u/AccordingAdvisor6505

Hi everyone,

I'm looking for advice because I've been dealing with a persistent pigmentation problem on my neck for almost two years, and I'm starting to feel hopeless.

The issue started after I used a liquid alcohol-based minoxidil product on my beard and neck area for an extended period of time. My skin became very irritated and red. After that, I switched to a foam version, but it left my neck constantly damp for many hours a day, often around 8 hours daily.

Shortly after making that switch, I experienced rapid pigment loss across my neck.

At its worst, most of the pigment on my neck was gone. The entire left side was affected, and the right side was very similar. I stopped using all potentially irritating products about 18 months ago and have not used anything irritating since.

Around the same time, I started using ketoconazole/dandruff shampoo because there was concern that a fungal component might be involved. From approximately August 2024 until April 2025, I gradually regained most of the lost pigmentation. The recovery was slow and progressive rather than sudden. I did not regain most of the pigment early on; instead, I saw a more stable improvement over many months.

I later stopped using ketoconazole, and after stopping, I noticed a few white patches returning near the side of my ear and under my jaw/chin area. When I restarted treatment, those areas improved much faster than before, which made me wonder whether there may still be some underlying fungal component involved.

I also had similar patches on my face, but those resolved completely after about 6–8 months.

Now, almost 18–20 months later, I'm left with what you can see in the photos. The frustrating part is that I do not have large completely white patches anymore. Instead, there is pigment throughout the entire neck.

One thing that makes this difficult to describe is that the pigmentation pattern is not simply a collection of isolated "islands." Some areas have integrated quite well and look relatively normal, while other areas still show visible variation in pigment density. There are pigmented dots, streaks, and interconnected networks throughout the neck, but some regions appear denser and more uniform than others.

When I look closely, I can see pigmented dots, streaks, and thin interconnected pathways across all affected areas. The problem is that the pigmentation never fully blends into a uniform background. Some areas carry pigment quite well, while other areas remain lighter and make the pattern visible.

The pigment clearly came back, and I can see pigmentation throughout the affected areas, but the final integration and blending into a normal skin tone seems incomplete. It feels as if the repigmentation happened, but the pigment never fully organized itself the way it was before.

Another reason I struggle to understand what caused this is that I have no known family history of autoimmune diseases. There is no vitiligo, autoimmune thyroid disease, alopecia areata, or other autoimmune conditions in my immediate family.

In addition, I have never developed similar patches anywhere else on my body. The pigment loss was limited to the areas where I had been applying minoxidil. The neck was by far the most affected area, and the facial patches that appeared during the same period eventually resolved. Outside of the areas exposed to minoxidil, I have not experienced pigment loss elsewhere.

Because of this, I have always wondered whether the trigger was local skin irritation, inflammation, barrier damage, or another localized process rather than a systemic autoimmune condition.

I'm struggling to understand what this is. Has anyone experienced something similar after severe irritation, contact dermatitis, post-inflammatory pigment changes, pityriasis versicolor, or another non-vitiligo cause?

Most importantly, has anyone experienced pigment returning gradually over many months, but the final step of blending and homogenization taking much longer?

At this point I'm willing to consider any recommendations. I feel stuck because the majority of the pigment is back, but it still doesn't look like my normal neck did before all of this started.

Any advice or similar experiences would be greatly appreciated.

Hi everyone,

I'm looking for advice because I've been dealing with a persistent pigmentation problem on my neck for almost two years, and I'm starting to feel hopeless.

The issue started after I used a liquid alcohol-based minoxidil product on my beard and neck area for an extended period of time. My skin became very irritated and red. After that, I switched to a foam version, but it left my neck constantly damp for many hours a day, often around 8 hours daily.

Shortly after making that switch, I experienced rapid pigment loss across my neck.

At its worst, most of the pigment on my neck was gone. The entire left side was affected, and the right side was very similar. I stopped using all potentially irritating products about 18 months ago and have not used anything irritating since.

Around the same time, I started using ketoconazole/dandruff shampoo because there was concern that a fungal component might be involved. From approximately August 2024 until April 2025, I gradually regained most of the lost pigmentation. The recovery was slow and progressive rather than sudden. I did not regain most of the pigment early on; instead, I saw a more stable improvement over many months.

I later stopped using ketoconazole, and after stopping, I noticed a few white patches returning near the side of my ear and under my jaw/chin area. When I restarted treatment, those areas improved much faster than before, which made me wonder whether there may still be some underlying fungal component involved.

I also had similar patches on my face, but those resolved completely after about 6–8 months.

Now, almost 18–20 months later, I'm left with what you can see in the photos. The frustrating part is that I do not have large completely white patches anymore. Instead, there is pigment throughout the entire neck.

One thing that makes this difficult to describe is that the pigmentation pattern is not simply a collection of isolated "islands." Some areas have integrated quite well and look relatively normal, while other areas still show visible variation in pigment density. There are pigmented dots, streaks, and interconnected networks throughout the neck, but some regions appear denser and more uniform than others.

When I look closely, I can see pigmented dots, streaks, and thin interconnected pathways across all affected areas. The problem is that the pigmentation never fully blends into a uniform background. Some areas carry pigment quite well, while other areas remain lighter and make the pattern visible.

The pigment clearly came back, and I can see pigmentation throughout the affected areas, but the final integration and blending into a normal skin tone seems incomplete. It feels as if the repigmentation happened, but the pigment never fully organized itself the way it was before.

Another reason I struggle to understand what caused this is that I have no known family history of autoimmune diseases. There is no vitiligo, autoimmune thyroid disease, alopecia areata, or other autoimmune conditions in my immediate family.

In addition, I have never developed similar patches anywhere else on my body. The pigment loss was limited to the areas where I had been applying minoxidil. The neck was by far the most affected area, and the facial patches that appeared during the same period eventually resolved. Outside of the areas exposed to minoxidil, I have not experienced pigment loss elsewhere.

Because of this, I have always wondered whether the trigger was local skin irritation, inflammation, barrier damage, or another localized process rather than a systemic autoimmune condition.

I'm struggling to understand what this is. Has anyone experienced something similar after severe irritation, contact dermatitis, post-inflammatory pigment changes, pityriasis versicolor, or another non-vitiligo cause?

Most importantly, has anyone experienced pigment returning gradually over many months, but the final step of blending and homogenization taking much longer?

At this point I'm willing to consider any recommendations. I feel stuck because the majority of the pigment is back, but it still doesn't look like my normal neck did before all of this started.

Any advice or similar experiences would be greatly appreciated.

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