Is there a specific dietary regimen to follow for individuals with vitiligo?

The vitiligo is an acquired, non-communicable skin disorder characterised by a selective loss of melanocytes, the pigment-producing epidermal cells responsible for melanin production. This depigmentation appears as white patches of varying size, which can affect both the skin and the mucous membranes, and sometimes even hair. The prevalence of vitiligo is estimated to affect between 0.5 and 2% of the global population, regardless of sex or ethnic origin. The mechanisms involved in its development are multifactorial, and vitiligo is considered an autoimmune disease in which the immune system targets and destroys melanocytes. However, this autoimmune response appears to be triggered by a combination of factors — genetic, environmental, neurochemical and metabolic — that interact closely.

In this context, many individuals affected by vitiligo question the effects of their dietary regimen.

• A gluten-free diet for vitiligo patients?

  First of all, some studies suggest that gluten may influence the development of vitiligo in certain patients. Indeed, in people with coeliac disease, an autoimmune disorder triggered by gluten ingestion, this protein elicits an excessive immune response. This can lead to intestinal damage, but also a systemic inflammation affecting other organs. If this inflammation becomes chronic, it can disrupt immune balance and promote further autoimmune reactions, potentially exacerbating vitiligo. This is why a gluten-free diet could be worth considering.

• Vitamin supplementation in patients with vitiligo?

  Several studies have highlighted an association between vitiligo and certain vitamin deficiencies, particularly in vitamin D. This vitamin, synthesised in the skin under the influence of UVB rays, plays an important role in immune regulation, melanocyte differentiation and the modulation of oxidative stress. An Egyptian study of 40 patients and 30 healthy individuals showed that subjects with non-segmental vitiligo exhibited significantly lower serum levels of vitamin D than controls. Another study of 150 patients with vitiligo confirmed these findings: individuals not receiving UV phototherapy had lower vitamin D levels than control subjects. Adequate dietary intake of vitamin D therefore appears essential for patients with vitiligo.

  In contrast, the results for vitamins C and E, both antioxidants, remain contradictory. A meta-analysis involving 570 cases of vitiligo and 580 controls found no significant difference in serum concentrations of these vitamins between the two groups. However, some smaller-scale studies have observed relative deficiencies, suggesting a possible role for antioxidant status in the pathophysiology of vitiligo.

  These observations prompted interest in the therapeutic potential of vitamin D supplementation. A pilot study conducted in vitamin D-deficient adults demonstrated that high-dose oral supplementation (35 000 IU/day for six months) achieved partial repigmentation (25 to 75%) in 88% of patients (14 out of 16). Similarly, a prospective study in 14 children aged 6 to 17 years with both vitiligo and vitamin D deficiency reported a significant reduction in depigmented areas when vitamin D was combined with topical tacrolimus, compared with tacrolimus alone.

• Trace elements: beneficial in cases of vitiligo?

  Recent research and several meta-analyses have highlighted the potential role of certain trace elements, notably zinc and copper, in the pathophysiology of vitiligo. A meta-analysis comprising 41 studies conducted between 1970 and 2022 demonstrated that patients with vitiligo (n = 3,353) had significantly lower serum levels of zinc and copper than control subjects (n = 10,638), while their selenium levels were higher. These findings suggest a global imbalance of trace element metabolism in individuals with vitiligo, which may contribute to melanocyte destruction.

  Zinc plays a crucial role in maintaining cutaneous homeostasis, modulating the immune response and supporting the activity of antioxidant enzymes. A zinc deficiency could thus exacerbate the oxidative stress and promote melanocyte damage, intensifying depigmentation. Copper, meanwhile, serves as a cofactor for tyrosinase, an enzyme involved in melanogenesis. Reduced copper availability can impair melanin synthesis and contribute to the hypopigmentation observed in vitiligo.

  A cross-sectional study conducted in India involving 60 patients with vitiligo and 60 controls revealed a significant positive correlation between copper levels in affected and unaffected areas, although mean serum concentrations did not differ significantly. Meanwhile, another study of 100 patients and 60 healthy controls reported lower serum zinc and higher copper levels in vitiligo patients. These findings underscore the complexity of the roles of these two trace elements, suggesting that the Cu/Zn imbalance may influence melanocyte survival and disease progression.

  Thus, although these elements play essential roles in pigmentation and cellular protection, their interactions and the effects of supplementation still require in-depth investigation.

• The emerging role of prebiotics and probiotics in vitiligo.

  Rising interest in the use of prebiotics and probiotics in patients with vitiligo arises from recent discoveries surrounding the gut–skin axis, a bidirectional system involved in several inflammatory and autoimmune skin disorders. Studies have revealed alterations in the intestinal microbiota in these patients, a phenomenon known as dysbiosis, likely linked to mitochondrial damage and hyperactivation of the innate immune response. These intestinal imbalances may amplify systemic oxidative stress and promote melanocyte destruction.

  Prebiotics and probiotics act in a complementary way to restore this balance. Prebiotics, such as certain dietary fibres or fermented juices, promote the growth of beneficial gut bacteria, whereas probiotics directly introduce microorganisms capable of strengthening the intestinal flora. There are also combined formulations, known as synbiotics, which pair the two to potentiate their respective effects. Together, these compounds aim to stabilise the intestinal barrier, modulate systemic inflammation and rebalance the immune response, all mechanisms likely to favourably influence the progression of vitiligo.

  Certain specific bacterial strains have demonstrated compelling immunological and antioxidant potential. The strain Lactobacillus rhamnosus has been shown to stimulate regulatory T cell activity, thereby helping to reduce the autoimmunity associated with melanocyte destruction. Lactobacillus plantarum, meanwhile, exhibits antioxidant properties capable of attenuating circulating oxidative stress markers, which may be beneficial in vitiligo. Finally, Bifidobacterium bifidum supports intestinal barrier integrity by limiting intestinal permeability and, consequently, the dissemination of systemic inflammatory mediators that could exacerbate the disease.

  These experimental data suggest that the intestinal microbiota may play an indirect but decisive role in regulating skin immune and oxidative responses. However, it is important to note that no clinical study to date has evaluated the efficacy of prebiotics and probiotics in patients with vitiligo. The results obtained are primarily based on experimental models or on extrapolations from other cutaneous autoimmune diseases, such as psoriasis or eczema.

• The impact of a high-fat diet on the progression of vitiligo.

  Dietary fats play a pivotal role in the modulation of immune and inflammatory responses, two key mechanisms in the pathogenesis of vitiligo. In particular, polyunsaturated fatty acids such as omega-3 and omega-6 contribute to the regulation of cytokine production and lipid mediators of inflammation, notably prostaglandins and leukotrienes. These membrane lipids directly influence immune cell activity and oxidative stress, both processes involved in the destruction of melanocytes.

  A study involving 100 patients with vitiligo and 110 healthy controls found that affected subjects exhibited a higher intake of saturated fatty acids and a lower intake of long-chain polyunsaturated fatty acids, notably eicosapentaenoic acid and docosahexaenoic acid. These two omega-3 fatty acids, derived from oily fish or marine oils, are recognised for their anti-inflammatory properties and their ability to regulate the expression of adaptive immunity genes. Insufficient consumption of these protective lipids could therefore promote an enhanced inflammatory response and contribute to the progression of depigmented lesions. Furthermore, the study also highlighted that a high total fat intake significantly increased the risk of vitiligo, emphasising the importance of balanced fat consumption.

  Metabolic correlations were examined further in another study conducted on 60 patients with vitiligo compared with 60 controls. The results showed a significantly higher body mass index in the patients, as well as an association between increased consumption of fats and oils and more severe vitiligo, particularly on the trunk. These observations suggest a potential link between lipid imbalances and the clinical severity of vitiligo.

  In conclusion, not all fats are created equal : unsaturated fatty acids, such as omega-3s found in oily fish (salmon, mackerel, sardine), flax seeds, walnuts and rapeseed or chia oils, promote an anti-inflammatory environment. Conversely, saturated fatty acids present in fatty meats, butter, fried foods and ultra-processed products tend to amplify oxidative stress and inflammation, potentially exacerbating melanocyte vulnerability.

• Could carbohydrates impact the progression of vitiligo?

  Diets that are excessively rich in carbohydrates and poor in protein could influence the pathophysiology of vitiligo by favouring a dysregulated autophagy, a cellular self-destruction mechanism triggered by prolonged protein deficiency. This abnormal autophagy, observed in several autoimmune disorders, could contribute to the degeneration of melanocytes by increasing oxidative stress and local inflammatory signalling.

  A retrospective study evaluated the impact of a low-carbohydrate, high-protein diet in patients with vitiligo at various stages of the disease. Both those at an early stage (n = 20) and those with a more stable form (n = 10) showed an improvement in vitiligo severity after six months and at one year of follow-up when this diet was combined with topical therapy. These results suggest that it is important to have a good carbohydrate/protein balance, especially from lean meats, legumes and eggs, particularly for individuals with vitiligo.

Note : In addition to the vitamins and minerals already mentioned, other nutrients, such as green tea or turmeric, may also have a beneficial effect on vitiligo. Their antioxidant and anti-inflammatory properties could help to protect melanocytes and slow the progression of the condition.

In short, whether or not one suffers from vitiligo, the dietary recommendation is the same: to maintain a balanced and varied diet. It may be beneficial to consult a doctor to identify any nutrient deficiencies and, if necessary, receive a prescription for supplements, but self-supplementation should be avoided.

• NASHAWATI R. & al. The role of diet and supplements in vitiligo management. Dermatologic Clinics (2017).

• LOTTI T. & al. Functional nutrition as integrated approach in vitiligo management. Dermatologic Therapy (2018).

• INGOLE N. & al. Diet and vitiligo: The story So far. Cureus (2022).

• KANDA N. & al. Dietary habits in adult Japanese patients with vitiligo. The Journal of Dermatology (2024).

• LIPNER S. R. & al. Dietary interventions, supplements, and plant-derived compounds for adjunct vitiligo management: A review of the literature. Nutrients (2025).