Are sensitive skin types more at risk of developing vitiligo?

A fragile skin can be defined as skin whose cutaneous barrier is compromised, making it particularly vulnerable to external aggressions, such as wind, temperature changes, allergens, or pollution. Individuals with fragile skin often exhibit redness and skin irritations and are more prone to developing local inflammations, which can lead to an alteration in the skin's structure and more extensive skin reactions. Having fragile skin can, for example, increase the likelihood of developing contact eczema.

The fragility of the skin does not cause vitiligo but could act as a triggering factor in predisposed individuals, by exacerbating an already latent phenomenon, of an autoimmune or genetic type.

Indeed, vitiligo is often linked to hereditary factors. Several studies have shown that mutations in certain genes involved in immune regulation, apoptosis, or even the biology of melanocytes can increase susceptibility to this disease. Furthermore, immunity is at the heart of vitiligo, where the immune system attacks and erroneously destroys melanocytes, the cells that synthesize melanin. The absence of this pigment in the epidermis leads to the formation of white spots on the skin. The immunological component of vitiligo is also strongly suggested by the fact that this skin condition is often accompanied by other autoimmune diseases, such as hypothyroidism, rheumatoid arthritis, or type 1 diabetes.

However, it is important to note that the onset of vitiligo is not exclusively linked to genetics or autoimmunity: external factors can also play a role. As mentioned earlier, individuals with sensitive skin are particularly susceptible to skin traumas, such as burns, cuts, or even sunburns. These irritations can trigger a Koebner phenomenon, a reaction that corresponds to the reproduction of a pre-existing skin disease on a previously healthy skin area following a trauma. This phenomenon is particularly observed in individuals with vitiligo.

It seems plausible that sensitive skin, with its compromised skin barrier, may be more susceptible to the Koebner phenomenon, and thus the emergence of new vitiligo spots. However, this would only apply to individuals with a predisposition to vitiligo. Yet, to date, the link between sensitive skin and the onset of vitiligo has not been scientifically established. The idea that skin sensitivity could be a triggering factor for vitiligo in predisposed individuals by exacerbating the risk of the Koebner phenomenon is, for now, only a hypothesis.