Is vitiligo passed down?
It runs in families, but not the way eye colour does. Most children of a parent with vitiligo do not develop it. Most people with vitiligo have no close relative who has it either. A family history raises the odds a little. It does not set them. Evidence Evidence Evidence
What is known
- Sources cited, not yet graded
Whether a child will inherit it is what parents ask first, often on the day of the diagnosis. The genetics review I read reports that about 20 per cent of people with vitiligo have at least one affected first-degree relative. That is a parent, a sibling or a child. The other four in five have none. The same review reports a concordance rate of about 23 per cent in identical twins. Identical twins share the same genes, so that figure sits well below half. I checked a family survey of white probands and their relatives, and it reports the same twin figure. NIAMS tells readers that researchers believe family history and genes may play a role.
What is uncertain
- Depends on you
A figure measured across a studied group is not a figure for your family. The family survey rests on what relatives reported rather than on examining each one. It is more than twenty years old. Both records draw on groups of mostly European ancestry. Neither one forecasts a child.
Questions for your dermatologist
Given who in my family has this, what would you say the picture is for my children?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Which relatives are worth naming when you take my history?
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Is there a genetic test that would tell me?
Not one that predicts vitiligo. The condition is polygenic. Many genes each add a small amount, and non-genetic factors add the rest. No single result can be read as a yes or a no for a child. Evidence Evidence Evidence
What is known
- Sources cited, not yet graded
The genetics review I read records that genome-wide studies have found around 50 regions of the genome linked to vitiligo. Most of those regions sit in genes for immune control. Some sit in genes for the pigment cell. Each one shifts risk slightly rather than deciding it. I went through the BAD guideline looking for a genetic test in its work-up, and there is none. It sets out history, examination and named blood tests instead.
What is uncertain
- Depends on you
A linked region is a finding about populations, not a result about you. The review summarises work up to 2017, so the count of regions has moved since. The BAD guideline was written for UK care and read the research up to May 2019. Which tests suit you is a call your clinician makes, not a rule from a page.
Questions for your dermatologist
Is any testing useful here, and what would it actually tell us?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Would a referral to genetics change how you would manage this for my family?
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Why do thyroid disease and diabetes keep coming up in the same families?
Because several autoimmune conditions share the same immune genes. That is why a dermatologist asks about relatives, and not only about vitiligo. It is a reason to give a full family history. It is not a reason to expect any of it. Evidence Evidence Evidence Evidence
What is known
- Sources cited, not yet graded
The family survey I read reports that some other conditions came up more often in these families than expected. It names autoimmune thyroid disease, adult-onset type 1 diabetes, pernicious anaemia, Addison disease, lupus and psoriasis. A genetics review records that many of the linked immune genes are shared with other autoimmune diseases. The BAD guideline calls autoimmunity a contributor to how vitiligo develops. Its work-up covers looking for linked autoimmune conditions, and it advises thyroid function and antithyroid antibody tests. The AAD tells readers that a dermatologist can watch for other diseases such as thyroid disease.
What is uncertain
- Depends on you
A condition appearing more often in a group of families is not a diagnosis in yours. None of these records says that one relative with thyroid disease changes what happens to your child. The BAD guideline sets no testing plan for everyone. The AAD page is patient education and puts no figure on the risk it names.
Questions for your dermatologist
Which conditions in my family are worth writing into my notes?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Would you screen me for any of these because of that history, and how often?
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What can I watch for in my child, and when do we see a dermatologist?
Watch without hunting. A new pale patch that stays, a ring of pale skin around a mole, or a patch of white hair is worth showing to a clinician. Book a visit when something is there to look at. A pale patch on a child has many causes, and telling them apart is a clinician job. Evidence Evidence Evidence Evidence
What is known
- Sources cited, not yet graded
I looked up what the AAD tells parents. Vitiligo can develop anywhere on the skin, and patches usually appear first on the face, arms, hands or feet. It records that vitiligo can affect the hair. A skin reference calls the loss of hair colour leukotrichia. It lists leukotrichia and halo naevi, the pale rings around moles, among the signs read when a pattern is changing. The BAD guideline sets out a table of look-alikes. Eczema, psoriasis, lichen planus, pityriasis alba and piebaldism sit on it. The International Vitiligo Task Force records assessment as something a clinician does.
What is uncertain
- Depends on you
The BAD table is a list, not a method a parent can apply at home. It does not say how to tell any two of those conditions apart. No reference diagnoses a child from a description or a photograph. Nothing here says how likely a given patch is to be vitiligo, and nothing here is a screening schedule.
Questions for your dermatologist
My child has a pale patch here. What are you looking at when you examine it?
Saving keeps this on your device and needs JavaScript, which is off in this browser.What would you want us to bring back if it changes?
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What has the research not settled?
Why one person with the risk genes develops vitiligo and another does not. Genes set part of the picture. Something else finishes it, and that part is still being worked out. Evidence Evidence Evidence
What is known
- Sources cited, not yet graded
The concordance rate of about 23 per cent in identical twins is the clearest statement of that gap. Two people with the same genes usually do not both have vitiligo. The genetics review therefore records that non-genetic factors matter too. NIAMS records that an event such as sunburn, emotional distress or chemical exposure can sometimes trigger vitiligo or make it worse. The 2012 classification consensus records a general impression that injury-linked patches and stability are related, then states that objective data are lacking.
What is uncertain
- Depends on you
A twin figure describes pairs of twins, not a parent and a child. NIAMS names contributing factors rather than one determined cause. Looking back at a remembered event does not identify a cause for anyone. The genetics work keeps moving, so what is written here has a date on it.
Questions for your dermatologist
Has the genetics research changed since my last visit?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Where would you send me to read about the current genetics work?
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Evidence behind this page
Sources
Each evidence badge opens the source and its limits. The full list stays available here.
- American Academy of DermatologyPatient education · Patient education, tier 5Independence not established
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports patient-facing context that skin which has lost its color can burn readily and that shade, clothing and labeled sunscreen use are broad protection options. It also supports that for some people a skin injury triggers new spots or patches, and it names cuts, scrapes and burns. The wound a tattoo makes can lead to the Koebner phenomenon, with new spots appearing about 10 to 14 days later. It supports that a tattoo added for pigment may not blend with natural skin color, that its color can eventually bleed, and that the vitiligo underneath can spread over time. It supports the page telling readers to avoid tanning, indoors and outdoors, because tanning increases the contrast between natural skin color and the light spots and patches. That is what it says makes vitiligo more noticeable. It supports that tanning beds, sun lamps and other indoor tanning devices are not safe alternatives to the sun. Like the sun, they can burn skin that has lost pigment and worsen vitiligo. It supports that a bad sunburn can worsen vitiligo, and that on a lighter skin tone untanned skin often makes the spots and patches less noticeable. It supports that self-tanners and skin dyes tend to last 3 to 5 days, against one day for makeup. It names dihydroxyacetone as the ingredient to look for, and says natural-looking results take practice. It supports that vitiligo increases the risk of some other diseases such as thyroid disease, and that a dermatologist can monitor for them.
What it does not support
The page acknowledges support from Incyte Dermatology, so it does not independently establish treatment efficacy. It does not establish a personalized sun plan, a product ranking or a treatment-day instruction. It gives no frequency for injury-related patches and no way to tell in advance who they happen to. It gives no measure of how much tanning changes contrast, no threshold for a bad sunburn, and no way to tell whether one person’s vitiligo will worsen. It compares no tanning device with prescribed narrowband UVB and establishes nothing about medical phototherapy. It names no product or brand for camouflage, self-tanner or skin dye.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- National Institute of Arthritis and Musculoskeletal and Skin DiseasesPatient education · Patient education, tier 5Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports that vitiligo is an autoimmune disease in which the immune system attacks melanocytes. Researchers believe family history and genes may play a role. An event such as sunburn, emotional distress, or chemical exposure can sometimes trigger vitiligo or make it worse. These are contributing factors, not a single determined cause repeated in every case.
What it does not support
It does not state that there is no single known cause. It does not rule out a specific trigger for one individual. It does not let a reader diagnose their own cause from a remembered event or timeline.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- Dermatologic Clinics (Spritz RA, Andersen GHL)Systematic review · Clinical research, tier 2Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
Why the independence label says this: An academic review of the genetics literature. No product is named and no manufacturer is involved in it.
What this source supports
It supports that vitiligo runs in families but is not passed on in a simple pattern. It supports that about 20 per cent of people with vitiligo have at least one affected first-degree relative. It supports that the risk for a first-degree relative is still low in absolute terms. It supports that the concordance rate in identical twins is about 23 per cent. It supports that vitiligo is polygenic: many genes each add a small amount, alongside non-genetic factors. It supports that genome-wide studies have found around 50 regions of the genome linked to vitiligo. It supports that many of those regions sit in genes for immune regulation, and some in genes for the pigment cell. It supports that the same immune genes are shared with other autoimmune diseases.
What it does not support
It is a review, not a test and not a prediction. It gives no risk figure for one named family. It does not support a genetic test that tells a parent whether a child will develop vitiligo. It sets no screening schedule, names no treatment, and does not diagnose anybody. Its figures come from studied groups of mostly European ancestry, so they may not carry across every population.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- Pigment Cell Research (Alkhateeb A, Fain PR, Thody A, Bennett DC, Spritz RA)Observational study · Clinical research, tier 2Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
Why the independence label says this: An academic family survey. No manufacturer took part and no product is named in it.
What this source supports
It supports that vitiligo clusters in families without following a single-gene pattern. It supports that most people with vitiligo in this survey had no affected first-degree relative. It supports that the concordance rate among identical twins was about 23 per cent. It supports that autoimmune thyroid disease, adult-onset type 1 diabetes, pernicious anaemia, Addison disease, systemic lupus erythematosus and psoriasis were reported more often in these families than expected. It supports naming those conditions as the ones that come up in a family history.
What it does not support
It is a survey of white probands and their relatives, so its figures may not carry across other populations. It relies on what families reported, not on examining every relative. It gives no risk figure for one named child. It is more than twenty years old. It does not diagnose anybody, name a treatment, or set a screening schedule.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- Journal of the European Academy of Dermatology and VenereologyGuideline · Regulatory / guideline, tier 1Relevant relationship disclosed
- Published
- SteadySkin last checked
What this source can and cannot tell you
Why the independence label says this: The journal is the publisher. This label refers to extensive author relationships disclosed for the recommendation, not to the journal itself.
What this source supports
It supports current expert-consensus terminology, clinical assessment, disease-activity evaluation, treatment-goal discussion, and shared decision-making. Its modified assessment check list names where the patches are as a disease feature, and gives genital involvement as its own example. It records white hairs as an item of its own, apart from what the vitiligo has done in the past six months. Its classification table keeps mucosal vitiligo as a subtype, both across more than one site and at one site alone. It supports planning care around what is there to work with, and its example is hair that still has its color. It names stable vitiligo and active vitiligo as two different states that change the care plan. Its shared-decision steps ask what the patient wants from care. At the time it was written, one cream form of a newer drug type had just been approved. Pill forms of that same drug type were still being studied.
What it does not support
It is not independent comparative proof. It cannot diagnose a reader from a description or photograph. It gives no figure for genital involvement, and it does not name lichen sclerosus. It does not set out the Vitiligo European Task Force grading scale. It puts no figure on white hairs and predicts nothing for one person.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- British Journal of Dermatology (Eleftheriadou V, et al.)Guideline · Regulatory / guideline, tier 1Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports the clinical history and assessment domains, evaluation of associated autoimmune conditions, its recommendation for thyroid function and antithyroid antibody screening, current classification context, treatment-option map, psychosocial assessment, medical photography and the limits of pediatric evidence. Its classification table defines mucosal vitiligo as the oral or genital mucosae. One mucosal site alone is filed as undetermined or unclassified. Its differential diagnosis table lists genital or extragenital lichen sclerosus among the conditions that can be mistaken for vitiligo. That table also lists eczema, psoriasis, lichen planus, pityriasis alba and piebaldism. It calls autoimmunity a contributor to the pathogenesis of vitiligo. It reports an earlier review finding a possible negative impact on intimacy and sexual functioning. It tells clinicians to discuss the psychosocial impact of living with the condition. R28 offers a skin camouflage visit to people who want one. R10 to R14 name potent or very potent topical steroids as the first choice, with a topical calcineurin-inhibitor cream as an option for the face. These are different creams with different proof behind them. R20 names narrowband UVB as the first light option. It says the skin often does better on the face and trunk than on hands and feet. It says there is not enough proof to use any one current pill alone for vitiligo that is not changing. R25 and Table 2 keep cell grafting for vitiligo that is not changing and did not respond to other care. They also say a doctor cannot always tell if the vitiligo has truly stopped changing.
What it does not support
It was designed for UK care and reviewed literature through May 2019; it does not establish a universal testing plan, prescribe an individual plan, or establish current US labeling or coverage. Its differential diagnosis table is a list, not a method a reader can apply to their own skin. It does not say how to tell any two of those conditions apart. It gives no figure for how often vitiligo affects genital skin.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- Pigment Cell & Melanoma Research (Ezzedine K, et al.)Guideline · Regulatory / guideline, tier 1Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports separating segmental vitiligo from nonsegmental forms and recognizing mixed and initially unclassified presentations. Classification is a clinical and longitudinal judgment. Its section on the Koebner phenomenon supports defining that phenomenon as patches developing at sites of previously unaffected skin that was specifically injured. It endorses the Vitiligo European Task Force classification of that phenomenon into history-based, clinical-observation-based and experimentally induced forms. Its section on mucosal vitiligo defines that term as the oral or genital mucosae. Where the patches are at one site alone, and especially a genital one, that section says a differential diagnosis of lichen sclerosus should be addressed by biopsy. It records that genital lichen sclerosus and vitiligo have been reported together.
What it does not support
It does not support self-classification from symmetry, one patch or a photograph, and it does not predict an individual response. On the Koebner phenomenon it records a general impression that the phenomenon and disease stability are related, then states that objective data are lacking. It also says scientific evidence is lacking for attributing vitiligo to daily friction from washing, dressing, personal care, sports, occupational activity or pressure from clothing. On lichen sclerosus it cites one reference from 2000 and calls a link a possibility, not a finding. It counts nothing and gives no rate.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- DermNet (Dr Bushra Alsayaydeh, Dermatologist, Amman, Jordan)Patient education · Patient education, tier 5Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports a dermatology reference account of vitiligo. It supports that loss of hair color is called leukotrichia or poliosis. It supports that this may affect the scalp, eyebrows, eyelashes and body hair in 10 to 60 per cent of patients. It supports that it does not correlate with disease activity. It supports that it could be a predictor of poorer response to therapy, because the melanocyte reservoir in hair follicles is destroyed. It supports that treatment is most successful on the face and trunk. It supports that hands, feet, and areas with white hair respond poorly. It supports that new patches are more likely to respond to medical therapy than long-standing ones. It supports that the hair follicle is the main source of pigment restoration. It supports that another potential reservoir can be at the borders of the white patches. It supports that poor prognostic indicators include longstanding disease, leukotrichia, mucosal involvement and the Koebner phenomenon. It supports that segmental vitiligo often has an irregular border with leukotrichia. It supports that leukotrichia and halo naevi are listed as predictors of transformation into the mixed variant. It supports that the Vitiligo European Task Force assesses five sites: head and neck, trunk, arms, legs, and hands and feet. It supports that its grading runs from 0 for normal pigmentation to 4 for complete hair whitening. It supports that its clinical assessment form records sex, age, duration of disease and age of onset. It supports that premature hair greying has been described but that the association is still uncertain.
What it does not support
It is a dermatology reference page, not a trial and not a measurement of any one person. Its 10 to 60 per cent figure is a span, stated on the page without a study behind that span. Its wording on response to therapy is that hair whitening could be a predictor, which is weaker than a finding. Nothing on it predicts whether one patch or one hair will repigment, how much color returns, or how long that takes. It sets no treatment, no dose, no schedule and no product. It does not diagnose white hair on a reader as vitiligo. Its author line is dated August 2022 and the page records a last review of 11 July 2023, so parts of it are older than the date registered here.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- American Academy of DermatologyPatient education · Patient education, tier 5Relevant relationship disclosed
- Published
- SteadySkin last checked
What this source can and cannot tell you
Why the independence label says this: The page carries a line thanking Incyte Dermatology for its support. Incyte sells a topical medicine for vitiligo, so the page is not independent of a commercial interest in the subject, even though the AAD states that it developed the content itself.
What this source supports
Supports that vitiligo can develop anywhere on a person’s skin, and that the patches usually appear first on the face, arms, hands or feet. It supports that some people lose color in areas called mucous membranes, which the page says includes the genitals and the inside of the mouth and nose. It supports that vitiligo can affect the hair, and that it can develop inside the ear.
What it does not support
It is a patient-education page rather than a study. It counts nothing: it does not say how many people lose color in the genital area, in whom, or when in the course of the condition. It does not diagnose a reader, and it names no treatment for any site. It is a US page, last updated 15 April 2026, and it acknowledges support from Incyte Dermatology.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.