Vitiligo in infants and children
Diagnosis and treatment

The main goal of vitiligo treatment is to recover at least part of the lost skin color. How much and how quickly pigment returns varies from person to person, but improvement is generally slow and gradual.

For example, when phototherapy or ointment treatment is continued for several months or more, pigment cells regenerate within the white patches, appearing as brown spots that spread, and the skin color begins to return. However, it is difficult for the original skin color to be fully restored at once; partial repigmentation usually occurs slowly. The pigment gained through treatment can also fade again over time, so maintenance treatment may be needed to keep the results. Rather than thinking in terms of a complete cure, it is more realistic to focus on regaining as much skin color as possible through ongoing care and preventing the condition from worsening.

The speed and pattern of vitiligo's progression differ from person to person and are hard to predict. It generally tends to progress slowly, but it can sometimes spread rapidly. In active vitiligo, where new patches appear frequently, a short course of oral corticosteroids (such as prednisone) may be tried to slow the progression. Segmental vitiligo, which is confined to one side of the body, usually begins at a young age, progresses quickly for about 6–12 months, and then typically stops. Non-segmental vitiligo (the common, generalized form) has no definite point at which it fully stops progressing, but treatment can restrain the expansion of patches or slow it down.

No. Vitiligo is not a contagious disease. It is not caused by bacterial or viral infection, and it cannot be transmitted through contact with a patient. It is a non-infectious skin condition arising from an autoimmune abnormality, so you can be completely at ease — skin contact or sharing daily life with someone with vitiligo carries no risk of transmission at all.

Daily care and lifestyle habits matter in vitiligo as well. Following the skin-care and lifestyle guidelines below helps prevent the condition from worsening and keeps the skin healthy.

Vitiligo is a condition that can affect anyone, regardless of age or ethnicity. It occurs in about 0.5–2% of the world's population, at roughly similar rates regardless of skin color or ethnicity. How noticeable it is, however, can differ by skin tone. In people with darker skin or those who tan easily, the color contrast between the white patches and the surrounding normal skin is sharp, making the patches stand out more. In people with very fair skin, the white patches may be relatively less visible. In terms of age, onset at a young age is common. About 50% of all vitiligo patients experience their first symptoms before age 20, and onset in childhood is not unusual.

In young children and adolescents in particular, segmental vitiligo confined to one area is reported relatively often; as described above, this form tends to progress briefly in the early stage and then stop. In adults, the non-segmental form with patches appearing across the body is more common, but ultimately the underlying pathology of vitiligo does not differ greatly with age.

Vitiligo is a classic autoimmune disease. That is, it occurs when an abnormal immune response causes the body to recognize part of itself as an enemy and attack it. For this reason, people with vitiligo often have other autoimmune diseases as well, or have family members who do. The association with autoimmune thyroid disease (such as Hashimoto's thyroiditis or Graves' disease) is especially strong — about 20% of vitiligo patients are reported to also have a thyroid condition.

Vitiligo also tends to co-occur with autoimmune diseases such as alopecia areata, type 1 diabetes, pernicious anemia, psoriasis, rheumatoid arthritis, and lupus. Because genetic predispositions often overlap, certain immune-related genes are found in vitiligo patients, and multiple autoimmune diseases sometimes appear within one family. Patients diagnosed with vitiligo are therefore advised to be checked periodically for other autoimmune diseases (for example, with thyroid function tests).