Vitiligo & alopecia areata
Autoimmune conditionTwo autoimmune conditions of the skin and hair. Vitiligo destroys pigment cells, leaving white patches. Alopecia areata attacks hair follicles, causing patchy hair loss.
What happens
In vitiligo, immune cells target melanocytes, the cells that give skin its color. In alopecia areata, immune cells attack the growing part of the hair follicle. The follicle isn't destroyed, so hair can regrow. Both often occur alongside autoimmune thyroid disease.
Who gets it
Both affect women and men and often start before age 30. A family history and other autoimmune conditions raise the risk.
Common signs
- Smooth, milky-white patches of skin, often on the hands, face, or around the mouth and eyes
- Patches of hair that turn white early
- Round, smooth patches of hair loss on the scalp, eyebrows, or elsewhere
- Tiny dents in the nails
Labs to ask about
- Usually diagnosed by exam (a special UV lamp helps with vitiligo)
- TSH and TPO antibodies, since thyroid disease is common with both
- Complete blood count, ferritin, vitamin D, and B12 in some cases
How it's usually treated
- Steroid or calcineurin-inhibitor creams
- Light therapy for vitiligo
- JAK inhibitor creams or pills for some people
- Steroid injections into patches of hair loss
Supportive steps to discuss with your provider
- Protect light patches from the sun. They burn easily.
- Get screened for thyroid disease.
- Seek emotional support. Visible changes can be hard.
- If hair loss is all over rather than in patches, check iron and thyroid levels.
See a doctor promptly if you have
- Patches that are spreading quickly
- Hair loss with scarring, redness, or pain (this can be a different condition)
- Signs of thyroid problems
Related conditions
Hashimoto's thyroiditis
The most common cause of an underactive thyroid in the US. The immune system slowly damages the thyroid, so it makes less hormone over time.
Learn more →Pernicious anemia
The immune system attacks cells in the stomach lining that make intrinsic factor, a protein needed to absorb vitamin B12.
Learn more →Addison's disease
The immune system damages the adrenal glands, so they can't make enough cortisol and aldosterone. It's rare but serious, and different from everyday stress-related fatigue.
Learn more →
Wondering if your symptoms fit a pattern?
Dr. Lesher is a naturopathic doctor who specializes in women's autoimmune and chronic conditions. Since 2020, she has helped more than 900 patients overcome and heal from their conditions.