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According to my studies, physical trauma, friction, pressure, injuries and oxidative stress on a daily basis might be the main causative reasons for vitiligo spreading.

If you have patches on your face or if you think it may develop them, I believe there is a simple preventative action that might reduce the vitiligo worsening or even avoid it altogether.

Brief description:

It's possible that the physical friction/trauma in places where bones are close to the skin surface (bony prominences) induces vitiligo in predisposed people. This pattern is observed on finger tips, knees, elbows, feet, wrists and face (below). 

It is easy to understand that finger tips, knees, elbows, feet, wrists are submitted to a lot of trauma and friction on a daily basis, but I was rather puzzled with the occurrence of face-pattern vitiligo.

Firstly I thought that the friction on face was mainly caused by the following actions (see pictures below):

However  I've formed a more evidence-based conclusion:

1- Human head weighs around 5Kg (10-11 pounds);

2- When we are sleeping in "freefaller", "log", "foetus", "yearner" positions (see position chart below), the face might be suffering a pressure from the whole head equivalent to 50Kgf/m2. Despite the cushion/pillow absorption, it would be the same as having a 5kg (11 pounds) weight plate on your face for 6-8 hours of sleeping a day. It's definitely too much pressure for persons with a predisposition for vitiligo development.

 


So, my suggestion is to try to change the sleeping position to "soldier" or "starfish" (see above), to avoid the bone pressure against the face. At the very least, it's worth a long term try.

Additionally, a Contoured Pillow Neck Support Cushion may give you more comfort.. 

Cheers.