white patches of skin due to the disappearance of melanocytes or pigment cells from these areas of skin. Usually this occurs on the back of the elbows, front of the knees, & around the eyes & mouth. Others areas may become involved as these white patches enlarge centrifugally & new patches appear. I have never come across any data that points to a specific cause for vitiligo although it tends to occur in areas that have significant movement or are exposed to daily causes of minor skin damage (elbows, knees, eyes, mouth, hands). In up to 30% of cases some minimal spontaneous repigmentation occurs particularly in sun exposed areas. Oral photochemotherapy medications combined with ultraviolet-A light exposure can darken areas of vitiligo but it takes 100 or 200 sessions & long term side effects may be undesireable.
Hydroquinone skin bleaching creams which can be used to lighten the areas not affected by vitiligo thereby decreasing the contrast or noticeability of the problem. The vitiligo affected areas can be tattooed to approach the color of the adjacent unaffected skin. This would have to be a medical grade quality tattoo to match skin color which is quite different than most ornamental tattos. If you choose this route you should first have a small test spot tattooed. The best option is laser dermabrasion or dermabrasion followed by the spraying on of pigmented cells harvested from a small piece of skin elsewhere on the body.