Guidelines for the Management of Vitiligo

The European Dermatology Forum Consensus

A. Taieb; A. Alomar; M. Böhm; M.L. Dell'Anna; A. De Pase; V. Eleftheriadou; K. Ezzedine; Y. Gauthier; D.J. Gawkrodger; T. Jouary; G. Leone; S. Moretti; L. Nieuweboer-Krobotova; M.J. Olsson; D. Parsad; T. Passeron; A. Tanew; W. van der Veen; N. van Geel; M. Whitton; A. Wolkerstorfer; M. Picardo

Disclosures

The British Journal of Dermatology. 2013;168(1):5-19. 

In This Article

Other Systemic Interventions: Antioxidants

The occurrence of cellular oxidative stress during the progression of vitiligo is the rationale for the topical or systemic administration of antioxidants.[85] Pseudocatalase, vitamin E, vitamin C, ubiquinone, lipoic acid, Polypodium leucotomos, catalase/superoxide dismutase combination, and Ginkgo biloba are antioxidants that have been used alone or, more frequently, in combination with phototherapy. The administration of antioxidants during or before phototherapy aims to counteract the oxidative stress induced by UV radiation itself, increasing its effectiveness.

Efficacy

Open trials suggested that oral or topical administration of single or multiple antioxidants stopped the progression of the disease and promoted repigmentation.[86] RCTs reported to date suggest that vitamin E is effective for the recovery of skin lipid peroxidation induced by PUVA treatment.[87] A mixture of α-lipoic acid, and vitamins E and C, administered in a double-blind placebo-controlled trial, promoted a reduction of UV dosage together with improvement of the repigmentation.[65] Polypodium leucotomos, an antioxidant photosensitizing and immunomodulator agent, was effective when used in association with PUVA or UVB.[66]Ginkgo biloba, a polyphenol compound with anti-inflammatory, immunomodulatory and antioxidant activities, also showed promising results. However, the number of enrolled patients is limited and outcome parameters are inconsistent.[88–90] No side-effects have been reported but long-term administration has raised concerns.[91]

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