When most people think of vitiligo, they picture smooth white patches on the skin. But vitiligo doesn’t stop at the skin’s surface. Because melanin is also present in your hair follicles, vitiligo can cause hair in affected areas to lose pigment as well. That means your eyelashes, eyebrows, beard and even body hair may gradually turn white. This can be surprising, especially if the skin around the area still looks fairly normal.
Seeing hair lose colour can feel unsettling, and many people wonder whether this means their vitiligo is worsening or whether it affects their treatment options. The truth is that hair depigmentation in vitiligo follows the same biological process as skin depigmentation, but the implications can be a little different because hair behaves differently from skin.
In this guide, I’ll explain why hair loses pigment in vitiligo, what it means for your skin’s prognosis, how to identify early signs, and what treatment options are available for pigmented hair-bearing areas. Understanding hair depigmentation can help you feel more in control and know when to seek specialist care.
Why Vitiligo Affects Hair as Well as Skin
Melanin is produced inside melanocytes, and these pigment-producing cells live not only in your skin but also inside your hair follicles. When vitiligo targets the skin, it can also affect the melanocytes inside the follicle. This leads to hair that turns white or grey in the areas affected by depigmentation.
For some people, hair lightening happens at the same time as skin pigment loss. For others, it may be an early warning sign before visible skin changes appear. In rare cases, hair may turn white even when the surrounding skin still appears normally pigmented.
How Hair Loses Pigment
- Follicle melanocyte damage – The immune system attacks melanocytes inside the follicle, stopping melanin production.
- Reduced melanin transfer – Even before melanocytes disappear, they may produce less pigment, causing lighter hair.
- Complete depigmentation – Over time, the follicle produces fully white hair because it no longer contains functioning pigment cells.
Hair depigmentation is therefore part of the same autoimmune process that affects your skin.
What Hair Depigmentation Looks Like in Vitiligo
Hair affected by vitiligo doesn’t always turn completely white overnight. The process can be slow and subtle, and it varies depending on where the hair is located. Some areas, like eyelashes, may show abrupt changes because the contrast is more noticeable. Other areas, like body hair, may show lighter tones before losing pigment entirely.
Common Patterns You Might Notice
- Individual lashes or brow hairs turning white
- Groups of hairs losing colour together
- A patch of beard hair turning white before the skin changes
- Sparse white body hairs in vitiligo-affected areas
- A “salt-and-pepper” effect where some hairs stay pigmented and others are pale
- Thin circles of pale skin around white hairs
Because melanin determines both skin tone and hair colour, the process often goes hand in hand.
Which Areas of Hair Are Most Commonly Affected?
Vitiligo can affect both the skin and the hair, and in many people, changes in hair colour may appear before noticeable skin patches. Hair depigmentation happens when melanocytes in the hair follicles lose their ability to produce pigment.
Because this process can occur in any hair-bearing area, some regions become more noticeable than others due to contrast, daily visibility or friction. Understanding which areas are commonly affected can help you recognise early signs and seek timely guidance.
Most Frequently Affected Areas
- Eyelashes – White eyelashes (poliosis) can appear suddenly and often draw attention because of strong contrast.
- Eyebrows – Brows may lighten gradually or in small clustered patches.
- Beard and moustache – Men often notice early hair depigmentation here, even before skin changes.
- Scalp hair – Vitiligo may cause white streaks, clusters of grey hairs, or isolated white patches.
- Arm, leg and body hair – Body hair can lose pigment more subtly and is often only noticed upon closer inspection.
- Pubic hair – Depigmentation here is not uncommon but is usually less visible.
Hair depigmentation can be one of the earliest signs of vitiligo, especially around the eyes and beard area.
Why Hair Depigmentation Matters Clinically
Although hair depigmentation itself is not harmful, it has clinical significance because it may indicate a deeper level of melanocyte loss. Unlike skin, which can often repigment when treatment begins early, hair follicles may be more resistant once melanocytes disappear.
What Hair Depigmentation Suggests
Deeper follicular involvement – When hair loses pigment, it indicates melanocyte loss deeper below the skin surface.
Lower likelihood of spontaneous repigmentation – Treatments can still work, but more intensive approaches may be needed.
Higher risk of stable or persistent patches – Some depigmented areas associated with white hair can remain unchanged without targeted therapy.
However, hair depigmentation does not mean treatment is ineffective. Many options exist to improve or restore pigment.
Early Signs That Hair Might Start Losing Pigment
You may begin to notice early signs of hair depigmentation even before any fully white hairs appear. These early indicators can be subtle, including lighter roots at the base of the hair shaft, irregular bands of pigment running along individual strands, or faint white halos around the hair follicles often a sign that the melanocytes responsible for colouring the hair are under stress. Eyebrows may also start to look slightly paler or thinner, which can be an early signal of reduced pigment activity.
When these hair changes occur alongside new areas of skin lightening, it may suggest that pigment loss is affecting both the skin and hair at the same time. Although these signs can be easy to overlook, noticing them early gives you the chance to seek a dermatologist’s opinion before the changes become more advanced. A specialist can assess whether these patterns relate to vitiligo or another condition and guide you on the best next steps for monitoring or treatment.
Why Eyelashes Often Lose Pigment First
Eyelashes are one of the earliest places where pigment loss becomes visible in vitiligo. Because lashes are small, fine and constantly renewing, any disruption in pigment production tends to show up quickly.
The skin around the eyes is also a common site for vitiligo to begin, which makes the lashes especially vulnerable. As a result, many people notice white eyelashes before any clear skin changes appear.
Why Lashes Are Vulnerable
High immune sensitivity – Facial follicles are more reactive to autoimmune disruptions.
Fast growth cycle – New white lashes grow quickly, making changes visible.
Friction and cosmetic exposure – Mascara, rubbing and makeup removal may increase follicular stress.
Many people feel particularly distressed by white eyelashes because the contrast is dramatic, but dermatologists see this pattern frequently and can offer targeted treatments.
Beard and Facial Hair Depigmentation
Many men first notice vitiligo in their beard, moustache or sideburns. Facial hair follicles are particularly sensitive to pigment changes, which is why depigmentation here can appear even before any changes on the surrounding skin become visible.
Common patterns include scattered white hairs, small round patches of fully white hair or pale strands emerging from an early vitiligo patch. In some cases, one side of the beard begins losing colour gradually, creating a noticeable contrast. If your beard starts to lighten before the nearby skin shows any fading, it may be an early sign of vitiligo.
Body Hair Depigmentation
Body hair depigmentation often goes unnoticed at first because the changes are subtle, especially on areas like the legs, arms, or chest. Many people only become aware of it once nearby skin begins to lighten, making the contrast more noticeable. You may see patches of lighter hair developing within vitiligo areas or notice that certain hairs turn white gradually over several months.
These pale or white hairs often stay light even after sun exposure, and small white dots may appear where pigment is lost at the follicle level. Body hair depigmentation usually happens alongside broader skin changes, so spotting both together can be an important clue that the condition is progressing.
Does Hair Depigmentation Predict Worse Vitiligo?
Noticing hair turning white in areas affected by vitiligo can understandably raise concerns, but it’s important to know what this change actually means. Hair depigmentation can signal deeper pigment loss, yet it doesn’t automatically indicate severe or rapidly spreading vitiligo. Understanding how dermatologists interpret this sign can help you view it in the right context.
How Dermatologists Interpret White Hair
- Indicator of deeper involvement – Hair loss suggests pigment cells deeper in the follicle have been affected.
- Lower likelihood of spontaneous recovery – This means treatment may need to be more targeted or prolonged.
- Not a predictor of spread – Hair depigmentation does not mean your vitiligo will spread quickly.
- Common in stable vitiligo – Many people with stable vitiligo also have white hair in affected areas.
In short, white hairs provide useful clinical information but do not define your prognosis alone.
How Dermatologists Diagnose Hair-Related Vitiligo
Diagnosing hair-related vitiligo involves a careful examination of both the hair and the surrounding skin. Tools like a Wood’s lamp are especially useful, as they make depigmented follicles appear bright white even before changes are visible to the naked eye. Dermatologists may also use dermatoscopy to closely inspect hair shafts and follicles for subtle signs of pigment loss.
In addition to these tools, doctors look for classic clinical patterns, such as periorbital or beard depigmentation, and assess medical history, including autoimmune conditions or family history, to strengthen their evaluation. A professional diagnosis is essential for choosing the most appropriate and effective treatment plan.
Can Pigment Return to Hair Affected by Vitiligo?
Hair repigmentation is possible, but it can be more challenging than skin repigmentation because melanocytes deep inside the follicle may have been completely lost. However, this does not mean improvement is impossible.
Factors That Affect Repigmentation
Presence of residual melanocytes – If some cells remain, repigmentation is more likely.
Type of vitiligo – Segmental vitiligo is often more resistant; non-segmental may respond better.
Treatment style – Phototherapy and targeted therapies often work best.
Consistency – Regular treatment increases the chance of visible improvement.
Some people regain full pigment in their hair, while others may see partial or no change.
Treatment Options for Hair Depigmentation in Vitiligo
Although hair is harder to repigment than skin, several treatments can help. Dermatologists often use combination therapy for the best results.
1. Targeted Phototherapy (Excimer Laser)
Targeted phototherapy using an excimer laser is a highly effective treatment for repigmenting both skin and hair in vitiligo. The laser delivers concentrated light directly to affected follicles, stimulating melanocyte activity, and some people notice early signs of repigmentation within weeks. It works particularly well in areas with dense hair, such as the eyebrows and beard.
2. Narrowband UVB (NB-UVB)
Narrowband UVB (NB-UVB) therapy, whether applied to the whole body or targeted areas, can help restore pigment in early or active vitiligo. It stimulates melanocyte migration, encouraging pigment cells to return to the hair follicles, and is especially useful for treating multiple patches at once. Many patients notice improvement in both skin and hair pigmentation as the treatment progresses.
3. Topical Medications
Topical medications can help reduce inflammation and support the return of pigment in vitiligo. Steroid creams work by calming autoimmune activity in the follicles, while calcineurin inhibitors like tacrolimus are especially useful for sensitive areas such as the eyebrows and eyelids. Newer options, including JAK inhibitors, are also increasingly being used to treat vitiligo.
4. Micropigmentation / Cosmetic Solutions
For people wanting fast cosmetic improvement, micropigmentation (brow tattooing or lash tinting) may be helpful. These options don’t treat the vitiligo but can provide an aesthetic solution while treatment continues.
Emotional Impact of Hair Depigmentation
Hair plays a significant role in personal identity and expression, so noticing depigmentation in eyelashes, eyebrows, or scalp hair can feel more emotionally impactful than changes in the skin. Many people report feeling self-conscious, anxious, or confused when white hairs appear, especially if the change happens suddenly.
To cope emotionally, it helps to seek reassurance early and understand what changes are normal. Connecting with support groups and exploring cosmetic options, such as temporary tinting or brow styling, can also restore confidence. Addressing the emotional impact is just as important as managing the physical symptoms of vitiligo.
When to Contact a Dermatologist
You should contact a dermatologist if you notice white hairs appearing in your eyebrows, eyelashes, beard, or body hair, particularly when accompanied by pale skin patches. Early consultation is important for spotting changes before they progress.
Seek medical advice if hairs turn white suddenly, confetti-like skin spots appear, patches develop around the eyes or lips, you have a family history of vitiligo or autoimmune conditions, or hair depigmentation continues to spread over weeks or months. A dermatologist can confirm the diagnosis and recommend early treatment to help stabilise pigment loss.
Frequently Asked Questions:
1. Why does vitiligo cause hair to lose pigment?
Vitiligo targets melanocytes, the pigment-producing cells, in both the skin and hair follicles. When these cells are damaged or destroyed, they stop producing melanin, the substance responsible for colour. As a result, hair in affected areas gradually turns white. This can happen alongside skin depigmentation, or in some cases, hair may lose colour before any noticeable changes appear on the surrounding skin. Hair depigmentation is essentially a sign that the autoimmune process affecting the skin has reached deeper into the follicle.
2. Can hair depigmentation occur without skin changes?
Yes, in some cases, hair can lose pigment even when the surrounding skin still looks normal. This often happens because melanocytes in hair follicles may be more sensitive to autoimmune activity or stress than those in the surrounding skin. Eyelashes, eyebrows, and facial hair are particularly susceptible, which is why some people notice white hairs before any visible skin patches appear. While the skin may eventually show depigmentation, hair changes can act as an early warning signal for clinicians.
3. Does white hair mean vitiligo is worsening?
Not necessarily. White hair in vitiligo indicates that pigment-producing cells in the follicle are affected, but it does not automatically mean the condition is progressing rapidly or becoming severe. Some people with stable vitiligo develop hair depigmentation without experiencing further spread of skin patches. Dermatologists consider hair depigmentation as a marker of deeper involvement, but they evaluate it alongside other factors, such as new skin patches, autoimmune activity, and family history, to determine disease stability.
4. Can hair repigment after vitiligo-related depigmentation?
Repigmentation of hair is possible, although it can be more challenging than restoring skin pigment. If some melanocytes remain in the follicle, treatments such as narrowband UVB therapy, excimer laser, or topical medications can stimulate pigment production. The type of vitiligo also influences outcomes; non-segmental vitiligo tends to respond better to treatment than segmental types. Consistent therapy over time may result in partial or full restoration of hair colour, though some hairs may remain white.
5. Why are eyelashes and eyebrows often affected first?
Eyelashes and eyebrows are frequently among the first hairs to show depigmentation because the follicles in these areas are small, densely packed, and sensitive to autoimmune attacks. Additionally, facial follicles experience frequent exposure to environmental stress, friction from makeup removal, and cosmetic products. These factors, combined with the high contrast between pigmented hair and lighter skin around the eyes, make depigmentation more noticeable in these areas early on.
6. Is beard or facial hair depigmentation common in men?
Yes, men may first notice vitiligo in their beard, moustache, or sideburns. Facial hair follicles are particularly sensitive, and depigmentation can appear even before skin patches are visible. White hairs may appear scattered, in small round patches, or as pale strands emerging from early vitiligo-affected skin. Often, one side of the beard may lighten more noticeably, creating a visual contrast that draws attention. This pattern is clinically significant because it indicates deeper involvement of melanocytes within the follicle.
7. Can hair depigmentation predict overall vitiligo severity?
Hair depigmentation provides some information about follicular involvement but is not a reliable predictor of the overall severity or spread of vitiligo. Some individuals with widespread skin patches may have minimal hair depigmentation, while others with limited skin involvement may notice significant white hairs. Dermatologists interpret hair changes as part of a broader assessment, considering the rate of new skin patch formation, the patient’s history, and other autoimmune risk factors to evaluate prognosis.
8. How do dermatologists diagnose hair-related vitiligo?
Diagnosis involves a careful examination of both hair and surrounding skin. Clinicians often use a Wood’s lamp, which highlights depigmented follicles as bright white even when changes are subtle. Dermatoscopy may also be used to inspect hair shafts and follicles closely. Additionally, medical history including family history, autoimmune conditions, and the pattern of pigment loss helps dermatologists confirm that hair depigmentation is due to vitiligo rather than another hair or skin disorder.
9. What treatment options are available for hair depigmentation in vitiligo?
Treatment strategies for hair depigmentation generally mirror those used for skin vitiligo but are often tailored to follicular involvement. Targeted phototherapy, such as excimer laser, can stimulate pigment production directly in affected hair follicles. Narrowband UVB therapy is effective for larger or multiple areas. Topical corticosteroids or calcineurin inhibitors may reduce autoimmune activity in sensitive regions like eyebrows or eyelashes. In cases where repigmentation is unlikely, cosmetic approaches such as micropigmentation or hair tinting can provide aesthetic solutions while treatment continues.
10. Should I consult a dermatologist if I notice white hairs without skin changes?
Yes, early consultation is recommended. White hairs, especially in areas like the eyebrows, eyelashes, or beard, can signal early vitiligo even before visible skin patches appear. Seeing a specialist allows for early diagnosis, assessment of progression risk, and timely initiation of treatments that may stabilise pigment loss and encourage repigmentation. Additionally, dermatologists can guide patients on monitoring and cosmetic management, helping reduce both emotional distress and potential long-term depigmentation.
Final Thought: Hair Depigmentation in Vitiligo
Hair depigmentation in vitiligo can be surprising and emotionally challenging, particularly when it affects visible areas like eyelashes, eyebrows, or facial hair. While white hairs indicate deeper involvement of pigment cells, they do not necessarily mean rapid disease progression or poor prognosis. Understanding hair depigmentation patterns, recognising early signs, and knowing the available treatment options can help you manage the condition with confidence.
If you’re considering vitiligo clinic in London, contact us at London Dermatology Centre to book a consultation with one of our specialists. Our team can provide personalised assessment and treatment plans to help stabilise pigment loss, support repigmentation, and address the emotional impact of vitiligo.
References:
1. Silverberg, N. B. & Fernandes, J. (2016) “Follicular vitiligo: A report of 8 cases”, International Journal of Dermatology, 55(11), e586–e591. https://pubmed.ncbi.nlm.nih.gov/26830867/
2. Rodrigues, M., Ezzedine, K., Hamzavi, I., Pandya, A.G. & Harris, J.E. (2017) “New discoveries in the pathogenesis and classification of vitiligo”, Journal of the American Academy of Dermatology, 77(1), pp.1–13. https://www.sciencedirect.com/science/article/pii/S0190962216309814
3. “Clinical and Molecular Aspects of Vitiligo Treatments”, (2018) International Journal of Molecular Sciences, 19(5), 1509. https://www.mdpi.com/1422-0067/19/5/1509
4. “Videodermoscopic Changes of the Hair in Vitiligo Lesions in Relation to Disease Duration”, (2022) Dermatology Practical & Conceptual. https://pmc.ncbi.nlm.nih.gov/articles/PMC9681164/
5. “A Prospective Study of Dermoscopic and Ultrastructural Features of Vitiligo‑Associated Leukotrichia”, (2010) Journal of the European Academy of Dermatology and Venereology https://pmc.ncbi.nlm.nih.gov/articles/PMC10749579/