What You Need to Know about Chemicals and Vitiligo
Medically reviewed by Dr. John Harris, dermatologist and Director of the UMass Vitiligo Clinic and Research Center.
Can hair dye cause vitiligo? Can it cause vitiligo to spread? What about chemicals in other products? If you’ve asked this question before, you aren’t alone. And the concern is real.
In 2017, Kanebo Cosmetics reported that more than 19,000 of its customers developed vitiligo after using its one of its products containing rhododenol, a brightening ingredient. The short answer is yes, chemicals can cause vitiligo – and make it worse – but it’s not always likely. Here’s the scoop.
Understanding what causes vitiligo
To understand chemicals’ impact on vitiligo, you first need to understand why vitiligo occurs. Vitiligo is caused by an autoimmune attack on melanocytes, the cells that produce melanin – the skin’s pigment.
There are multiple factors that influence the onset of vitiligo. The first is genetics. According to Dr. John Harris, dermatologist and Director of the UMass Vitiligo Clinic and Research Center, the genetic risk for vitiligo is as follows: 1 in 100 for the general population; 6 in 100 if you have a parent, sibling or child connection with vitiligo; and 23 in 100 if you have an identical twin with vitiligo.
The second cause is environmental factors, which can include stress, physical injury and chemicals. Each of these factors has the potential to initiate or exacerbate the autoimmune response in vitiligo. However, research around the types of chemicals and products that can result in vitiligo is minimal. To date, only four chemicals have been identified as vitiligo inducers. In addition, research has not yet proven that chemicals affect every patient in the same way.
Here’s what we know today.
Which chemicals and products are harmful?
Today there are four chemicals that have been identified as vitiligo-inducers: 4-tertiary-butyl phenol (4-TBP), which can be found in adhesives; 4-tertiary-butyl catechol (4-TBC), found in rubber and other products; and monobenzone and rhodenol, which are both skin-lightening products. In fact, monobenzone is the chemical used to remove pigment from the skin and is the only FDA-approved treatment for vitiligo.
The product with the most research tying it to vitiligo is permanent hair dyes, which have been proven to both induce vitiligo and make it worse.
A 2015 study published Pigment Cell & Melanoma Research provides evidence that use of permanent hair dye – which contains phenols – increases risk of vitiligo by 50%. The study leveraged data from the Nurses’ Health Study (NHS), which is updated biennially via mailed questionnaires. The survey included questions about current and past use, frequency of use, years of regular use and age at first use of permanent hair dyes. The association was stronger among those who have used permanent hair dyes for a longer duration and those who used it for the first time at an early age. These findings align with previous, smaller clinical trials that showed increased occurrence of vitiligo among patients with a history of using permanent hair dyes that contain high amounts of phenols.
In addition, a 2009 study by the Institute of Allergic and Immunologic Skin Diseases in India identified a list of products that might induce vitiligo, however the specific products and chemicals that caused vitiligo are not identified. For 73.7% of patients, the vitiligo was limited to the contact area, but 26.3% of patients had vitiligo spread to other areas of the body. The following products were reported by the named percentage of patients as causing vitiligo: hair dye (27%), deodorant/perfume (22%), detergent/cleanser (15%), adhesive “bindi” (12%), rubber sandal (9%), black socks/shoes (9%), eyeliner (8%), lip liner (5%), rubber condom (4%), lipstick (3%), fur toys (3%), toothpaste (2%), insecticide (2%), alta (decorative color on feet) (1%), amulet string (1%), rubber gloves (12%), lubricating and motor oils (7%), printing inks (4%) and laboratory chemicals (2%).
Why are these chemicals harmful?
Here’s your science lesson for the day. Your skin contains melanocytes, which are cells that produce the melanin that gives skin color. Vitiligo occurs when the immune system kills the melanocytes. This eliminates the production of melanin, resulting in the loss of pigment. That’s why white spots appear. The amino acid tyrosine, a type of phenol, is the basic building block that melanocytes use to create melanin.
The four chemicals identified above are also phenols – and they happen to have properties that mimic amino acid tyrosine. When your skin comes in contact with these chemicals, the melanocytes will use the chemicals in place of amino acid tyrosine. This results in inflammation and autoimmunity, which can either induce vitiligo or make it worse.
What can I do today?
If you’re concerned about the impact of chemicals in your products, you have a few options. You can check your products against theHousehold Products Database, a resource provided by the U.S. Department of Health and Human Services that details the potential health effects of more than 18,000 consumer brands. The Think Dirty app is another resource that helps users identify potential toxins in household, personal care and beauty products.
If you’re interested in staying on top of the latest research behind chemicals and vitiligo, you can follow Dr. Harris. A leading vitiligo researcher and dermatologist, Dr. Harris has a team of scientists studying chemical exposure and its impact on vitiligo and will publish results on his blog.
