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Did you know?
70 million people across
the world have vitiligo.
Take the vitiligo evaluation test now.
Tell us a bit about yourself
*You will receive your vitiligo evaluation test score on your contact details
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AGE
0-18
18-25
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Let's Begin
➜
QUESTION
1
/
10
Is your skin developing any visible white patches?
YES
NO
Since when did you start noticing these marks?
3 Months
More than 6 months
More than a year
Please select any option
Where do you generally find these patches?
Multiple selection
Hands
Legs
Face
Others
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➜
Does your skin experience any symptoms?
Multiple selection
Itching
Redness
None
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➜
Do you have any family history of vitiligo/
any other skin problem?
YES
NO
Do you suffer any of the below. Tick the relevant one
Multiple selection
Diabetes
Thyroid Disorder
Alopecia Areata
Any other Auto Immune Disorder
None
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➜
Are you undergoing any treatment?
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NO
What does the medicine comprise of?
Tick wherever relevant.
Multiple selection
Tablets
Creams and lotions
Cosmetic corrective Treatment
Ayurvedic
Homeopathy
Light Treatment
Any other
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➜
Is your skin problem affecting you emotionally?
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On the scale of 1-5 rate your stress level
0
5
Please rate
Submit
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Dear
, Thank you for taking our Vitiligo evaluation test!