Vitiligo is a complex condition, the exact cause of which is not known. It is believed to involve multiple factors (some of which are genetic) that result in skin cells called melanocytes becoming diseased and/or destroyed, preventing them from producing melanin, the pigment that colours our skin and hair.
Although the causes of vitiligo are not fully understood, one theory is that the melanocytes of skin with vitiligo are somehow inherently abnormal, stopping them from functioning normally.
Another possibility is that vitiligo is an autoimmune disease – in other words, a disease in which the immune system turns against the body’s own cells. This theory is supported by a number of changes that are observed in the immune cells of patients with vitiligo, as well as by the fact that patients with vitiligo have an increased likelihood of later developing other autoimmune conditions (including the thyroid diseases Graves disease and Hashimoto thyroiditis).
Oxidative stress (free radical damage) is increased in the skin of patients with vitiligo, and this may contribute to the destruction of the melanocytes.
None of these issues alone causes vitiligo, so it is thought likely that a combination of them, along with others yet to be identified, leads to the condition.