Vitiligo is a chronic dermatological condition with significant psychosocial implications. While psychological distress is commonly associated with its onset and progression by those with the condition, there is a lack of research on how these perceptions differ by gender, especially within the Brazilian context. This mixed-methods study aimed to address this gap by investigating gender-based differences in the perceived triggers and progression factors of vitiligo. The study included a sample of 232 Brazilians with vitiligo (68.5% women, Mage = 37.65 years, SD = 12.43). Data were collected via an online questionnaire with an open-ended question, and responses were analyzed using Similarity Analysis with IRaMuTeQ software. Findings revealed that participants predominantly attributed the skin condition’s onset and progression to mental health factors, including emotional turmoil, stress, neuroticism, and rumination. A significant gender disparity also emerged: women most frequently associated the condition with stress and depression, while men primarily cited genetic factors. These results underscore the gendered psychological burden of vitiligo. Therefore, considering gender-specific mental health needs and promoting interdisciplinary care are essential for enhancing therapeutic outcomes, improving quality of life, and reducing stigma.