Key Takeaways
- Global point prevalence typically falls within ~0.5–2%, with heterogeneity by region and methodology.
- Childhood onset is common (≈30–50% before age 20); sex distribution generally near 1:1.
- Quality-of-life burden is clinically meaningful (DLQI often mid-range), higher with facial involvement and darker phototypes.
- Frequent comorbidities include autoimmune thyroid disease, type 1 diabetes, and alopecia areata.
Abstract
This article synthesizes epidemiologic evidence on vitiligo prevalence and disease burden. We summarize global prevalence estimates, pediatric versus adult patterns, quality-of-life impact, and comorbidity profiles, highlighting methodological drivers of heterogeneity and implications for clinical practice and policy.
Methods
- Sources: indexed databases (MEDLINE/PubMed, Embase), major dermatology journals, systematic reviews, consensus statements.
- Study types: population-based surveys, clinic-based cohorts, school/community screenings, systematic reviews/meta-analyses.
- Outcomes: point/period prevalence, age at onset, sex ratio, DLQI/Skindex, comorbidity frequencies.
- Heterogeneity noted by sampling frame, case definition, skin phototype distribution, and diagnostic methods (clinical vs validated tools).
Global Prevalence
| Region | Representative prevalence (range) | Typical sources | Notes on heterogeneity |
|---|---|---|---|
| Europe | ~0.4–1.6% | Population/clinic-based studies; reviews | Variation by survey method; lower in lighter phototypes may reflect detection/reporting differences. |
| North America | ~0.5–1.0% | NHANES-style surveys; clinic cohorts | Case definition and self-report influence estimates. |
| South Asia | ~0.5–2.0% | Community screenings; hospital registries | Higher clinic attendance; regional hotspots reported. |
| Middle East | ~0.5–2.0% | National/tertiary center reports | Consanguinity and autoimmune clustering discussed. |
| Africa | ~0.4–2.8% | School/community surveys; reviews | Limited population-based data; stigma may affect participation. |
| East Asia | ~0.2–0.6% | Population surveys; insurance datasets | Diagnostic coding granularity impacts estimates. |
Reported prevalence tends to cluster around 0.5–2% globally, acknowledging wide methodological variability across studies and regions.
Children vs Adults
| Metric | Typical value | Comment |
|---|---|---|
| Onset < 12 years | ~20–35% | Childhood onset is common; family history and autoimmune diathesis relevant. |
| Onset < 20 years | ~30–50% | Up to half of cases begin during adolescence. |
| Sex ratio (F:M) | ≈1:1 | Small deviations reflect sampling (clinic vs community) rather than biology. |
| Segmental vitiligo share (peds) | Lower than non-segmental | Segmental forms present earlier but are less prevalent overall. |
Quality of Life (QoL)
Vitiligo impairs health-related QoL across domains of self-image, social functioning, and emotional well-being. Burden is often higher with facial involvement, darker phototypes, rapid progression, and in adolescents.
| Instrument | Typical results | Determinants of higher burden |
|---|---|---|
| DLQI (0–30) | Medians often in 5–10 range | Face/neck lesions, darker phototypes, extensive BSA, active spread. |
| Skindex-16/29 | Elevated emotion and functioning scores | Stigma, teasing, cultural norms, occupational exposure. |
| Anxiety/Depression scales | Higher odds vs controls | Adolescence, visible areas, limited social support. |
Comorbidities
- Autoimmune thyroid disease (Hashimoto’s/Graves); recommend TSH/thyroid antibody screening per local guidance.
- Alopecia areata, type 1 diabetes, pernicious anemia, and other autoimmune conditions variably co-occur.
- Atopic diathesis and other dermatologic comorbidities appear in subsets; ascertainment bias should be considered.
Health Economics
Economic burden includes direct medical costs (visits, phototherapy sessions, topicals), indirect costs (time off work/school), and intangible costs (psychosocial impact). Access to phototherapy and coverage for newer therapies influence regional disparities.
Limitations
Estimates vary by sampling frame (clinic vs community), diagnostic approach (self-report vs clinician-confirmed), and population structure (age/phototype). Underdiagnosis and stigma may bias prevalence downward in some regions.
References
- Krüger C, Schallreuter KU. A review of the worldwide prevalence of vitiligo in children/adolescents and adults. Int J Dermatol. 2012.
- Alikhan A, Felsten LM, Daly M, Petronic-Rosic V. Vitiligo: a comprehensive overview. Part I. J Am Acad Dermatol. 2011.
- Ezzedine K, Lim HW, Suzuki T, et al. Revised classification/nomenclature of vitiligo. Pigment Cell Melanoma Res. 2015.
- Hamzavi I, Lim HW, Syed Z, et al. Current and emerging treatments and PROs in vitiligo. Dermatol Clin. 2020.
- Recent QoL syntheses and stigma-focused reviews in dermatology journals (DLQI/Skindex-based analyses).