The key vitiligo symptom is the sudden onset of a single, few or many milky white patches of irregular shapes and sizes on the skin. Small areas of de-pigmentation gradually start spreading to involve larger areas of the body. The patches appear more prominent on dark-skinned people and can be quite disfiguring at times.
As far as the progress and reasons for white spots on the skin are concerned, they are highly unpredictable. Some cases experience an extremely fast advancement, with quick involvement of large areas of the body, whereas in some cases, there may be a few small patches that do not change much with time. The active phase of development of new patches can be followed by a phase that does not present any new patches.
The affected areas retain normal sensitivity to touch and pain; however, sensitivity towards the sun increases in many cases. Even hair over the affected parts (skin, scalp, beard, eyebrows, eyelashes, etc.) may lose its colour.
Over time, some of the vitiligo patches may re-pigment themselves.
Patches of vitiligo can affect any part of the body, though sun-exposed regions, along the folds of the skin (e.g., groins, armpits), areas around body orifices or sites of previous injury are commonly affected. Following are some common patterns of body affection seen in vitiligo patients:
- focal : the patches are limited to particular areas of the body;
- segmental : distribution of the patches is usually asymmetrical, affecting one side of the body;
- symmetrical : bilaterally symmetrical patches over the body;
- generalised : widespread patches spread all over the body;
- over bony prominences : the skin near the joints is affected;
- lip-tip vitiligo : vitiligo that is limited to the lips, tips of the fingers and toes; and
- genital vitiligo : private parts of the body are affected.
Living with vitiligo can be very difficult. Because the patches are often visible, people often mistake them for signs of leprosy, and end up treating the patient like a social outcast. People with vitiligo suffer tremendously from the fear of being socially rejected. This can be emotionally devastating and can lead to the distortion of one's self-image.