The main types at a glance
Segmental
- Usually stays on one side, often in one band
- Often starts early in life
- Tends to change for a while, then settle
- White hair inside a patch (leukotrichia) is common
Non-segmental
- The common form; usually appears on both sides in matching places
- Includes generalized, acrofacial, universal, mucosal and focal subtypes
- Can hold still for years or start changing again
- Sits closest to other autoimmune conditions
Mixed
- Segmental and non-segmental patterns present at the same time
- Named in the 2012 consensus classification alongside the two main types
- An early or unclear picture may be left unclassified instead
What are the types of vitiligo?
Two main ones. Segmental vitiligo sits on one part of the body, often one side. Non-segmental vitiligo is the common form, and it tends to appear on both sides in matching places. Some people have both at once, which is called mixed vitiligo. People I have heard from ask which pattern they have almost as soon as they ask whether it is vitiligo at all. Evidence Evidence Evidence
What is known
- Sources cited, not yet graded
I read the 2012 Vitiligo Global Issues Consensus Conference report, which set the naming still used today. It separates segmental from non-segmental vitiligo, keeps mixed vitiligo, and allows an unclassified label when a picture is not yet clear. Non-segmental vitiligo has named subtypes. Generalized means patches scattered across the body. Acrofacial means the face and the hands and feet. Universal means most of the skin has lost colour. Mucosal means the lips or the genital skin. A single mucosal site on its own is filed as undetermined instead. Focal means one small area that has not declared itself yet. I checked the BAD guideline and the Task Force against it, and both carry the same classification.
What is uncertain
- Depends on you
A type is a judgement made over time, not a label you can read off a photograph. Symmetry on its own does not settle it. Early on, one patch is often left unclassified on purpose. The classification was built for clinicians, and it predicts nothing for one person.
Questions for your dermatologist
Which type does my pattern look like to you right now?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Is there enough here to name a type yet, or is it too early?
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What does a segmental pattern tell a dermatologist?
That your vitiligo may behave differently from the common form. Segmental vitiligo usually keeps to one band or one side. It often starts early in life. It tends to change for a while and then settle. White hair inside a patch is a familiar part of the picture. Evidence Evidence Evidence Evidence
What is known
- Sources cited, not yet graded
I read a dermatology reference that records segmental vitiligo as often having an irregular border with white hair in it. White hair in a patch has a name, leukotrichia, and the same reference reports it in 10 to 60 per cent of patients. It records the hair follicle as the main source of returning pigment, and says areas with white hair respond poorly. It lists white hair among the poor signs for colour coming back, alongside longstanding patches, mucosal involvement and new patches after injury. The International Vitiligo Task Force records white hairs as an assessment item of their own.
What is uncertain
- Depends on you
That reference is a summary page, not a trial. Its 10 to 60 per cent span has no study named behind it. Its wording is that white hair could predict a poorer response, which is weaker than a finding. Settling is a pattern, not a promise. The BAD guideline says a doctor cannot always tell when vitiligo has truly stopped changing.
Questions for your dermatologist
Do my patches sit in one segment, and does that change what you expect?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Do you see white hair inside my patches, and what does that tell you?
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What does a non-segmental pattern tell a dermatologist?
That the picture is wider. Non-segmental vitiligo often shows up on both sides in matching places. It can hold still for years or start changing again. It is also the form that sits closest to other autoimmune conditions. Evidence Evidence Evidence
What is known
- Sources cited, not yet graded
I went back to the BAD guideline, which calls autoimmunity a contributor to how vitiligo develops. Its assessment covers looking for associated autoimmune conditions, and it recommends thyroid function and antithyroid antibody screening. The AAD tells readers that vitiligo raises the risk of some other diseases, such as thyroid disease, and that a dermatologist can watch for them. The International Vitiligo Task Force keeps stable and active vitiligo as two states that change the plan.
What is uncertain
- Depends on you
A link between conditions is not a cause and not a diagnosis. Having this type does not mean you will develop thyroid disease. The BAD guideline was written for UK care and sets no universal testing plan. Which checks make sense for you is your clinician’s call, not a rule I can set.
Questions for your dermatologist
Given my pattern, does thyroid or other autoimmune screening make sense for me now?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Would you repeat any of those checks over time, and how often?
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What tells a dermatologist that vitiligo is active right now?
Recent change, read from your history and an examination together. Three appearances come up often. A patch with a band of in-between colour at its edge is called trichrome. Small scattered dots of colour loss are often called confetti. New patches where the skin was injured have their own name. Evidence Evidence Evidence Evidence Evidence
What is known
- Sources cited, not yet graded
I went back to the classification consensus for that last one, the Koebner phenomenon. It defines the phenomenon as patches developing where previously unaffected skin was specifically injured. It sorts it into what a person reports, what a clinician observes, and what a test induces. The Task Force treats active and stable vitiligo as two states that change the plan. Its assessment list asks what your skin has done in the past six months, and records white hairs separately. Canadian consensus guidance puts activity beside extent, site, age, goals and burden when options are discussed.
What is uncertain
- Depends on you
There is no home test for activity. The consensus records a general impression that injury-linked patches and stability are related, then says objective data are lacking. A dermatology reference records that white hair does not track activity. None of these sources counts how often trichrome or confetti spots predict change. A judgement made today can be revised at the next visit.
Questions for your dermatologist
Would you call my vitiligo active or stable today, and how sure are you?
Saving keeps this on your device and needs JavaScript, which is off in this browser.What would you like me to write down before the next visit?
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Why does the type change what gets discussed?
Because several records name a type themselves. An approval can cover one type and not the other. Grafting is kept for vitiligo that is not changing. So the name in your notes shapes which options are even on the table. Evidence Evidence Evidence Evidence
What is known
- Sources cited, not yet graded
I read the current US Opzelura (ruxolitinib) cream label, which defines its indication as non-segmental vitiligo. In Europe the Commission authorized Rinvoq (upadacitinib) on 24 July 2026 for non-segmental vitiligo in adults and adolescents aged 12 and over who are candidates for systemic therapy. The FDA record for the RECELL device covers repigmentation of stable depigmented vitiligo in a defined adult population and a trained professional setting. Recommendation R25 of the BAD guideline keeps cell grafting for vitiligo that is not changing and did not respond to other care.
What is uncertain
- Depends on you
An approval is not a recommendation, and none of these records says what suits you. A European authorization sets no US or UK approval and no coverage. The FDA record does not approve every grafting procedure, define stability for a reader, or guarantee a colour match. I would ask where each option stands where you live.
Questions for your dermatologist
Does my type rule any option in or out for me?
Saving keeps this on your device and needs JavaScript, which is off in this browser.If a procedure is ever discussed, what would you need to see first?
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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.
- Dermatology and Therapy (Prajapati VH, et al.)Guideline · Regulatory / guideline, tier 1Relevant relationship disclosed
- Published
- SteadySkin last checked
What this source can and cannot tell you
Why the independence label says this: Incyte funded the study, journal fee, and medical-writing support. The article says Incyte had no editorial control; authors also disclosed relevant company relationships.
What this source supports
Supports a current consensus map in which treatment choices depend on activity, extent, site, age, goals and burden, and in which selected systemic medicines may be considered off-label for unstable or rapidly progressing disease.
What it does not support
It is Canadian expert consensus with disclosed relationships, not US regulatory approval, comparative proof, a dosing guide or an individual treatment sequence.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- DailyMed, U.S. National Library of MedicineRegulatory · Regulatory / guideline, tier 1Independence not established
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports the defined US nonsegmental-vitiligo indication, limitations of use, boxed warnings, skin-cancer and ultraviolet precautions, and clinical-study labeling.
What it does not support
It also supports the labeled dosing instruction: "Apply a thin layer of OPZELURA topically twice daily to affected areas of up to 10% body surface area." It further supports the labeled re-evaluation point: "If the patient does not find the repigmentation meaningful by 24 weeks, the patient should be re-evaluated by the healthcare provider." It also supports the vitiligo-trial adverse-reaction rates at 1% incidence or greater: application-site acne 6%, application-site itching 5%, a common-cold-type illness (nasopharyngitis) 4%, headache 4%, urinary tract infection 2%, application-site redness (erythema) 2%, and fever (pyrexia) 1%. It does not guarantee benefit, establish suitability beyond the labeled population, authorize adding phototherapy, or state which reaction should prompt a call to the prescriber beyond directing patients to the Medication Guide and their healthcare provider.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- U.S. Food and Drug AdministrationRegulatory · Regulatory / guideline, tier 1Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports FDA authorization of this device for repigmentation of stable depigmented vitiligo lesions in a defined adult population and trained professional setting.
What it does not support
It does not approve every grafting procedure, define stability for a reader or guarantee color match, durability or satisfaction.
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.