Conditions
Vitiligo: what it is and how we help
Vitiligo is a long-lasting autoimmune condition in which the skin loses its color, leaving milky-white patches. It is not contagious. The doctor evaluates it by video, tells it apart from other light patches, gives you a lab order to check your thyroid and, for treatments such as light therapy, refers you to a specialist. We see adults and children of all ages.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Red, painful eyes or changes in your vision
- A spot that changes shape, bleeds or grows quickly
- Thoughts of harming yourself (call 988 or Línea PAS)
Help lines
At a glance
Vitiligo
Common symptoms
- Milky-white patches on the skin
- Hair turning white in those areas
- Loss of color inside the mouth or nose
- Other names
- Skin depigmentation
- Usual test
- Blood tests for thyroid and other autoimmune conditions
- Treatment
- Corticosteroid or calcineurin-inhibitor creams and light therapy, with a specialist
On this page(8)
What is vitiligo?
Vitiligo is a chronic autoimmune condition: the immune system attacks and destroys melanocytes, the cells that give skin its color. That leaves patches of skin without pigment.
According to NIAMS, anyone can get it, at any age, but for many people the patches start before age 20. It is more common in people with a family history of vitiligo or with certain autoimmune diseases, such as thyroid disease, type 1 diabetes, psoriasis, rheumatoid arthritis, lupus, Addison's disease or pernicious anemia (a cause of vitamin B12 deficiency).
It is not contagious and not caused by anything you did. White patches can also be something else: tinea versicolor, for example, is a fungal infection treated differently. See fungal skin infection.
How we help with vitiligo by video
You see Dr. Diana Nieves Castro, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. The doctor looks at the patches on camera (you can send photos through the secure link if she asks) and asks when they started and whether vitiligo or autoimmune conditions run in your family.
Because vitiligo goes hand in hand with other autoimmune conditions, the doctor can give you a lab order to check your thyroid and other blood tests at a lab near you, and review the results with you. See hypothyroidism.
Treatments to bring the color back, such as light therapy, laser or surgery, are done by a specialist: if you want to treat it, we refer you. We see children of all ages, with a parent or legal guardian on camera with ID.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text This is how you see a doctor online with us.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer.
Get your plan.
If needed, you get a lab order and a referral to a specialist.
What the visit costs
A vitiligo evaluation is a US$79 doctor visit, the same price for every age, with no membership. If we give you a lab order, reviewing those results with the doctor is a US$49 follow-up visit. The lab charges separately. See prices.
Vitiligo symptoms
The main symptom is loss of color (depigmentation). In non-segmental vitiligo, the most common type, patches usually appear on both sides of the body. In segmental vitiligo they appear on one side or area only, and it usually stops after 6 to 12 months.
- Milky-white patches on the skin
- Hair turning white in those areas
- Loss of color inside the mouth or nose
Treatment and skin care
NIAMS explains that there is no cure for vitiligo, but treatments can be very effective at stopping it and bringing color back. They include corticosteroid or calcineurin-inhibitor creams, light therapy and laser, and, for long-standing cases, surgery. These are chosen and followed with a specialist.
Protect your skin from the sun, especially in Puerto Rico: skin without pigment burns easily. Use sunscreen and covering clothes; see how to avoid sunburn. Makeup, self-tanners or dyes can cover patches if you wish.
Vitiligo can affect how you feel about yourself. Talking with a mental health professional helps; if you are in crisis, call 988 or Línea PAS at 1-800-981-0023.
When to get in-person care or go to the ER
Vitiligo is not an emergency. For your safety, get care or call 911 if you notice:
- Red, painful eyes or changes in your vision
- A spot that changes shape, bleeds or grows quickly
- Thoughts of harming yourself (call 988 or Línea PAS)
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Is vitiligo contagious?
Can vitiligo be cured?
Why test my thyroid if I have vitiligo?
Are white patches always vitiligo?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (3)
- Vitiligo (NIAMS, NIH) (opens in a new tab) (accessed 2026-10-02)
- Vitiligo: diagnosis, treatment, and steps to take (NIAMS, NIH) (opens in a new tab) (accessed 2026-10-02)
- Pernicious anemia (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)