Can a gluten-free diet reverse vitiligo?

Last Updated on 25th October 2023 by Caroline Haye

Why this is an important question to ask

Can a gluten-free diet reverse vitiligo? It’s a question that crops up quite regularly on vitiligo forums… A simple enough one, you would think. And yet, no one seems to have a definite answer or verifiable proof one way or the other.

Most doctors take the view that gluten consumption is only a problem if you have coeliac disease. But, if this is true, why do we hear of so many individuals who claim their vitiligo (or other chronic condition) is adversely affected by eating gluten… And improves when they stop. Surely they don’t all have coeliac disease. (Or do they?)

The fact is that there is not enough scientific evidence available either to confirm or disprove a link between gluten and pigment loss. So I am not going to spend too long trying to argue the point here. All I really want to do in the following paragraphs is this… To explain why I think that, for anyone with vitiligo, it is important to ask the question in the first place and then make a balanced decision on what to do about it. But first things first…

What is gluten?

Gluten is a natural substance, found primarily in wheat, barley and rye. It is the protein that gives structure to these grains. So most breads and flours contain gluten by default. But, because it is so good at creating texture and cohesion in all sorts of recipes, gluten is also extracted and added to a wide range of processed foods…Meaning that the majority of ready-to-eat groceries and restaurant meals are likely to contain it in one form or another.

Is gluten bad for you?

Gluten isn’t bad for you in the sense of being toxic or inherently unhealthy. In fact, it is highly nutritious in itself. But it is a difficult protein to digest. Actually, the human digestive system can’t completely break it down, meaning that some undigested gluten ends up in the small intestine. This does not cause noticeable health issues for most people. And it would probably not pose any problem at all if we only ate a small quantity of gluten on a daily basis. But the fact is that bread, pastry and processed foods have become the backbone of the modern western diet… Which may account for why so many more people seem to have a problem with it today, compared to past generations who would have consumed a lot fewer baked goods and virtually no processed foods.

The health problems that gluten can cause range from minor gluten intolerance to full-blown coeliac disease. And evidence strongly suggests these are on the increase. In fact, diagnosed cases of coeliac disease have been increasing by 7.5% year on year in the past several decades across the industrialised western world, according to recent studies.

What is coeliac (celiac) disease?

Coeliac disease is an autoimmune condition that develops when the body’s defensive system reacts to the presence of gluten by mistakenly attacking healthy tissue. This damages the surface of the small bowel and interferes with the body’s ability to take in nutrients from food. Not surprisingly, it can cause a lot of unpleasant symptoms. (Ranging from digestive discomfort to headaches and fatigue.) Not only that, but it causes nutritional deficiencies… Which, in turn, lead to other illnesses too, including a range of skin disorders. One of the more useful skin manifestations that can occur is an intensely itchy blistering rash called dermatitis herpetiformis which acts as a kind of “gluten warning system” that may alert you to the fact that you have accidentally consumed gluten.

As with vitiligo, there is no cure for the condition, so the only way to keep it in check is to cut out gluten consumption. Failing to do this makes the condition worse over time and can affect every system in the body. Consequences include vitamin B12 and folate deficiency (which, interestingly are also common in vitiligo) and even bowel cancer.

Unfortunately, coeliac disease and non-coeliac gluten intolerance are not the easiest conditions to diagnose. Many of the symptoms can mistakenly be attributed to other conditions and the reliability of testing is quite poor. Sometimes the only way to be sure you have the condition is to cut out gluten and monitor the effects. (And this can take months or even years, given the time needed for the intestinal lining and other internal processes to heal). So a lot of sufferers are unaware that they have it. Which is really unfortunate because it is a serious disease which will wreck your health if you do nothing about it.

Is there a link between coeliac disease and vitiligo or not?

As yet, no proven, direct link that I know of has been established. In fact, vitiligo does not even make it onto the list of related conditions and diseases on the Celiac.org website. (However, most other common autoimmune conditions are listed, so I’m guessing this is just an oversight.) The autoimmune element of both conditions would be the obvious similarity. Both involve an inappropriate immune response that damages healthy cells. In the case of coeliac disease, it is the lining of the intestines that is targeted, whereas in vitiligo it is the pigment-producing melanocyte cells. But the only relevance of this seems to be that having one autoimmune condition makes it more likely you will develop another. So you have a statistically higher chance of having more than one.

The other possible connection between the two conditions is a genetic one. Paragraph 11 in this research paper entitled The Skin in Celiac Disease Patients: The Other Side of the Coin suggests that a common signal in the immune system may well be triggered by a gluten rich diet in vitiligo as well as in coeliac disease.

So should I cut out gluten if I have vitiligo?

If you want an answer to this question, a good starting point is to get a test. If you test positive for either non-coeliac or coeliac gluten intolerance, then the decision is easy. You will need to stop eating gluten. Simple as that.

But what if you test negative (since tests are far from conclusive) but still suspect gluten is causing you problems? Then all you can do is use your judgement and make our own decision. Your doctor will not be in a position to make that decision for you. When it comes to problematic conditions like vitiligo, the medical profession cannot micromanage every aspect of our diet and lifestyle for us. So it is up to each of us to minimise our own exposure to potential triggers (See Vitiligo Susceptibility).

Bear in mind that testing for wheat allergy may also be helpful. Noticing an improvement in your health when you cut out bread and pastry does not necessarily mean you are gluten intolerant. It could mean you are allergic to wheat. And any untreated allergy will cause inflammation that could affect your vitiligo. So you may discover that you can eat gluten but need to avoid wheat.

Reasons to go gluten-free

Whether a direct link between gluten consumption and vitiligo exists or not, they do share certain genetic and autoimmune factors in common. And, as mentioned before, we do know that having one autoimmune condition increases the odds of having another. So, maybe the question comes down to this: am I willing to take the chance that gluten is damaging my health (and my skin) without my knowing about it?

If not, then cutting it out, if only as a preventative measure or a limited-time experiment, makes perfect sense. If, after a period of time, you begin to feel better or your vitiligo improves, you will know you made the right choice. And you will have done your health no harm at all… As long as you take the opportunity to eat mainly fresh, healthy foods, rather than too many of the highly processed gluten-free baked goods on the market these days.

At the very least, I hope that this article has helped you to appreciate (if you didn’t already) that all the fuss over gluten should not be dismissed out of hand as an urban myth or social media fuelled fad. No doubt there is an element of that. But gluten intolerance and coeliac disease are seriously harmful conditions and are on the rise. For people with these conditions eating a gluten-free diet is not a lifestyle choice. It is a medical necessity. So it’s worth at least considering the chances and implications of being in that category yourself.

A personal note

I did not even think of testing for gluten intolerance until several years after my re-pigmentation. And when I finally did, the test results were negative. I decided some time later to try eliminating gluten from my diet anyway, purely as an experiment. I have always struggled with digestive problems and I had also started to develop a “gluten rash” on my elbows every time I ate any gluten-containing ingredients. So going gluten-free seemed like a good idea. Sure enough, the rash stays away as long as I avoid gluten. I also feel better generally. And my perception is that the few remaining under-pigmented areas I have left have improved further since making this change about 18 months ago. So this is why I decided to share my thoughts and experiences on the whole gluten question in this article. I hope you find them helpful.