Background The involvement of visible areas in vitiligo has been found to be correlated with increased psychiatric morbidity. Even though multiple tools were developed to assess vitiligo, no cut-off for improvement or worsening of vitiligo from the patients’ perspective has been established. Objectives To determine the minimal clinically important difference (MCID) of the Self-Assessment Vitiligo Extent Score (SA-VES) for patients with vitiligo and to evaluate, from the patient’s perspective, the importance of the change in the involvement of visible areas (face and hands) in patients’ overall perception of disease worsening/improving. Methods This is a cross-sectional study in the context of the ComPaRe e-cohort. Adult vitiligo patients were invited to participate and fill in online questionnaires. They completed the SA-VES two times, with a one year interval. In addition, they answered a 5-point Likert anchor question aimed at assessing their perception of the evolution of the extent of their vitiligo. The MCID was calculated using distribution-based and anchor-based approaches. The change of vitiliginous lesions on the face or hands was compared to the overall extent of vitiligo (patches on all body areas) using a logistic regression. Results In total, 244 vitiligo patients were included in the analyses, among which 8% (n=20) were improved. The MCID in worsened patients was equal to a 1.29% body surface area (BSA) (95% CI: [1.01, 1.43]) increase of the SA-VES. For improved participants, the MCID was equal to a decrease of the total SA-VES by 1.330% (95% CI: [0.867, 1.697]). Patients’ perception of the change in their vitiligo was increased seven folds when it affected the face as compared to the rest of the body. Conclusions The changes of the facial SA-VES were highly correlated with the global impression of extent.