Vitiligo-Inducing Substances

Why does it happen ? It’s often the fault of phenols

• Like monobenzone, chemicals that induce vitiligo are mostly phenols, which contain a benzene ring with hydroxyl group attached.
• Examples include:
  • 4-tert-butylcatechol
  • 4-tert-butylphenol
• Mechanism: chemical phenols appear to act as tyrosine analogs that disrupt normal tyrosinase function and induce stress within the melanocyte, which activates innate inflammation that induces autoimmunity.

“Outbreak” of vitiligo in Japan in 2013

• Skin depigmentation in over 18,000 users of a new skin-lightening cream produced by cosmetic
  company Kanebo; led to recall of cosmetic cream: The substance is called Rhododenol (click here to read more)
• Affected ~2% of users
• At site of contact with cream and also some remote depigmentation
• Generally resolved after discontinued use and treatment

Hair dye use implicated as chemical inducers of vitiligo

• Multiple case reports since 1993
• Use >5 years or starting before age 30 increased vitiligo risk 50%

Other household products thought to induce vitiligo, contain phenols, but still unproven

• Detergents/cleansers
• Ornamental dyes
• Latex
• Leather
• Resins/adhesives

Non-phenolic inducers of vitiligo (different mechanism, through inflammation)

• Imiquimod
• IFN-α

Author: John E. Harris, MD, PhD, Chemicals that induce Vitiligo. S006 – Vitiligo. AAD 2016 – Washington DC, United States USA