What should I keep track of before my follow-up?
Write down what you noticed, where it happened, whether you were able to follow your treatment plan, and any reaction or interruption. Also keep the questions you want answered at your next visit. Bring that history to your dermatologist, who can interpret it with your examination and treatment plan. Evidence Evidence Evidence
Why this item matters
- Sources cited, not yet graded
I read what clinicians look at when they review vitiligo care. It is where patches are and whether the condition appears active. It is also what treatment has been used, any side effects, and how care is affecting daily life. A short, consistent record can preserve details that are hard to remember later.
Check before moving on
- Depends on you
A record can still miss changes or capture unrelated skin events, and more entries do not automatically make an interpretation more accurate. Only a qualified clinician can decide what a change means for diagnosis or care.
Questions for your clinician
What would you like me to keep track of before my next appointment?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Which changes or reactions should I report before my follow-up?
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How can I take photos that are easier to compare?
When practical, use the same framing, distance, background and ordinary lighting each time, and keep the original date. That reduces obvious differences between photos, but a phone photo still is not a calibrated medical measurement. Evidence Evidence
Why this item matters
- Sources cited, not yet graded
The clinical guidance I read recognizes standardized medical photography as one way to document vitiligo over time. In personal records, repeating the basic setup makes side-by-side review less vulnerable to obvious changes in angle, scale and lighting.
Check before moving on
- Depends on you
Phones change color, contrast and exposure automatically, while season, surrounding skin color and camera processing can change how a patch appears. Even carefully repeated photographs may not show clinically meaningful change reliably.
Questions for your clinician
Would photos be useful for the areas we are following?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Is there a particular angle or reference marker you want me to use?
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Can I tell from a photo whether my vitiligo is improving or worsening?
Not from a photo alone. A photo can preserve what the camera captured, but it cannot prove that treatment caused a change. It cannot reliably separate repigmentation from differences in lighting, season or camera processing. Evidence Evidence
Why this item matters
- Sources cited, not yet graded
Whether it is working, week to week, is what most people want a photograph to settle. Clinicians interpret photographs alongside the history, examination and the pattern of change. Repeated images can support that conversation when their limitations stay visible.
Check before moving on
- Depends on you
Use before-and-after images as part of the history, not as proof that treatment caused a change. Changes may be uneven across body sites, and one encouraging or discouraging image may not represent the whole picture.
Questions for your clinician
When you compare these photos, what changes do you consider meaningful?
Saving keeps this on your device and needs JavaScript, which is off in this browser.What other information do you need before interpreting the change?
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What does a VASI score, or another vitiligo score, tell me?
Measures such as the Vitiligo Area Scoring Index, or VASI, are used by researchers and clinicians. They give a structured way to describe how much skin is affected or how it has changed. A score is not a diagnosis, a universal definition of success, or a reason to change treatment on your own. Evidence Evidence Evidence
Why this item matters
- Sources cited, not yet graded
Research uses structured outcome measures so groups and time points can be compared more consistently. I looked up where VASI came from. It was developed and first compared against patient and physician global assessments in a selected adult research population, which is the setting it was built for. Different measures may focus on extent, repigmentation, noticeability or quality of life, so the name of a score matters as much as the number.
Check before moving on
- Depends on you
Scores have measurement limits, and a study’s definition of improvement may not match what matters to you. A score also cannot capture every side effect, access problem, practical burden or emotional effect.
Questions for your clinician
What does the score you are using measure?
Saving keeps this on your device and needs JavaScript, which is off in this browser.How will my own goals be considered alongside any score?
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What else should we discuss besides whether pigment returned?
Bring up new patches, reactions, how hard the plan is to follow, missed or interrupted care, access problems, and whether the plan still fits your priorities. Pigment returning may matter to you, but it is not the only part of care worth reviewing. Evidence Evidence
Why this item matters
- Sources cited, not yet graded
The guidelines I read include quality of life, adverse effects, adherence burden and personal goals in management discussions. That broader view helps separate “nothing changed in the photograph” from “nothing important happened.”
Check before moving on
- Depends on you
No checklist can decide whether a plan should continue, stop or change. What each observation means depends on your treatment, health history and the instructions from the clinician responsible for your care.
Questions for your clinician
How will we decide whether this plan still fits my goal?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Can we discuss burden and side effects as well as visible change?
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Evidence behind this page
Sources
Each evidence badge opens the source and its limits. The full list stays available here.
- Archives of Dermatology (Hamzavi I, et al.)Randomized trial · Clinical research, tier 2Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports the original development and initial comparison of the Vitiligo Area Scoring Index with patient and physician global assessments in a selected adult research population.
What it does not support
It does not make VASI a home diagnostic tool, establish a universal success threshold or support changing an individual treatment from a self-calculated score.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- JAMA Dermatology (Ezzedine K, et al.)Observational study · Supporting research, tier 3Independence not established
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports defined research use and psychometric evaluation of facial and total VASI measures and the need to interpret score change in the studied context.
What it does not support
The analysis used sponsor trial data and included AbbVie authors; it does not establish one personally meaningful outcome, validate untrained home scoring or provide a treatment-change rule.
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.
- 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 a patient-facing description of clinician diagnosis using history and examination, possible use of a Wood lamp and selected tests, broad treatment categories, variable response and whole-person support.
What it does not support
It is educational context, not primary efficacy evidence, an online diagnostic method or a universal testing checklist.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.