World Vitiligo Day 2025: How to Manage Vitiligo Flare-Ups? - Dr Asha Zacharia

Vitiligo causes discolouration patches of skin (and sometimes hair) to turn white. It is an autoimmune response. That is when the body's infection-fighting system, called the "immune system," attacks healthy cells. In this case, the affected cells are the ones that give skin its colour.

The main symptom is skin turning white. The areas of skin that are affected depend on the type of vitiligo. The most common type is called "generalized vitiligo" or "vitiligo vulgaris."

Generalized vitiligo usually affects both the left and right sides of the body symmetrically.

Acrofacial vitiligo affects only the:

• Fingers, toes, ears, or other body parts that are far from the centre of the body.
• Skin surrounding openings in the body, such as the mouth, eyes, and nose.

Segmental vitiligo only affects the left or the right side of the body.

Vitiligo often happens along with other autoimmune problems.

Management of vitiligo flare-up involves combination of treatments

1. Medical Treatment

• Topical corticosteroids: Reduce inflammation and may help restore pigment during a flare-up.
• Topical calcineurin inhibitors: For mild to moderate vitiligo.
• Phototherapy (narrowband UVB): Can help stimulate repigmentation, especially for widespread or resistant cases.
• Excimer laser: Useful for targeting small areas.
• Oral corticosteroids (short term use): Soto stabilize
• Phototherapy (narrowband UVB): Can help stimulate repigmentation, especially for widespread or resistant cases.
• Excimer laser: Useful for targeting small areas.
• Oral corticosteroids (short-term use): Sometimes prescribed during aggressive flare-ups to stabilize disease progression.

2. Protect Your Skin from Sunlight

• Use broad-spectrum sunscreen (SPF 30+): Prevents burns and reduces contrast between normal and depigmented skin.
• Wear protective clothing and seek shade when possible.

3. Anti-Inflammatory Diet

• Increase antioxidant-rich foods: Berries, leafy greens, nuts, green tea.
• Reduce pro-inflammatory foods: Processed foods, excess sugar, red meat, and dairy.

4. Stress Management

Stress is a known trigger for vitiligo flares. Consider:

• Mindfulness, yoga, or meditation.
• Regular sleep and exercise.
• Support groups or therapy if needed.

5. Avoid Skin Trauma (Koebner Phenomenon)

• Be gentle with your skin-avoid scratching, friction, or injury.
• Avoid tattoos or harsh cosmetic treatments during a flare-up.

6. Consider Emerging or Alternative Treatments

• Janus kinase (JAK) inhibitors.
• Micropigmentation (tattooing) for stable, non-responsive areas.
• Depigmentation therapy (monobenzone) if vitiligo is widespread, and you want to unify skin tone.

Like any other autoimmune disorder, the results of treatment of vitiligo are subjective and treatment has to be continued for long. That said, with the advent of lasers and new advancements in surgical intervention, treatment is promising.

It's very important to address the stigma attached to it as it is not at all a contagious disease but just a change in skin colour. It is not related to a particular diet or lifestyle. Many times patients are too anxious, and they fall into the trap of quacks, leading to deterioration of the disease.