Does vitiligo spread in the winter?

Last Updated on 1st November 2021 by Caroline Haye

Why cold weather may worsen pigment loss

Just three weeks ago I was waxing lyrical about the golden beauty of the countryside in autumn. But the weather reports this week have been warning of snow. And my daily walks over the past few days have seen me swap a thin fleece for my warmest jacket, scarf, hat and gloves as the slide from one season into the next picks up pace. Covering up your skin can be a blessing if you want to hide your white patches. But some people notice that the cold, dark months leave them with even more pigment loss. So, does vitiligo spread in the winter?

I used to look forward to winter

I can remember how I used to feel at this time of year B.R. (Before Repigmentation!). As the first frosts started to bite I used to breathe a sigh of relief. For the next few months at least, I would no longer have to mess about with fake tans. I wouldn’t need to apply a full face of make-up every day. And there would be no more impossible decisions to make about what clothes I could wear to keep cool and fashionable, without exposing my white patches.

Life was about to become less complicated and less stressful. And the greatest luxury of all was that I could almost completely forget about my vitiligo. I could behave and feel the same as everyone else around me. It was as if the summer had worn me out from fretting and focusing on my skin all the time. And now, finally, there would be some respite from it all. Nowadays, I am sad when summer ends. So much so, that I immediately start looking forward to taking a winter break somewhere hot. This is how much my perspective has changed since regaining my normal skin colour. It has changed everything.

So, if you have vitiligo and live in the northern hemisphere, the good news is that you are about to be able to hide your skin under layers of fabric. Not only that, but you will probably also notice the contrast between your normal skin and the vitiligo patches will decrease as the sunless weeks go by. That’s the good news…
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Can cold weather cause vitiligo to spread?

But, on the other side of the coin, you could find you lose more pigment during these months. I remember wondering whether the first sunny days of spring would reveal new lesions. And, more often than not, I discovered that my vitiligo had indeed spread while I wasn’t looking. So, does this mean that the winter is in some way harmful for vitiligo sufferers? And, if so, why?

I have blogged before on the question of sun exposure (see Is Sunshine Good For Vitiligo?). And I mentioned that UV exposure is an important component of every successful vitiligo treatment I have ever come across. (Including my own.) But excessive exposure, resulting in sunburn, can easily cause further pigment loss. So it is a question of moderation.

Of course, it is easy enough to get some sun exposure during the summer. (Well, perhaps that’s debatable if you live in England.) But not everyone has the opportunity in winter – unless we have access to a UV device.  We are simply stuck with the weather we have… Which raises the question of how common vitiligo is in sunnier parts of the world, compared to less sunny parts.

Vitiligo is less severe in sunny climates

​I couldn’t find any evidence to suggest that vitiligo is any more prevalent in one part of the world than any other. But there is research to suggest that vitiligo sufferers who live near the equator tend to have less widespread lesions than those who live further away from it… Suggesting that regular sun exposure is good for controlling the condition.

It is unfortunate that those of us who live in countries with distinct seasons lose all significant sunshine for several months a year. For us, it is either feast or famine, when it comes to UV exposure. So it’s a question of making the most of what sunny weather we have and maybe substituting phototherapy the rest of the time. (Creating our own little equatorial climate!)

It is not difficult to understand why sunshine (in sensible moderation) is good for vitiligo. Everyone knows that it takes UV light to trigger the tanning process. And UV also stimulates the production of vitamin D (in which vitiligo sufferer’s tend to be deficient). But the fact that a lack of UV during winter does the opposite is perhaps not something we think much about.

In a sense, the long, dark winter after the bright summer months is similar to night-time after the day. The relative darkness reduces levels of the hormone serotonin in the brain, raises levels of melatonin  and reduces our production of Melanocyte-Stimulating Hormones (MSH). The cycle of day and night usually regulates these hormonal changes. Serotonin is needed, amongst many other functions, to wake us up. Whereas melatonin helps send us to sleep. But maybe this virtual night-time that we call winter upsets the balance of hormones in some people. And maybe this is what causes some individuals to suffer from Seasonal Affective Disorder, or SAD, some to lack vitamin D and some to lose pigment.

“Hibernation” can make us complacent

Winter also presents another, unrelated, risk for vitiligo sufferers. And that is that we can become so forgetful of our skin that we stop taking care of it. Maybe we forget to avoid potential vitiligo triggers, for example.

Another thing that can go out the window during the winter is a healthy diet. It’s easy to eat like a caveman and consume salads, fresh vegetables and unprocessed meats in summer. But when it’s snowing outside and dark by 4pm we find ourselves craving comfort foods. And many of these are low in key nutrients (often ones that we already lack). Some even contain ingredients that aggravate the digestive system in susceptible individuals… adding to the autoimmune response and causing vitiligo to spread.

It is also a time of year when we reach for heavier garments with necklines and cuffs that can increase friction to the skin. And darker coloured fabrics containing stronger dyes. Both of these things can potentially trigger de-pigmentation if you have vitiligo.

What I am saying is that, whilst the colder weather can be a wonderful opportunity for people with vitiligo to forget their troubles and simply get on with life (which is clearly a very positive thing to do), I believe that it is a mistake to take our eye off the ball altogether. I would suggest that it is just as important during this season to stick with any treatments and protocols that have proved beneficial during the rest of the year. And, ideally, find a way to include UV exposure if at all possible. So here’s to either living somewhere that has winter sunshine, owning a UV lamp or – best of all – taking lots of sunny vacations!

​Above all else, we know that stressing over all of this can also be counterproductive.  So, whatever else you do to keep your vitiligo in check, my advice is to…

… LOOK AFTER YOUR SKIN THIS WINTER!