Vitiligo: What are the risks of transmission to children?

Vitiligo is a skin condition during which white patches appear on the skin. All skin types can be affected, from the darkest to the lightest. Vitiligo can take two forms: a segmental form, which is less common and only affects one half of the body, and a non-segmental form, where the entire body can be affected. Often considered a benign disease, vitiligo should not be taken lightly: while it is not dangerous to health, it can have significant psychological repercussions. In this context, it is understandable for prospective parents with vitiligo to question the potential risks of transmission to their children.

Although vitiligo is not considered a hereditary disease, it does have a strong genetic component, enough to concern prospective parents. Moreover, several studies have shown that the risk of developing vitiligo is higher when a first-degree relative, that is, one of the parents, children, or siblings, also has this disease. It seems indeed that the risk of being affected by this depigmentation is 7 to 8 times higher when one has a first-degree relative with vitiligo. Furthermore, it appears that about 20% of people affected by vitiligo have at least one first-degree relative suffering from this disease.

Even though it's not certain, there is a risk of transmitting vitiligo to one's children.

A study conducted with 245 families, where at least one child was affected by vitiligo, sought to evaluate this risk. In total, in 57 families, or 23%, at least one of the parents had vitiligo. Vitiligo is a polygenic disease, meaning it is caused by the alteration of several genes, the rate of transmission from male or female parents to offspring should be more or less comparable. However, here it was observed that the paternal transmission of the disease was significantly higher: 57.5% of transmissions were from father to child, while 42.5% were from mother to child.

Another interesting point from the study: the analysis of parental transmissions revealed that the father transmitted twice as many disease genes to his sons than to his daughters, suggesting a paternal transmission with maternal imprinting. This is a genetic phenomenon where a gene inherited from the father has its expression influenced by the genetic heritage transmitted by the mother.

In the case of vitiligo, this peculiarity could be explained by the slight differences observed between the immune systems of women and men. The oestrogens, female hormones, promote immunological processes directed by CD4+ regulatory T cells and B lymphocytes, while androgens, male hormones, enhance the activity of CD4+ and CD8+ regulatory T cells. As vitiligo is largely mediated by an autoimmune process, the different actions of oestrogens and androgens on the immune system could explain why the transmission of the disease is more often paternal.

If we refer to the scientific literature, the risk of transmitting vitiligo to one's child is around 5 to 6%.