Japanese study finds vitiligo has a strong impact on daily life and mental health

Japanese patients with vitiligo experienced lower quality of life and higher levels of anxiety and depression, especially when the disease affected their social life or had relapsed, according to a study published in November in The Journal of Dermatology.

Vitiligo is a disease that causes patches of skin to lose their natural color because of the loss of pigment-producing cells. It affects at least 1% of people worldwide and can develop at any age, with men and women equally likely to get it. In Japan, vitiligo is less common than in some other countries, affecting about 0.5% of the population.

Beyond the changes in skin color, vitiligo can affect daily life significantly and emotional well-being. Those with the condition often experience stress, anxiety and depression, and their social life and self-confidence can be affected.

How much vitiligo impacts a person depends on factors such as age, sex, the size of affected areas and how long they’ve lived with the condition.

Outside of these effects, research looking at the experiences of those with vitiligo in Japan has been limited. Most past research included only small groups or didn’t explore how personal and disease characteristics affect quality of life and mental health.

To better understand this, researchers of Kindai University at Nara Hospital and of Pfizer Japan conducted a web-based survey of patients with vitiligo in Japan between October and November 2024. They aimed to find out how vitiligo affects daily life, mental health and overall quality of life, and which patient and disease factors contribute to a greater impact.

Participants were adults aged 18 to 79 years who said a doctor had diagnosed them with vitiligo. Those with other serious diseases were not included to avoid confusing results.

The survey collected information about symptoms, disease duration and affected body areas. Quality of life was measured using the SF-12v2, which looks at physical, social and emotional health compared to the general Japanese population. Researchers also used the Dermatology Life Quality Index (DLQI) to see how skin disease affects daily life and the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression.

Additionally, data were analyzed to see how disease duration, body surface area affected, age, sex and other factors were linked to quality of life and mental health. Comparisons between the different survey scores were also examined.

Out of 271 adults in Japan with vitiligo, about half were male and half were female, with an average age of 45 years. Most participants had light skin and over half had vitiligo for more than five years. The face and hands were the most common areas affected and nearly a third had experienced a relapse after symptoms improved. About a third were receiving treatment at the time of the survey.

Researchers used three main tools to measure quality of life and mental health. Compared with Japanese population norms, patients had lower scores in social functioning, role activities and emotional health.

The DLQI showed that 62.7% of patients reported at least some effect on their daily life, with an average score of 5.3. Anxiety and depression resulted in 19% of participants who showed definite signs of anxiety or depression.

The study also found that disease characteristics affected outcomes. Patients with moderate disease duration or body surface area involvement reported the highest levels of psychological distress. Younger age, shorter disease duration, a family history of vitiligo and relapse were linked to worse quality of life and more anxiety or depression.

Based on the study design and results, the overall study provides insights into how vitiligo affects quality of life and psychological well-being in Japanese adults. One strength is that the researchers used well-known tools such as the SF-12v2, DLQI and HADS, which makes it easier to compare these results with other studies and with the general Japanese population.

The study also looked at how age, how long a person has had vitiligo, how much of the body is affected, relapse and family history relate to quality of life and mental health. These findings help show which factors are most linked to worse outcomes.

However, the study has limits. It relied on patients reporting their own diagnoses and disease severity. It didn’t include children and many adults in the survey had only small areas of skin involved, which may make the results less generalizable. Also, the tools used were not made specifically for vitiligo and the online survey design may have introduced selection bias.

The authors suggest ongoing vitiligo management even for mild cases and stress addressing mental health support early in the disease diagnosis.