies that cause melanocytes to stop functioning. The exact cause of vitiligo isn’t fully understood, but a combination of genetic and environmental factors may play a role.
Causes of vitiligo include:
Genetics/family history Certain types of cancer Autoimmune disorders Overexposure to neurochemicals released from nerve endings in the skin that harm melanocytes
Diagnosis
The diagnosis of hypopigmentation and vitiligo is straightforward. Your healthcare provider will examine your skin. They may use a device called a Wood’s lamp to look at the affected areas more closely to determine the exact cause of your symptoms and provide a diagnosis.
StressSkin damage through cuts or sunburn Exposure to harsh chemicalsViruses
Your healthcare provider may ask about:
Family history of vitiligo Personal or family history of thyroid disease and autoimmune conditionsPrevious injuries in the affected area
They may ask about additional symptoms to determine the root cause of hypopigmentation. For example, if you’re peeing more frequently and often feel thirsty, this may point to diabetes, which is linked to hypopigmentation.
Additional tests, such as blood tests for thyroid disease, glucose levels, and vitamin B12 levels, are used to check for hypopigmentation-associated conditions. A skin biopsy may be performed to check for skin infections and skin cancer. A biopsy can also help diagnose a type of vitiligo called inflammatory vitiligo.
Treatment
Once your healthcare provider has diagnosed you, they will work with you to develop an appropriate treatment plan. An accurate diagnosis is important because treatments vary depending on the cause.
How Is Hypopigmentation Treated?
Hypopigmentation treatment depends on several factors, including your overall health, the area of skin affected, and the underlying cause. In some cases, such as when a burn or injury causes a lack of color, the hypopigmentation may resolve as the skin heals and does not require treatment.
If hypopigmentation treatment is needed or you’d like to be proactive about reducing the appearance of white spots and patches, treatment options include:
Topical corticosteroids Topical calcineurin inhibitors (TCIs)
When underlying health conditions cause hypopigmentation, it may improve or resolve when the condition is treated.
How Is Vitiligo Treated?
There is no cure for vitiligo, but treatments are available to add color to depigmented patches of skin and slow the progression of the disease.
If you opt for treatment, your healthcare provider will consider various factors when developing a treatment plan, including:
Age Skin type Extent and location of depigmentation Impact of vitiligo on self-esteem and quality of life
Vitiligo treatment options include:
Camouflage therapy (e. g. , makeup, hair dye) Topical corticosteroids Topical immunosuppressant medications Phototherapy Surgical skin grafting (placing unaffected skin from another part of the body onto the affected areas) Ginkgo biloba herbal therapy
Prevention
Predicting the development of hypopigmentation and vitiligo is challenging. Various factors contribute to the onset of lighter patches of skin. There are things you can do to lessen the severity of hypopigmentation and vitiligo, including:
Avoid prolonged exposure to the sunAvoid artificial tanning bedsApply sunscreen with a high sun protection factor (SPF) before going outdoors Wear wide-brimmed hats when outdoors
Summary
Hypopigmentation and vitiligo cause light patches of skin. The key difference is that hypopigmentation is associated with health conditions and injuries that may cause skin discoloration in spots or patches.
In contrast, vitiligo is an autoimmune disorder that destroys melanocyte cells in your body that give your skin color, causing white patches to form. Treatment is unnecessary, but some people prefer a proactive approach and try treatments to reduce the appearance of lighter-colored skin patches to slow the progression of vitiligo.
A Word From Verywell
Hypopigmentation and vitiligo are generally not harmful to the body. Many people with these conditions experience emotional distress and feel self-conscious about changes to their appearance. A skin specialist, like a dermatologist, can help you manage the condition. Connecting with people with hypopigmentation or vitiligo can provide a sense of community and make you feel less alone.
