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

The vitiligo is an acquired, noncontagious skin disorder characterized by a selective loss of melanocytes, the pigment-producing cells of the epidermis responsible for melanin production. This depigmentation manifests as the appearance of variably sized white patches that can affect the skin as well as mucous membranes, and sometimes even hair. The prevalence of vitiligo is estimated to range between 0.5% and 2% of the global population, with no predilection for sex or ethnic origin. The mechanisms involved in its development are multifactorial, but vitiligo is considered an autoimmune disorder in which the immune system targets and destroys melanocytes. However, this autoimmune reaction appears to be triggered by a combination of factors — genetic, environmental, neurochemical, and metabolic — that interact closely.

In this context, many individuals living with vitiligo question the impact of their dietary regimen.

• A gluten-free diet for patients with vitiligo?

  First, some studies suggest that gluten could influence the development of vitiligo in certain patients. Indeed, in individuals with celiac disease, an autoimmune disorder triggered by gluten ingestion, this protein triggers an excessive immune response. This can lead to intestinal damage, but also to a systemic inflammation affecting other organs. If this inflammation becomes chronic, it can disrupt immune balance and promote other autoimmune reactions that may exacerbate vitiligo. Therefore, a gluten-free diet could be of interest.

• Vitamin supplementation in patients with vitiligo?

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

  However, the findings regarding vitamins C and E, both antioxidants, remain contradictory. A meta-analysis pooling 570 vitiligo cases and 580 controls found no significant difference in serum levels of these vitamins between the two groups. Nonetheless, some smaller studies have observed relative deficiencies, suggesting a possible involvement of antioxidant status in the pathophysiology of vitiligo.

  These observations led to exploring the therapeutic potential of vitamin D supplementation. A pilot study conducted in vitamin D–deficient adults showed that high-dose oral supplementation (35,000 IU/day for six months) produced partial repigmentation (25 to 75%) in 88% of patients (14 of 16). Similarly, a prospective study of 14 children aged 6 to 17 years presenting 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: are they beneficial for 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 pooling 41 studies conducted between 1970 and 2022 showed 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 in trace element metabolism in individuals with vitiligo, which may contribute to melanocyte destruction.

  Zinc plays a crucial role in maintaining skin homeostasis, modulating the immune response, and the activity of antioxidant enzymes. A zinc deficiency could thus exacerbate the oxidative stress and promote melanocyte damage, intensifying depigmentation. Copper, in turn, is a cofactor for tyrosinase, an enzyme involved in the melanogenesis process. A reduction in its availability can disrupt melanin synthesis and contribute to the hypopigmentation observed in vitiligo.

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

  Thus, although these elements play essential roles in pigmentation and cellular protection, their interactions and the impact of supplementation still require further extensive research.

• The emerging role of prebiotics and probiotics in vitiligo.

  The growing interest in the use of prebiotics and probiotics in patients with vitiligo stems from recent findings on the gut-skin axis, a bidirectional system involved in various inflammatory and autoimmune skin disorders. Studies have highlighted alterations in the intestinal microbiota in these patients, a phenomenon referred to as dysbiosis, which may be associated with mitochondrial damage and hyperactivation of the innate immune response. These intestinal imbalances could exacerbate systemic oxidative stress and promote melanocyte destruction.

  Prebiotics and probiotics act in a complementary fashion to restore this balance. Prebiotics, such as certain dietary fibers or fermented juices, promote the growth of beneficial gut bacteria, while probiotics directly deliver microorganisms capable of reinforcing the intestinal flora. There are also combined formulations, known as synbiotics, which merge the two to potentiate their respective effects. Together, these compounds aim to stabilize the intestinal barrier, modulate systemic inflammation, and rebalance the immune response, all mechanisms likely to favorably influence the progression of vitiligo.

  Some specific bacterial strains have demonstrated notable immunological and antioxidant potential. The strain Lactobacillus rhamnosus has been shown to stimulate regulatory T-cell activity, thereby helping to reduce the autoimmune response associated with melanocyte destruction. Lactobacillus plantarum, for its part, exhibits antioxidant properties that can attenuate circulating oxidative stress markers, which may be beneficial in vitiligo. Finally, Bifidobacterium bifidum supports intestinal barrier integrity by limiting gut permeability and, consequently, the systemic spread of inflammatory mediators that could exacerbate the disease.

  These experimental data suggest that the gut microbiota may play an indirect yet decisive role in regulating cutaneous 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 findings largely rely on experimental models or on extrapolations from other autoimmune skin diseases, such as psoriasis or eczema.

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

  Dietary fats play a critical role in the modulation of immune and inflammatory responses, two central 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, two processes involved in melanocyte destruction.

  A study conducted on 100 vitiligo patients and 110 healthy controls revealed that the affected subjects had a higher consumption of saturated fatty acids and a reduced intake of long-chain polyunsaturated fatty acids, notably eicosapentaenoic acid and docosahexaenoic acid. These two omega-3 fatty acids, derived from fatty fish or marine oils, are recognized for their anti-inflammatory properties and their ability to regulate the expression of genes involved in adaptive immunity. Insufficient consumption of these protective lipids could therefore promote an increased inflammatory response and contribute to the progression of depigmented lesions. Moreover, the study also highlighted that a high total lipid intake significantly increased the risk of vitiligo, emphasizing the importance of balanced fat intake.

  Metabolic correlations were further explored in another study involving 60 vitiligo patients compared with 60 controls. The results demonstrated a significantly higher body mass index in patients, as well as an association between increased consumption of fats and oils and more severe vitiligo, particularly on the trunk. These findings 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 present in fatty fish (salmon, mackerel, sardine), flaxseeds, walnuts, and canola or chia oils, promote an anti-inflammatory environment. In contrast, saturated fatty acids found in fatty meats, butter, fried foods, and ultra-processed products tend to exacerbate oxidative stress and inflammation, potentially aggravating melanocyte vulnerability.

• Is there an impact of carbohydrates on the progression of vitiligo?

  Diets that are too high in carbohydrates and low in protein may influence the pathophysiology of vitiligo by promoting a dysregulated autophagy, a cellular self-destruction process triggered by prolonged protein deficiency. This abnormal autophagy, observed in several autoimmune disorders, could contribute to melanocyte degeneration by increasing oxidative stress and local inflammatory signaling.

  A retrospective study evaluated the impact of a low-carbohydrate, high-protein diet in vitiligo patients at various stages of the disease. Both subjects 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 one year of follow-up, when this diet was combined with topical treatments. These results suggest that it is important to have a good carbohydrate/protein balance, notably those sourced from lean meats, legumes, and eggs, especially for individuals with vitiligo.

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

In summary, whether or not one has vitiligo, the dietary recommendation is the same: maintain a balanced and varied diet. It may be worthwhile to consult your physician to check for any deficiencies and, if necessary, have nutritional supplements prescribed, but it’s best to avoid self‐supplementation.

• 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).