Vitiligo manifests as acquired white or hypopigmented macules or patches. The lesions are usually well demarcated, and they are round, oval, or linear in shape. The borders may be convex. Lesions enlarge centrifugally over time at an unpredictable rate. Lesions range from millimeters to centimeters in size. Initial lesions occur most frequently on the hands, forearms, feet, and face, favoring a perioral and periocular distribution.

Vitiligo lesions may be localized or generalized, with the latter being more common than the former. Localized vitiligo is restricted to one general area with a segmental or quasidermatomal distribution. Generalized vitiligo implies more than one general area of involvement. In this situation, the macules are usually found on both sides of the trunk, either symmetrically or asymmetrically arrayed.

Symptoms of Vitiligo in TCM include:
1. Syndrome of Liver Qi Stagnation and Blood Stasis
Main Symptoms: White macules on the skin, mostly on the face, accompanied by qi stagnation, vexation, restlessness, slightly red tongue, or purple dark tongue or with purple spots, thin and whitish coating, or whitish and greasy coating, and wiry pulse.

2. Syndrome of Qi and Blood Deficiency
Main Symptoms: White macules, accompanied by fatigue, lassitude, pale complexion or yellowish complexion, spontaneous perspiration, slightly red tongue, thin and whitish coating, and thready pulse.
Therapeutic Methods: Benefit qi, nourish blood, activate blood and expel wind.