First, let me explain what vitiligo actually is.

Vitiligo is essentially a condition where the pigment cells in a localized area produce relatively fewer granules. It's important to note that these melanocytes remain alive and functional - they haven't died off, and the condition has no relation to the Chinese terms "dian" or "feng" that make up its name. I prefer to call it hypopigmented patches or simply white patches. While vitiligo presents as white patches, the amount of pigment granules is actually a matter of degree - it's simply lighter in color compared to the surrounding skin.

Occasionally developing a white patch, we refer to it as localized vitiligo. What you need to pay attention to is:

1. Take a photo of the affected area each month. If it gradually expands, we have particularly effective treatment options.

2. If it remains unchanged in the same spot for one, two, or three months, the treatment effectiveness at this stage is actually quite poor.

So what should you do?

If it's a very small white patch that doesn't grow, it can be covered. Nowadays, there are many concealers available. When applied, they may not wash off easily and can be reapplied daily to match the natural skin tone. A white patch is simply a color change—it doesn't hurt, itch, or spread, so what happens with my own body is my responsibility and has nothing to do with others. Therefore, for many so-called vitiligo cases, the main challenge is overcoming the psychological barrier.

Many people get startled when they hear the term "vitiligo," but the proportion of cases that progress to full-body vitiligo is less than one in ten million. If you have one patch turning white, don't scare yourself unnecessarily.

1. Skin pigmentation is never completely uniform across the body. Having a white patch on your arm doesn't necessarily mean it will spread to your face.

2. Having a white patch doesn't necessarily require treatment. The term "vitiligo" (literally "white wind" in Chinese) is actually misleading—it has nothing to do with "wind" or any other traditional Chinese medical concept. It's simply a localized loss or reduction of pigment.

3. So-called hypopigmentation means two different colors appear on the skin. The simplest way to identify it is - if you can clearly see a white patch from one meter away, you might consider it vitiligo. Many people stare hard but still can't see anything - that's definitely not vitiligo. True vitiligo means complete pigment loss in that area. Losing just 20-30% pigment doesn't count.

4. Some people particularly fear it spreading to the face, but having a white patch on your arm has no relation to face outbreaks. If you have a vitiligo patch on your body and observe no expansion after one, two, or three months, you can safely ignore it.

Is a white patch on a child's face vitiligo?

Many children develop patchy white spots on their faces, which makes parents very anxious. They bring their children to the hospital, asking doctors if it might be vitiligo. Currently, there's significant fear about vitiligo. In reality, most of these cases are what we commonly call "peach blossom tinea."

Why do tinea versicolor patches appear? It’s because when children's skin isn’t yet producing sebum, conditions like Malassezia fungal overgrowth can occur, leading to patchy discoloration. For these children, applying more moisturizer helps. Once they enter puberty and their skin starts producing oil, conditions like tinea versicolor, pityriasis alba, or simple white patches will naturally resolve on their own. It's important not to mistake these for vitiligo.