Vitiligo

Vitiligo is an autoimmune condition in which melanocytes - the cells producing skin pigment - are destroyed, leaving sharply defined white patches. It affects roughly 1% of people worldwide, commonly begins before age 30, and often appears first on the hands, face, and areas around body openings. Non-segmental vitiligo is the usual form, tends to be symmetrical, and can progress in episodes; segmental vitiligo affects one area, often starts younger and stabilises sooner. It clusters with other autoimmune conditions, particularly autoimmune thyroid disease, which is worth screening for. The psychological impact is frequently underestimated and is a legitimate part of treatment. Dermatologist-led care is what changes the course: topical corticosteroids or calcineurin inhibitors for limited disease, narrowband UVB phototherapy for widespread disease, and newer topical JAK inhibitors, with repigmentation typically taking many months and responding best on the face and neck. Sun protection matters because depigmented skin burns readily. Supplement evidence is modest and adjunctive: Polypodium leucotomos extract and oral antioxidants including vitamins C and E, alpha-lipoic acid and Ginkgo biloba have small trials suggesting slightly better repigmentation when combined with phototherapy. Vitamin D and B12 or folate deficiencies are worth correcting where present. Nothing works as a standalone treatment.