What is happening in the skin
The cells responsible for skin colour are called melanocytes. In vitiligo the immune system attacks and destroys them. Where there are no melanocytes there is no pigment: a white patch with well-defined borders appears, which does not itch, hurt or scale.
It usually starts on the hands, around the mouth and eyes, armpits, groin and areas of friction or trauma. On darker skin the contrast is far greater — which is why the psychological and social impact in Mexico is considerably higher than in fair-skinned populations. That is not a minor detail: it is part of the clinical problem.
What must be said immediately
It is not contagious. Not by contact, not by sharing clothes, not in any way. It is autoimmune.
It is not a fungus and antifungals do absolutely nothing. Mistaking it for tinea is common and costs months.
It is not dangerous to your physical health, but skin without pigment burns easily: photoprotection is mandatory, not optional.
It is associated with other autoimmune diseases, particularly of the thyroid. That is why initial work-up usually includes it: one of the reasons vitiligo needs a doctor rather than internet advice.
What to genuinely expect
The goal of treatment is twofold: halt the spread and, where possible, repigment. Both are achievable, with realistic expectations.
What responds best: lesions on the face and neck, recent ones, and those in areas rich in hair follicles — because pigment repopulates from the follicle, which is why repigmentation is usually first seen as dots around the hairs.
What responds worst: lesions on hands, fingers, feet and lips (few follicles), and old, stable patches of many years. Here honesty is required: complete repigmentation may not be a realistic goal, and promising it is cruel.
Repigmentation is slow: measured in months, not weeks. Stopping at six weeks “because it is not working” is the commonest cause of failure.
How it is treated
Prescribed and supervised in the dermatology consultation. No drug names here:
- Phototherapy (narrowband UVB): still the central tool in extensive disease, and among the most effective treatments available. In a cabin, on a schedule. See phototherapy.
- Topical therapy under prescription for localised lesions.
- Strict photoprotection: depigmented skin has no defence against the sun. Keeping the surrounding skin from tanning also reduces the contrast.
- Thyroid screening and other autoimmune work-up where appropriate.
- Psychological support where needed. This is not a polite add-on: in a visible disease, emotional impact is part of the clinical picture, and treating it is treating the patient.
Who handles it here
Diagnosis and treatment of vitiligo belong to the clinic’s dermatology consultation — the same one with which Dr. Francisco Arellano Ocampo founded the house in 1971. Dr. Arístides Arellano is a plastic surgeon, not a dermatologist: his contribution here is surgical and reconstructive, and the disease itself is managed in the consultation. Book at dermatology consultation.
Dr. Arístides Arellano is a plastic surgeon holding a specialty licence: he practises under a Mexican medical licence (D.G.P. 1125959) and a specialty licence in Plastic & Reconstructive Surgery (0002008), both issued by the Directorate General of Professions (DGP), which reissued his certificate of professional standing in 2025. His career began before Mexico’s present-day specialty-board system existed: he belongs to the founding generation of plastic surgery in Puebla, the second generation of a surgical tradition started in 1971 by Dr. Francisco Arellano Ocampo. Trust is verified, not promised: both licences are public and anyone can look them up in the DGP’s National Registry of Professionals.
Risks and expectations
Every medical treatment —topicals, peels and energy-based devices included— carries risk and requires a prior assessment. In darker skin (Fitzpatrick IV–VI, the most common phototypes in Mexico) a poorly indicated procedure can darken the patch instead of lightening it. Results may vary according to each patient, their phototype and their individual triggers.
Trust is verified, not promised. All 210 scanned documents —degree, licences, diplomas, publications and certificates, from 1977 to 2025— are open in Dr. Arístides Arellano’s credential archive, alongside an explanation of the difference between a specialty licence and a board certification.
Control plan
- DiagnosisDermatology consultation. Tinea ruled out, thyroid screened.
- Goal 1Halt the spread of lesions.
- Goal 2Repigment where possible. Face and neck respond best.
- PhototherapyNarrowband UVB in a cabin, on a schedule. The central tool.
- PaceMonths, not weeks. Stopping early is the #1 cause of failure.
- AlwaysStrict photoprotection. Skin without pigment has no defence.
Frequently asked questions
Is vitiligo contagious?
No, in no way. It is an autoimmune disease: the immune system destroys the cells that make pigment. It is not transmitted by contact, or by sharing clothes, towels or a pool. It is one of the false beliefs that causes the most suffering to those who have it, and it is worth saying out loud.
Is it a fungus?
No, and antifungals do absolutely nothing. Mistaking vitiligo for tinea is common and leads to months of useless treatment. Diagnosis is made in the dermatology consultation, which also rules out other causes of white patches.
Can the colour come back?
In many cases yes, but with realistic expectations. Lesions on the face and neck, recent ones, and those in areas rich in hair follicles respond best, because pigment repopulates from the follicle. Hands, fingers, feet and lips respond worst, as do old, stable patches of many years, where complete repigmentation may not be a realistic goal.
How long does treatment take?
Months, not weeks. Repigmentation is slow and is usually first seen as dots of colour around the hairs inside the patch. Stopping at six weeks “because it is not working” is the commonest cause of failure: the treatment needs time to show whether it helps.
Is vitiligo associated with other diseases?
Yes, particularly other autoimmune diseases, and notably those of the thyroid. That is why the initial work-up usually includes a thyroid assessment. It is one of the reasons vitiligo needs to be seen by a doctor: it is not only a question of skin colour.
Every case is different. Discuss yours in a personal consultation.
Book a consultation on WhatsAppEvery figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.
Educational content; it does not replace a medical consultation. Results may vary from person to person.