Vitiligo or chemical leukoderma?

Last Updated on 18th January 2023 by Caroline Haye

It looks exactly like vitiligo but could have an environmental cause

Chemical leukoderma (sometimes called occupational vitiligo) is the loss of areas of skin pigment due to contact with certain chemicals. And  anyone can suffer from it, whether they have a history of vitiligo or not. It is not the same as idiopathic vitiligo. But it looks the same. So what do you need to know about occupational vitiligo or chemical leukoderma? 

The first documented cases of chemical leukoderma

The first documented cases of occupational leukoderma occurred in workers who wore rubber garments or gloves containing monobenzyl ether of hydroquinone.  Hospital cleaning staff who handle industrial cleaning agents containing phenolic antiseptic detergents have suffered chemical depigmentation as a result.

I have always assumed that most environmental exposure to harmful substances occurs in the industrial workplace. But so-called occupational vitiligo can result from chemical contact at home or during normal daily activities.  The worst chemical culprits are compounds called 4-substituted phenols. These are destructive to functional melanocytes. And they can cause permanent depigmentation of the skin. The most commonly implicated chemicals are para-tertiary butyl phenol, para-tertiary butyl catechol, monobenzyl ether of hydroquinone, hydroquinone and related compounds. 

Every day items that can cause de-pigmentation

Here is a list of some of the everyday items that can cause de-pigmentation when handled on a regular basis: 

• the adhesives often used in the manufacture or repair of shoes
• rubber wristbands
• the adhesive tape and rubber products used in some underwear (bra, girdles, knickers)
• rubber condoms
• self-adhesive bindis (the cosmetic spot worn by many Indian women on the forehead
• the ECG (electrocardiograph) electrodes used in hospitals to measure the electrical activity in a patient’s heart
• hair dyes
• underarm deodorants
• some household detergents
• rubber sandals
• dark clothing dyes
• duplicating paper
• germicidal detergents
• insecticides
• latex gloves
• paints
• photographic chemicals
• printing inks
• soap antioxidents
• synthetic oils
• varnish and lacquer resins

One of the ironic things about this whole subject is that, because I have sensitive skin and a history of vitiligo myself, I have always made a point of using rubber gloves before handling household cleaners.  But, as it turns out, the very items I was relying on to protect me from harmful chemical exposure are themselves among the hazards I should be avoiding. 

How to avoid “occupational” vitiligo

So, how on earth are we supposed to steer clear of these chemical nasties lurking in our everyday items and garments? Well, we could spend half our life researching the ingredients that went into the manufacture of every individual product we purchase. But a simpler way is just to select the least complicated and most natural alternatives available on the market every time. For example, natural fabrics and simple, traditional product formulations. Maybe even, if possible, make them yourself out of good old fashioned, natural ingredients. And if you have to use products containing questionable ingredients, wear skin-friendly protective gloves.

However, if you are into reading lists, here are some of the ingredients to avoid. This is not an exhaustive list but it will hopefully help you steer clear of some of the most harmful chemical hazards out there.

• Hydroquinone
• Monobenzylether of hydroquinone
• Monoethylether of hydroquinone (p-ethoxyphenol)
• Monomethylether of hydroquinone (p-methoxyphenol)
• p-Cresol
• p-Isopropylcatechol
• p-Methylcatechol
• p-Nonylphenol
• p-Octylphenol
• p-Phenylphenol
• p-tert-Amylphenol
• p-tert-Butylcatechol
• p-tert-Butylphenol
• N,N′,N″-Triethylenethiophosphoramide (thio-TEPA)
• Mercaptoamines, e.g. N-2-mercaptoethyl-dimethylamine hydrochloride (MEDA)
• Physostigmine
• Sodium lauryl sulfate

My own vitiligo has virtually gone now, and what little of it is left has stabilised. (Thanks to applying the therapy I describe on my Nutrition Summary page.)  But, knowing that we are surrounded by so many hidden environmental toxins in today’s high-tech, highly processed consumer society, I will be looking very carefully indeed in future at the products I buy and use on a regular basis.