Medical Dermatology

Vitiligo Treatment in Singapore

Dr. Liew Hui Min

accredited consultant dermatologist

Vitiligo is a skin condition where patches of skin lose their natural pigment due to the destruction or dysfunction of melanocytes; the cells responsible for producing melanin. This condition can affect any part of the body and is more noticeable in individuals with darker skin tones. While vitiligo is not physically harmful or contagious, it may lead to emotional distress or reduced self-esteem due to changes in appearance. Early evaluation helps guide treatment and manage associated autoimmune risks.

Symptoms Causes Types Diagnosis Treatment Prevention FAQ

Symptoms of Vitiligo

Vitiligo typically presents with the following signs:

White or light patches on the skin: These patches typically start small and may gradually increase in size over time. They can appear anywhere on the body but commonly develop on sun-exposed areas like hands, face, and arms.
Premature whitening of hair: Hair on your scalp, eyebrows, eyelashes, or beard may turn white or grey earlier than expected, particularly in areas affected by vitiligo.
Loss of colour in mucous membranes: The tissues inside your mouth and nose may lose their natural colour, though this occurs less frequently than skin changes.

Causes and Risk Factors

Vitiligo develops due to a combination of genetic, autoimmune, and environmental factors:

Autoimmune response

The body’s immune system mistakenly attacks and destroys melanocytes. This is considered the most common cause of vitiligo.
Family history

Having relatives with vitiligo or other autoimmune conditions increases your likelihood of developing the condition. About 20-30% of people with vitiligo have an affected family member.
Trigger events

Severe sunburn, skin trauma, or emotional stress may trigger vitiligo in predisposed individuals. These events don’t cause vitiligo directly but may initiate its appearance.
Associated conditions

People with autoimmune disorders like thyroid disease, type 1 diabetes, or alopecia areata have a higher risk of developing vitiligo.

Types of Vitiligo

Vitiligo is classified based on the distribution of pigment loss:

Non-segmental vitiligo

The most common form, affecting both sides of the body in a relatively symmetrical pattern. Patches often appear on hands, fingertips, around body openings, and areas prone to injury.

Segmental vitiligo

Affects only one side or segment of the body, typically appearing at a younger age. This type tends to progress for a year or two before stabilising.

Focal vitiligo

Limited to one or a few small areas without a specific pattern. This type may remain stable or progress to other forms over time.

Diagnostic Methods

Dermatologists use several approaches to accurately diagnose vitiligo and rule out other skin conditions.

Visual examination: A thorough inspection of the skin to identify characteristic white patches and their distribution patterns across affected and unaffected areas.

Wood’s lamp examination: A special ultraviolet light that makes vitiligo patches appear bright white, helping identify affected areas not clearly visible in normal light.

Skin biopsy: A small sample of affected skin may be taken to confirm the absence of melanocytes and rule out other conditions causing skin lightening.

Blood tests: Laboratory tests check for associated autoimmune conditions, including thyroid function, diabetes markers, and vitamin levels.

Vitiligo Treatment Options

Non-Surgical Treatments

Several options are available to restore pigment or reduce contrast between affected and unaffected areas:

Topical corticosteroids: Help stimulate pigment return in early or localised cases. This is likely to be the first line treatment.

Topical calcineurin inhibitors: Effective for sensitive areas such as the face and neck. This treatment is considered a second line to replace topical corticosteroid, as part of maintenance therapy.

Topical JAK inhibitors: This new novel topical treatment is approved for vitiligo. This is relatively safe and will need assessment by a dermatologist prior to application.

Phototherapy (narrowband UVB): Exposes the skin to specific UV light to reactivate melanocytes; typically requires multiple sessions.

Combination therapy: Concurrent use of topical medications and phototherapy often yields better results.

Oral corticosteroids: This treatment can be considered for progressive vitiligo, though not recommended in young children or patients with other medical health conditions.

Surgical Treatments

For patients with stable vitiligo unresponsive to non-surgical options:

Skin grafting: Small sections of healthy, pigmented skin are transplanted to depigmented areas.

Blister grafting: Uses suction blisters to transfer the skin’s upper layers.

Melanocyte transplantation: Involves growing pigment-producing cells in the lab before reintroducing them into affected skin.

Prevention and Management

While vitiligo cannot be prevented, its progression and appearance can be managed with consistent care. Use broad-spectrum sunscreen daily to protect depigmented skin from sunburn. Avoid skin trauma, tight clothing, or harsh skincare products that may trigger new patches. For those concerned about appearance, camouflage cosmetics can help even out skin tone. Regular follow-ups with a dermatologist are important for monitoring stability and tailoring treatment as needed.

Frequently Asked Questions

Is vitiligo hereditary?

Yes, vitiligo has a genetic component, with about 20–30% of affected individuals having a family history.

Can vitiligo develop suddenly?

Yes. In some cases, white patches appear quickly over weeks or months. Others may experience slow and progressive changes.

Does vitiligo cause discomfort?

Vitiligo itself does not cause pain or itching, but affected areas are more vulnerable to sunburn.

Are there activities I should avoid?

It’s best to avoid excessive sun exposure and skin trauma. There are no general activity restrictions beyond protecting sensitive areas. Sun avoidance is not recommended.

Can vitiligo be cured?

There is currently no cure for vitiligo, but treatments can help restore pigmentation, improve and stabilise skin appearance over time.

Dr Liew Hui Min

Dually Accredited Dermatologist In Singapore and the UK

Dr. Liew Hui Min is an accredited consultant dermatologist from the Ministry of Health and the General Medical Council UK.

Her clinical interest includes:

Paediatric Dermatology,
Women’s Dermatology,
General Adult Dermatology.

Having trained in major London Hospitals, Dr Liew returned to Singapore in 2014 as a Consultant at KK Women’s and Children’s Hospital (KKH) where she specialised in paediatric, women, obstetric and vulva dermatology. Currently, Dr Liew practices at The Skin Drs. clinic located at Gleneagles Hospital.

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