Skin of Color Savvy: Understanding Vitiligo in Skin of Color and Beyond

Welcome to Skin of Color Savvy: The Art and Science of Treating Patients of Color!

In this Savvy Conversations episode of Skin of Color Savvy: The Art and Science of Treating Patients of Color, 2 leading voices in vitiligo care—Iltefat Hamzavi, MD, FAAD, the co-founder and past president of the Global Vitiligo Foundation, and Tasneem F. Mohammad, MD, FAAD, staff physician in the Department of Dermatology at Henry Ford Health—engaged in a thoughtful discussion on the clinical, cultural, and psychosocial complexities of managing vitiligo across diverse patient populations.

Skin of Color Savvy is a podcast by the Skin of Color Society (SOCS) and produced by HCPLive. Hamzavi opens this episode of the podcast by exploring how vitiligo manifests differently in patients with skin of color. In darker-skinned patients, depigmented patches are often more striking, heightening visibility and stigma, while in lighter-skinned individuals, lesions may require Wood’s lamp examination for full delineation. Mohammad shares clinical anecdotes highlighting how cultural pressures, particularly around marriage and employment, amplify the disease’s burden, with patients in some communities facing broken engagements or job discrimination because of their condition.

The discussion explores data from the VALIANT study, which documented strikingly high rates of depression and anxiety among vitiligo patients worldwide—up to 89% in India and 50% in the US—underscoring that vitiligo is far more than a cosmetic issue. Both experts stress that dismissing the disease as “cosmetic” or claiming no treatments exist can profoundly harm patients. Instead, clinicians should validate patient concerns, tailor management to quality-of-life impact, and offer referrals to specialized centers when appropriate.

Diagnostic pitfalls are also covered, including confusion with pityriasis alba, nevus depigmentosus, and hypopigmented mycosis fungoides. Mohammad notes that biopsy, while not typically required, may be essential in equivocal cases, and emphasizes collaboration with dermatopathologists. They also highlight novel diagnostic tools such as the “stamp test” with excimer laser to distinguish vitiligo from mimickers.

When it comes to treatment, Mohammad advocates for combination approaches—topicals with phototherapy, oral agents for stabilization, and surgery for stable localized disease—while tailoring strategies to patient goals and expectations. Education is critical, particularly for communities with medical mistrust or unrealistic expectations about rapid repigmentation. Beyond pharmacologic and procedural therapies, both physicians emphasize the importance of support groups like BE STRONG and community-building initiatives through the Global Vitiligo Foundation, which provide patients with agency and emotional resilience.

The conversation concludes with practical takeaways: vitiligo requires time, empathy, and individualized care. Clinicians are encouraged to validate concerns, screen for mental health comorbidities, and connect patients to resources. As Mohammad reminds listeners, vitiligo is not just skin deep—the impact on identity, relationships, and mental health must remain central to care.

To learn more about SOCS’s mentorship programs and initiatives, visit Skin of Color Society.

Editor's note: This episode was edited with the help of AI tools.