Vitiligo is usually not associated with Lyme disease, although both conditions may occur at the same time.

Lyme disease is caused by the bite of a tick infected with bacteria called Borrelia burgdorferi. The body often responds to this infection with a circle of inflammation (redness) around the site of the tick bite. This redness is called "erythema migrans." As the skin redness fades, it may fade first as an inner circle, sometimes leaving a pink patch in the very center. This gives a "bulls-eye" appearance to the skin.

Sometimes people also develop other symptoms from the infection transmitted by the tick bite. A person might develop fever, fatigue, pain and swelling in one or more joints. They might also have nerve problems such as Bell's palsy. Not everyone who has the rash gets other symptoms. And some people who never see a rash get these other symptoms.

The type of central fading inside the red rash of Lyme disease is different from vitiligo. Vitiligo is caused by the loss of melanocytes from skin. This results in the appearance of very white skin in the areas where melanocytes are lost. Melanocytes are the skin cells that produce skin pigment, which gives our skin its color. The tendency to develop vitiligo can be inherited.

One theory about why melanocytes are lost involves an immune response. Although there is also an immune response with Lyme disease, the type of immune response is quite different from the immune reaction to melanocytes associated vitiligo.