Treatments are safe, providing you follow the directions outlined. Topical anti-inflammatory creams are adjusted accordingly as skin is more sensitive to irritation. My usual prescription is a lower concentration of calcineurin inhibitors.

Phototherapy for vitiligo has a long safety record. PUVA or psoralen with UVA is not used in this area due to concerns over carcinogenic effects long term.

Yes, the genital areas are frequently involved. The main signs of vitiligo are patches of white skin. Vitiligo of the penis usually appears on the foreskin & shaft however the glans or head of the penis is frequently involved. This is more noticeable if you have dark skin. Involvement of the pubic hair is common & presents as grey or white hairs.

You might also notice symptoms not related to your genitals, such as:

• White patches involving other areas such as the face, nipples, trunk & limbs.
• Gray or white hair
• Loss of colour in your mucus membranes, such as the linings of your mouth and nose

Vitiligo can develop at any age; however genital involvement is usually seen before the age of 25. Some cases develop much later.

It may, however once stable, it is unlikely to spread.

Most patients will have stable vitiligo, meaning the areas do not change for years to come.

Nope. Fertility is not affected by vitiligo. This includes male & female patients. Additionally white patches on genital areas do not reduce sperm or egg counts.

Penile vitiligo does not cause any symptoms including erectile dysfunction, painful urination, premature ejaculation, or difficulty urinating. If you have any symptoms, it is unrelated to your condition- see a urologist or discuss with your GP. A dermatologist is unlikely to help you.

Yes & no; the question is complex. Your offspring are not likely to get vitiligo, however they are at increased risk of developing vitiligo & other autoimmune conditions like diabetes, vitamin B12 deficiency, & thyroid disease. These conditions usually manifest after the teenage years.

Hard one to answer; no pun intended. Here is the scientific answer; in some cases, friction & trauma can worsen the disease. This is called Koebner. Google it. Areas such as the knees & elbows are prone to white patches. The same applies to areas of friction in the genital area. Get it?

Vitiligo is usually diagnosed during a thorough physical exam. If it’s affecting your penis, your doctor will likely examine the rest of your body as well. In most cases vitiligo can be diagnosed without the need for special tests. Other conditions that may mimic vitiligo include BXO & lichen sclerosis. These conditions are best treated by either a urologist or general dermatologist. 

I do not perform surgery on genital areas due to the high incidence of scarring in these areas. This means no surgical procedures on the penis. I do consider surgery for extensive areas around the nipples that fail vitiligo creams & phototherapy.

Foreskin vitiligo can be treated with circumcision, see a urologist for this, not a dermatologist.

There are reports of fractional lasers in the literature. They can work in 5-10% of cases & are not first line treatment for vitiligo. Lasers for vitiligo are best attempted in a public hospital setting as it is classed a novel & experimental. This includes the excimer 308 laser. 

You can’t wash away vitiligo, however it is important to use a non-irritating wash in this area- especially if you are combining phototherapy (which gives you sensitive skin) & topical creams. Recommended washes include- Cetaphil, QV Gentle Wash & Cerave.

If in doubt, look for the word gentle. 

This is one area you do not want to get wrong with DIY skin care or home-made remedies. The genital area is prone to both allergic & irritant contact dermatitis. You have been warned.

If the diagnosis is certain, you can try to use tacrolimus 0.03 to 0.1% ointment as tolerated. The most common brand is Protopic. Resourceful patients can source this online. Don’t try psoralens at home.

A diet that is low in acidic foods can reduce inflammation. How much it helps with vitiligo is still unknown. Regardless it is simple to follow. Type is the term ‘acidic foods’ in Google, don’t eat these foods. Examples include citrus fruits & tomatoes.

Food high in antioxidants such as legumes, & leafy green vegetables are advocated. Even if they have no impact on vitiligo, they can help your overall health. Do it. Placebo works in over one quarter of cases.

Much like diet, there is no harm trying, though the evidence is low. It’s worth giving it a go as vitamins & supplements have little or no side effects. Supplements include vitamin B12, folate & iron. There are some reports that multivitamin B capsules can help.

Herbal supplements like ginkgo biloba can be beneficial in some cases of vitiligo. Antioxidants include resveratrol, ginseng & green tea. 

The appearance of penis or genital vitiligo will initially make you uncomfortable, but the condition itself is harmless. While it may take a new sexual partner a little time to get used to it, you both will get to the point where the appearance of vitiligo no longer registers. Medical therapy can help some, but not all cases.

Dermatologists do require a real time appointment, so do not send photos of your genitals. These photos make good Christmas cards to fellow colleagues.

Book an appointment with our dermatologists at Clinic Cutis. You will require a referral from a GP.

Vitiligo treatments are largely subsidized by Medicare. This saves over $7500 per year for patients. Phototherapy sessions are bulk billed, hence do not cost anything (apart from time). Creams cost approximately 50 to 90 cents a day.