Mental Health May Play a Role in Vitiligo Treatment Efficacy, Study Shows

Patients with vitiligo, a chronic autoimmune skin disorder characterized by patches of depigmented skin, experience significantly worse treatment outcomes when they have severe anxiety-depression, according to a new study in Frontiers in Psychology.

While anxiety-depression are common comorbidities of vitiligo, large-scale studies detailing the condition’s impact on vitiligo onset and treatment outcomes have been lacking. This observational study, led by Miaoni Zhou, M.D. from Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, included results from 782 patients, and identified a correlation between the severity of anxiety-depression and disease progression.

“This suggests that anxiety-depression not only increase the risk of vitiligo onset but also play a substantial role in influencing the clinical characteristics and treatment outcomes of vitiligo,” the study authors wrote. Observational studies such as this typically provide clues, rather than proof, of cause and effect.

Previous research has demonstrated the effectiveness of adding mental interventions for patients with other skin diseases, according to the study. For instance, psychological therapy has helped eliminate symptoms in patients with urticaria (hives), and improved outcomes for patients with atopic dermatitis, while reducing their use of topical corticosteroids.

The study suggests the connection between mental health and vitiligo is through the brain-skin axis, a pathway that links emotional stress to skin conditions. Anxiety and depression can trigger the release of stress hormones, which may lead to neurogenic inflammation and disrupt melanin production, worsening vitiligo. Chronic stress could further inhibit the skin’s ability to regenerate pigment.

Among the vitiligo study participants, more than 65% experienced varying degrees of anxiety-depression, with 40% classified as having moderate to severe symptoms. Those on the more severe side of the anxiety-depression scale should be targeted for proactive psychological interventions, suggested the study authors.

“Within this group, active psychological intervention has the potential to significantly enhance the efficacy of vitiligo treatment.,” the researcher wrote.

Age was also a factor in the results. Llder patients had higher anxiety-depression levels as well longer disease duration and larger affected body surface areas. They also showed increased vitiligo activity and progression.