Sopak (Vitiligo): Punca, Tanda, Jenis & Rawatan

Sopak (vitiligo) is a long-term skin condition that causes pale or white patches where the skin has lost its colour. It is not contagious and is not harmful to your general health. The most common type is thought to be autoimmune and is linked with thyroid disease. There is no cure yet, but treatments can restore some colour in some people, and sun protection is important because the white patches burn easily. Sopak garam is a different condition: it is a traditional name for gegata (hives). This guide explains the signs, types, causes, treatment and where to get help in Malaysia.

Apa itu sopak (vitiligo)?

The Kamus Dewan describes sopak as a skin disease that causes white patches, often on the hands or feet. In medical terms this is vitiligo. The NHS describes vitiligo as a long-term condition where pale white patches develop on the skin because of a lack of melanin, the pigment that gives skin its colour.

Key facts:

• It is not contagious. The NHS says vitiligo is not caused by an infection, and you cannot catch it from someone who has it.
• It is not harmful to your health, although it can change your appearance (American Academy of Dermatology, AAD).
• It is fairly common. Cleveland Clinic says about 1% of people worldwide have vitiligo, and DermNet gives a range of 0.5–2%.
• It affects all skin tones about equally, but it is more visible on darker or tanned skin (AAD), which is why it can be very noticeable on many Malaysian skin tones.
• It can start at any age. The AAD says about half of people with vitiligo develop it before age 20, and DermNet gives an average age of onset of 20–24 years.

Sopak vs sopak garam: not the same condition

Many people search for "sopak garam", but it is not the same as sopak (vitiligo). A Malaysian doctor writing for DoctorOnCall explains that sopak garam, kelopak garam, gegata and "ludah jin" are traditional names for urticaria (hives).

If you have itchy, raised welts that come and go, see our guide to gegata (hives) instead.

Tanda sopak: what the patches look like

The NHS says vitiligo often starts as a pale patch of skin that gradually turns completely white. Other features include:

• the centre of a patch may be white, with paler skin around it; it may look slightly pink if there are blood vessels under the skin;
• the edges may be smooth or irregular, and are sometimes red and inflamed, or have brownish discolouration;
• hair growing in the area can turn white or grey, including on the scalp, eyebrows or eyelashes;
• vitiligo does not usually cause discomfort such as dryness, but the patches may occasionally be itchy (NHS). In a study of 62 people with vitiligo at Universiti Kebangsaan Malaysia, 22.6% reported itch (Teh and Jamil, 2024).

Where it appears: vitiligo can affect any area of skin. The NHS says it commonly affects the face (especially around the mouth and eyes), fingers and wrists, armpits, groin and genitals, and the inside of the mouth. Cleveland Clinic says it typically begins on the hands, forearms, feet and face.

How it changes: the AAD says patches may stay the same size for years or grow larger, and new patches can appear. There is no way to predict how much skin will be affected.

Jenis sopak (types of vitiligo)

Doctors describe vitiligo by how it spreads. According to the NHS and AAD:

Punca sopak (causes and triggers)

Vitiligo happens when there are not enough working melanocytes, the skin cells that make melanin (NHS).

• Autoimmune: non-segmental vitiligo is thought to be an autoimmune condition, where the immune system attacks and destroys the melanocytes (NHS, AAD).
• Nerve chemicals: segmental vitiligo is thought to be caused by chemicals released from nerve endings in the skin that are poisonous to melanocytes (NHS).
• Genes and family history: having a close blood relative with vitiligo raises your risk, but does not mean you will get it (AAD). Cleveland Clinic says studies suggest about 30% of cases are genetic.

Possible triggers listed by the NHS and AAD include:

• a severe sunburn, or skin injury such as cuts, scrapes or burns (new patches at the site of an injury are called the Koebner response);
• stressful events, such as childbirth;
• hormonal changes, such as puberty;
• contact with certain chemicals, such as those in some hair dyes or products used to even out skin tone (AAD).

Cleveland Clinic confirms vitiligo does not spread from person to person through physical contact.

Sopak and other autoimmune conditions

Because non-segmental vitiligo is autoimmune, people with it are more likely to have other autoimmune conditions. The NHS and Cleveland Clinic mention:

• thyroid disease: DermNet says this is the strongest link, affecting up to 15% of adults with vitiligo. In the Universiti Kebangsaan Malaysia study, thyroid antibodies were found in 19.7% of patients (Teh and Jamil, 2024). See our guide to tiroid (thyroid problems);
• pernicious anaemia, an autoimmune cause of vitamin B12 deficiency (see kurang darah (anaemia));
• type 1 diabetes, Addison's disease, lupus, rheumatoid arthritis and psoriasis;
• alopecia areata, a type of patchy hair loss (AAD; see our guide to rambut gugur).

Not everyone with vitiligo will develop these conditions (NHS). The NHS also says vitiligo may be associated with inflammation in the eye (uveitis) and some hearing loss; the AAD explains that the inner ear contains pigment cells.

Sopak, panau or something else?

Not every pale patch is vitiligo. The AAD says lighter patches can also be caused by tinea versicolor or a skin injury, and the NHS mentions pityriasis versicolor, a fungal infection that causes loss of pigment.

• Panau (tinea or pityriasis versicolor): a common fungal infection that can cause lighter or darker patches, usually on the chest, back and upper arms. It is treated with antifungal products. See our guide to kurap dan panau.
• Pale skin after an injury: the AAD says light spots can also be caused by a skin injury.

Because these conditions need different treatment, see a doctor before buying antifungal, steroid or lightening creams for a white patch.

How doctors diagnose sopak

The NHS says a GP can usually diagnose vitiligo by examining the affected skin. They may ask:

• whether anyone in your family has vitiligo or another autoimmune condition;
• whether you have injured the skin, for example with sunburn or a rash;
• whether the patches are spreading or have improved on their own;
• how the patches affect your confidence, daily life and work.

Tests that may be used:

• Wood's lamp: a special ultraviolet lamp used in a dark room. Vitiligo patches are easier to see under it, which helps tell vitiligo apart from conditions such as pityriasis versicolor (NHS, AAD).
• Blood tests: to check your thyroid and look for other autoimmune conditions (NHS, AAD).

In Malaysia, you can start at a klinik kesihatan or GP, who can refer you to a dermatology (skin) clinic at a government hospital or to a private dermatologist (pakar kulit).

Rawatan sopak (treatment options)

Treatment is optional. The AAD says some people choose not to treat vitiligo, or prefer to cover patches with make-up, self-tanner or skin dye. If you want treatment, the aim is to restore lost colour and stop patches spreading. Important points from the NHS and AAD:

• there is no cure, and the white patches are usually permanent;
• treatment works slowly, colour returns a little at a time, and it may fade again after treatment;
• the face and neck tend to respond best, while the lips, fingertips and toes respond least;
• no single treatment works for everyone, so a dermatologist will tailor a plan to you.

Treatments a doctor may offer:

Pregnancy: the NHS says topical steroids from a GP are not usually prescribed to pregnant women, and you should be referred to a dermatologist if you are pregnant and need treatment.

What to avoid:

• The NHS says sunlamps you can buy for home use are not recommended. They are less effective than hospital phototherapy and are not regulated, so they may not be safe.
• The NHS says there is no evidence that complementary therapies relieve or prevent vitiligo, and only very limited evidence for the herbal remedy ginkgo biloba. Check with a doctor before using herbal remedies, as some can interact with medicines.
• Do not use unregistered lightening or "sopak" creams sold online. The AAD notes that some chemicals in products used to even out skin tone can trigger vitiligo.

Sun protection for sopak

Skin with vitiligo has little or no melanin, so it sunburns very easily. The NHS says sunburn is a severe risk and advises:

• always using a sunscreen, ideally with SPF 50 or above;
• never using sunbeds.

Covering up with clothing and staying in the shade during the strong midday sun also help protect white patches.

Sun protection also matters because sunburn can trigger new patches (NHS, AAD). The AAD says people with vitiligo do not have a higher risk of skin cancer in the white patches, but they can still get skin cancer, so protecting the skin is still essential. Our guide to kanser kulit explains how to check your skin.

Living with sopak: confidence and mental health

Vitiligo is not painful, but visible patches can affect confidence. The NHS says problems with confidence and self-esteem are common, especially when exposed skin is affected.

• In a study of 100 adults with vitiligo at Hospital Tengku Ampuan Rahimah, Klang, 12% had depression and 21% had anxiety. The authors recommended that doctors routinely check the mental health of people with vitiligo (Ting and Ng, 2023).
• The NHS says a GP can refer you to a psychologist or counsellor, for example for cognitive behavioural therapy (CBT), and that support groups can help.

If you feel low most days or have lost interest in things you used to enjoy, talk to a doctor. Our guide to kemurungan (depression) explains the signs and where to get help.

When to see a doctor

See a doctor if:

• you notice new pale or white patches and are not sure what they are;
• patches are spreading or appearing quickly;
• you have white patches together with symptoms of thyroid disease, diabetes or another autoimmune condition, such as tiredness, feeling very thirsty or weight changes;
• you have vitiligo and notice changes in your eyesight or hearing;
• vitiligo is affecting your mood, confidence or daily life, or you would like treatment.

The AAD notes that treatment tends to work better the sooner it starts, although people who have had vitiligo for years can still see some colour return.

Frequently asked questions (FAQ)

Apa itu sopak (what is vitiligo)?

Sopak is the Malay word for vitiligo, a long-term condition where pale or white patches develop on the skin because the skin has lost its pigment, melanin. It often affects the face, hands, armpits, groin and skin around the mouth and eyes. Cleveland Clinic says about 1% of people worldwide have vitiligo, and it is more visible on darker skin.

Adakah sopak berjangkit (is vitiligo contagious)?

No. Vitiligo is not caused by an infection and you cannot catch it from someone else or pass it on through touch. It is thought to be an autoimmune condition, where the immune system attacks the cells that give skin its colour.

Apa punca sopak (what causes vitiligo)?

Vitiligo happens when there are not enough working melanocytes, the cells that make skin pigment. The most common type is thought to be autoimmune. It can run in families and is linked with other autoimmune conditions, especially thyroid disease. Possible triggers include severe sunburn, cuts or other skin injury, stressful events such as childbirth, and contact with certain chemicals.

Sopak garam dan sopak, sama ke?

No. Sopak means vitiligo, which causes pale or white patches of skin that usually last a long time. Sopak garam is a traditional name for gegata (urticaria or hives), which causes a raised, itchy rash that usually gets better within a few days. They are different conditions with different treatments.

Boleh sembuh ke sopak (can vitiligo be cured)?

There is no cure for vitiligo yet, and the white patches are usually permanent. However, treatments such as prescription creams and light therapy can restore some skin colour in some people, and camouflage creams can cover patches. Treatment works slowly, does not work for everyone and the colour may fade again, so a dermatologist will plan treatment with you.

Adakah sopak menyebabkan kanser kulit (does vitiligo cause skin cancer)?

The American Academy of Dermatology says people with vitiligo do not have an increased risk of skin cancer in the patches where they have lost colour. However, these patches sunburn very easily, so it is important to protect them from the sun with clothing, shade and a high SPF sunscreen.

Apa beza sopak dan panau (vitiligo vs tinea versicolor)?

Panau (pityriasis or tinea versicolor) is a common fungal skin infection that can cause lighter patches, often on the chest, back and upper arms, and it usually responds to antifungal treatment. Vitiligo is not an infection, and its patches often turn completely white over time. A doctor can tell them apart by examining the skin, sometimes using a special ultraviolet lamp called a Wood's lamp.

Disclaimer

This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.

References

• Vitiligo — NHS
• Vitiligo: Treatment — NHS
• Hives — NHS
• Vitiligo: Overview — American Academy of Dermatology (AAD)
• Vitiligo: Who gets and causes — AAD
• Vitiligo: Diagnosis and treatment — AAD
• Vitiligo — Cleveland Clinic
• Vitiligo — DermNet
• Sopak — Kamus Dewan Edisi Keempat, Pusat Rujukan Persuratan Melayu (DBP)
• Urticaria, nama lain bagi gegata / sopak garam / ludah jin — DoctorOnCall
• Ting YL, Ng TG. Prevalence of depression and anxiety among adults with vitiligo in a Malaysian tertiary hospital. Med J Malaysia. 2023;78(6):696–704.
• Teh YL, Jamil A. Epidermal biophysical characteristics in patients with vitiligo and the association with thyroid auto-immunity and itch. Indian J Dermatol. 2024;69(2):201.