What are the treatment options for vitiligo?

Updated: Oct 19, 2020
  • Author: Krista Roncone; Chief Editor: Dirk M Elston, MD  more...
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Answer

Various types of medications, phototherapy, laser therapy, and surgical therapy exist. However, it is important to note that in patients with lighter skin, no intervention may be needed. Instead, diligent sun protection may be the best strategy in order to avoid the surrounding normal skin from becoming more tan and making the lesions more obvious. When therapy is necessary, topical steroids, topical calcineurin inhibitors, and narrow-band ultraviolet (UV)–B phototherapy are widely used and are now considered the mainstays of treatment. However, treatment must be individualized and patients should be made aware of the risks associated with therapy. No single therapy for vitiligo produces predictably good results in all patients, and the response to therapy is highly variable. [30, 31, 32, 33, 34]

Some types of vitiligo or lesions in certain locations may be more or less responsive to treatment. Segmental vitiligo and an age of onset younger than 14 years have been associated with more refractory disease. [35]

During therapy, pigment cells arise and proliferate from the pilosebaceous unit, spare epidermal melanocytes, [36] and the border of lesions, and migrate up to 2-4 mm from the edge.


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