It’s caused by a disappearance of melanocytes, the cells that carry melanin, your skin-darkening pigment protein.
It arrives most often in early adulthood, and it affects men and women equally. It seems to run in families. It’s probably an auto-immune disorder, and it’s possibly related to other ones, like lupus.
There is no universally reliable treatment for vitiligo yet.
Specialised light therapy may slow the spread of whatever is happening. Vitamin D therapy has been tried, as has topical immunosuppression, with inconclusive results.
There is surgery, notably transfer of melanocytes to depigmented skin. It’s not clear how well this works yet.
Most people just try to keep out of the sun, because they don’t want tans that contrast with the white patches.
Localized vitiligo is pretty self-limiting. It usually stabilises quickly, and doesn’t progress.
Generalized vitiligo, on the other hand, might worsen for several years, then stabilize, and then worsen again. Whole-skin vitiligo is extremely rare.
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