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Dr. Johanna Gillbro - skin researcher, vitiligo patient and founder of Skinome, has spent more than two decades understanding why white patches occur in vitiligo. Already during her PhD, she studied the role that hydrogen peroxide plays in melanocyte damage and showed that enzyme mimetics can restore pigment (she herself repigmented 0.5% of her facial spots).
Below is her considered assessment - backed by international research - of what most often triggers new or worse outbreaks and how you can practically reduce the risk.
Individual variations are large. The advice here should be seen as general guidance – always discuss with your dermatologist before making major lifestyle or treatment changes.
| TRIGGER | MECHANISM | WHAT YOU CAN DO |
|---|---|---|
| Heavy UV exposure (getting sunburned) | UV increases ROS (Oxidative stress) → melanocyte apoptosis. | Recommend that you avoid the strongest sun between 11-15 and use sunscreen. |
| Mechanical trauma (Koebner phenomenon) | Abrasions, wounds, cuts, tattoos, pressure from bras, underwear, trouser waistbands - leave a stain exactly where the skin has been damaged. | Soft clothing, avoid skin damage, harsh exfoliation/shaving |
| Phenol & catechol chemicals (e.g. PTBP in hair dye, rubber glue) | Directly cytotoxic to melanocytes; can trigger “chemical vitiligo”. | Read the INCI list; choose PPD/phenol-free products & gloves. |
| Psychological/emotional stress/sleep deprivation | Cortisol & inflammatory cytokines correlate with disease activity. | Find ways to control stress/emotional distress |
| LIMITING FACTOR | WHAT RESEARCH SHOWS | PRACTICAL RULE OF THUMB |
|---|---|---|
| Strong Green Tea/EGCG Extract | EGCG inhibits pigmentation and can lead to new spots. | Enjoy regular tea, but avoid green tea. |
| Chlorinated swimming pools | Chlorine increases oxidative stress in the skin. | Shower immediately after bathing, apply antioxidant/barrier cream. |
| Dihydroxyacetone (sunless tanning) | The Maillard reaction + UV → can lead to oxidative stress in the skin. | Avoid |
| Camouflage makeup | Many types of opaque makeup can trigger vitiligo. | Choose powder format if possible. |
Skinome – “Johanna Gillbro visits Framgångspodden”
Schallreuter KU et al. “Estrogens can contribute to hydrogen peroxide generation…” J Invest Dermatol 2006. PubMed
Harris JE. “Chemical-Induced Vitiligo.” Dermatol Clin 2017. PubMed
Tan Y et al. "Koebner Phenomenon Is an Indicator of Vitiligo Activity." Clin Cosmet Investig Dermatol 2025.PMC
Kim YC et al. “Anti-melanogenic effects of black, green and white tea extracts.” J Vet Sci 2015. PMC
Snell JA et al. "Hypochlorous Acid as Environmental Skin Toxicant." Front Oncol 2022. PMC
Perer J et al. "Sunless-tanning agent DHA induces oxidative stress." Free Radic Biol Med 2020. PMC
Kaliyadan F. “Camouflage for patients with vitiligo.” Indian J Dermatol Venereol Leprol 2012. ijdvl.com
You Q and others "Gut microbiota dysbiosis orchestrates vitiligo-related oxidative stress." Microbiome 2025. PubMed
Frontiers in Psychology. “Anxiety—depression: a pivotal mental factor for vitiligo.” 2024. Frontiers
