Can you develop albinism over time, or is it something you have to be born with?

Albinism vs vitiligo. If you are born with a genetic mutation that prevents production of melanin (and other pigments), then you are an albino and have albinism. If you begin to lose pigment (typically in patches) as you age, then you likely have vitiligo (e.g. Michael jackson), which is a skin condition where the pigment-producing cells die for various reasons.