Psychosexual aspects of vitiligo: From stigma to clinical solutions

Background. This article summarizes current evidence on the impact of vitiligo on sexual function, quality of life, and interpersonal relationships, taking into account the role of anogenital involvement, anxiety–depressive disorders, distorted body image, and stigmatization. It also presents the results of our own clinical and psychosexual study of patients with vitiligo in the Russian Federation.

Aim. To assess the prevalence and characteristics of sexual dysfunction in patients with vitiligo and its association with clinical features of the disease and psycho-emotional status.

Materials and methods. A systematic literature search was performed in PubMed, EMBASE, Scopus, and the Cochrane Library. In addition, 50 patients with vitiligo (32 women, 18 men) aged 18–55 years were examined. The clinical type and distribution of lesions, sexual function (FSFI in women, IIEF-5 in men), quality of life (DLQI), anxiety and depression (HADS), and interpersonal and marital relationships (author-designed questionnaire) were evaluated.

Results. The literature confirms an increased risk of sexual dysfunction in patients with vitiligo, more pronounced in women, and its close association with anxiety, depression, and low self-esteem. In our cohort, sexual dysfunction was identified in 68.8% of women and 50% of men; anogenital involvement was associated with lower FSFI scores in women, while DLQI scores did not differ significantly between groups. Clinically relevant anxiety and depression were observed in nearly half of the patients and showed a negative correlation with sexual function.

Conclusions. Vitiligo is associated with considerable sexual and psycho-emotional distress, particularly in women and in patients with anogenital involvement. Assessment of sexual function and psychological status should be incorporated into the routine evaluation of patients with vitiligo, and their management requires a multidisciplinary approach.

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