Vitiligo produces milky-white patches of skin where pigment has been lost completely. These patches can appear anywhere on the body, but they show up most often on the face (in roughly 87% of cases), hands and feet (about 76%), and the arms and legs (around 60%). The patches are typically smooth and flat, with no change in skin texture.
How the Patches Look on Different Skin Tones
Vitiligo affects all races and skin tones equally, but the contrast between affected and unaffected skin varies dramatically depending on your natural complexion. On darker skin, the white patches are strikingly visible and can be one of the first things a person notices. On lighter skin, the patches may be subtle until summer, when surrounding skin tans and the affected areas stay pale. Sunscreen can minimize this contrast by limiting how much the surrounding skin darkens.
Regardless of skin tone, vitiligo patches are distinctly white, not just lighter than your normal color. This complete loss of pigment is what separates vitiligo from other conditions that cause faded or uneven skin.
Common Locations and Patterns
The most common form of vitiligo tends to appear symmetrically on both sides of the body. If a patch develops on one hand, a similar patch often appears on the other. These patches frequently show up on areas exposed to sun or friction: the face, hands, feet, elbows, knees, and around body openings like the eyes, nostrils, and mouth. They can grow quickly and sometimes merge to cover larger areas.
A less common form, called segmental vitiligo, behaves differently. It appears on only one side of the body in a localized band or strip. This type tends to start earlier in life and often stabilizes after a period of initial spreading, rather than continuing to expand over years.
Patches on Lips and Mucous Membranes
Vitiligo doesn’t only affect outer skin. It can develop on the lips, inside the mouth, and on genital tissue. Lip vitiligo is particularly noticeable because the vermilion border (the colored edge of the lips) loses its pigment, creating a washed-out appearance. It may show up at the corners of the mouth, across the full lip, or just at the lip tips. Pure mucosal vitiligo, where only mucous membrane areas are involved, accounts for about 2.3% of all vitiligo cases.
Hair Color Changes
Vitiligo can affect hair as well as skin. When a patch develops in a hairy area, the hair growing from that patch may turn white. This is called poliosis, and it can affect the scalp, eyebrows, eyelashes, and beard. A white tuft of hair in an otherwise normally pigmented area is a recognizable sign. White hair within a vitiligo patch is also considered a marker that repigmentation in that spot will be more difficult, since the pigment-producing cells in the hair follicle have also been destroyed.
Signs That Patches Are Spreading
Vitiligo patches don’t always look the same over time. When the condition is actively spreading, the borders of patches tend to look blurry or diffuse rather than crisp. You may also notice a “trichrome” effect at the edges: three distinct shades blending into each other, from white at the center to a tan or light brown zone to your normal skin color at the outer edge. This gradient is a visual clue that pigment loss is still in progress.
Another sign of active vitiligo is tiny white dots, sometimes described as confetti-like, appearing on skin that looks otherwise normal near an existing patch. These small satellite spots, each less than a millimeter across, suggest the condition is progressing. In contrast, stable vitiligo tends to have sharper, well-defined borders, sometimes with small islands of repigmentation appearing as dark dots within the white patch, often clustered around hair follicles.
New Patches After Skin Injury
Some people with vitiligo notice new patches forming at sites of skin injury. A cut, scrape, burn, or even a surgical scar can trigger depigmentation in the healing skin. This phenomenon occurs in a majority of people with vitiligo, though it generally requires deeper trauma that reaches below the surface layer of skin. Constant friction or pressure on certain areas, like from tight clothing or a watchband, has also been linked to new patch development, though this connection is less firmly established.
How Vitiligo Differs From Similar Conditions
Several other skin conditions cause lighter patches, but they look noticeably different from vitiligo on close inspection. Pityriasis alba, common in children, produces pale patches that start out red and scaly before fading to a lighter color. These patches are not completely white and have a slightly rough texture. Tinea versicolor, caused by a fungal overgrowth, creates dry, scaly spots with sharp borders that can range from white to yellow, pink, tan, or brown, and the patches don’t follow vitiligo’s typical symmetrical pattern.
The key distinguishing feature of vitiligo is the complete, milky-white depigmentation with smooth, normal-textured skin. There’s no flaking, no redness, and no raised edges. Under a UV lamp in a dermatologist’s office, vitiligo patches glow bright blue-white, which helps confirm the diagnosis and can reveal patches not yet visible to the naked eye.