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Vitiligo & alopecia areata

Autoimmune condition

Two autoimmune conditions of the skin and hair. Vitiligo destroys pigment cells, leaving white patches. Alopecia areata attacks hair follicles, causing patchy hair loss.

Affects:SkinHair
Close-up of a hair follicle in the skin, showing the hair shaft, root and bulb, an oil gland, and blood vessels
Illustration: Servier Medical Art, CC BY 4.0 (resized; some images adapted)

For education only — this guide can't diagnose you. If these signs sound familiar, talk with a healthcare provider. Book a consult 

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.

Signs worth getting checked

  • 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

Treatments your doctor may discuss

  • 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
Dr. Lesher, ND

Ready to find the root cause?

Dr. Lesher is a Naturopathic Doctor who focuses on autoimmune and chronic conditions in women. Since 2020, she's helped hundreds of patients stop managing symptoms and start healing.

Book a consult now