When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Vitiligo

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Evidence last reviewed: 18 Jun 2026
Topic last updated: 07 Jul 2026

Summary

Definition

History and exam

Key diagnostic factors

  • acral and periorificial depigmentation
  • perianal and genital depigmentation
  • age <30 years
  • recent cutaneous trauma
  • localized sunburn pain
  • enhancement and fluorescence with ultraviolet-A exposure
  • halo nevus
  • universal depigmentation
Full details

Risk factors

  • family history of vitiligo
  • autoimmune disease
  • chemical contact
Full details

Diagnostic tests

1st tests to order

  • clinical diagnosis
Full details

Tests to consider

  • Wood lamp exam
  • skin biopsy
Full details

Treatment algorithm

ACUTE

segmental vitiligo: active in previous 12 months

nonsegmental vitiligo: active in previous 6 months

ONGOING

segmental vitiligo: stable in previous 12 months

nonsegmental vitiligo: stable in previous 6 months

Contributors

Authors

Sancy A. Leachman, MD, PhD

Professor

Department of Dermatology

University of Utah

Salt Lake CIty, UT

Disclosures

SAL has acted as a consultant and/or investigator for Orlucent, Pathology Watch, Veriskin, and Merck, and has received an unrestricted educational grant from Castle Biosciences to support the War on Melanoma.

Annalise Abiodun, MD

Mohs Micrographic Surgery & Reconstructive Surgery/Dermatology

Tysons Corner, MidAtlantic Permanente Medical Group

McLean, VA

Disclosures

AA declares that she has no competing interests.

Acknowledgements

Professor Sancy A. Leachman and Dr Annalise Abiodun would like to gratefully acknowledge Professor John E. Harris, Dr Mehdi Rashighi, and Dr Bernhard Ortel, previous contributors to this topic.

Disclosures

JEH has acted as a consultant and/or investigator for Pfizer, Genzyme/Sanofi, Aclaris Therapeutics Inc., Incyte, Rheos Medicines, Sun Pharmaceuticals, LEO Pharma, Villaris Therapeutics Inc., Dermavant, Temprian, AbbVie Inc., Janssen, TeVido, BioDevices, EMD Serono, Almirall, Boston Pharma, Sonoma Biotherapeutics Inc., Methuselah Health, Twi Biotech, Pandion, Cogen Therapeutics Inc., Admirx, BridgeBio, AnaptysBio, Avita, and Frazier Management. He has equity in TeVido Biodevices, Rheos, and Villaris Therapeutics Inc., and is the Scientific Founder of Villaris Therapeutics Inc. JEH is an author of a number of references cited in this topic. MR has received consulting fees and/or research grants from the following: Pfizer, AbbVie, Dermavant, LEO Pharma, and Almirall. MR is an author of a reference cited in this topic. BO declares that he has no competing interests.

Peer reviewers

Iltefat Hamzavi, MD

Senior Staff Physician

Multicultural Dermatology Center

Henry Ford Hospital

Detroit, MI

Disclosures

IH is an author of a number of references cited in this topic.

Piergiacomo Calzavara-Pinton, MD

Chair

Dermatology Department

University of Brescia

Brescia

Italy

Disclosures

PC-P is an author of a number of references cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Ezzedine K, Lim HW, Suzuki T, et al. Revised classification/nomenclature of vitiligo and related issues: the Vitiligo Global Issues Consensus Conference. Pigment Cell Melanoma Res. 2012 May;25(3):E1-13.Full text  Abstract

van Geel N, Speeckaert R, Taïeb A, et al. Worldwide expert recommendations for the diagnosis and management of vitiligo: position statement from the International Vitiligo Task Force Part 1: towards a new management algorithm. J Eur Acad Dermatol Venereol. 2023 Nov;37(11):2173-84.Full text  Abstract

Taieb A, Alomar A, Böhm M, et al; Vitiligo European Task Force (VETF); European Academy of Dermatology and Venereology (EADV); Union Européenne des Médecins Spécialistes (UEMS). Guidelines for the management of vitiligo: the European Dermatology Forum consensus. Br J Dermatol. 2013 Jan;168(1):5-19.Full text  Abstract

Seneschal J, Speeckaert R, Taïeb A, et al. Worldwide expert recommendations for the diagnosis and management of vitiligo: position statement from the International Vitiligo Task Force-Part 2: specific treatment recommendations. J Eur Acad Dermatol Venereol. 2023 Nov;37(11):2185-95.Full text  Abstract

Rodrigues M, Ezzedine K, Hamzavi I, et al. Current and emerging treatments for vitiligo. J Am Acad Dermatol. 2017 Jul;77(1):17-29. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Vitiligo images

  • Differentials

    • Piebaldism
    • Waardenburg syndrome
    • Tuberous sclerosis
    More Differentials

  • Guidelines

    • Worldwide expert recommendations for the diagnosis and management of vitiligo: position statement from the International Vitiligo Task Force Part 1: towards a new management algorithm
    • Worldwide expert recommendations for the diagnosis and management of vitiligo: position statement from the international Vitiligo Task Force-Part 2: specific treatment recommendations
    More Guidelines
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer