How is vitiligo treated?

There is no cure for vitiligo. The goal of medical treatment is to create a uniform skin tone by either restoring color (repigmentation) or eliminating the remaining color (depigmentation). Common treatments include camouflage therapy, repigmentation therapy, light therapy and surgery. Counseling may also be recommended.

Camouflage therapy:

  • Using sunscreen with an SPF of 30 or higher. Also, the sunscreen should shield ultraviolet B light and ultraviolet A light (UVB and UVA). Use of sunscreens minimizes tanning, thereby limiting the contrast between affected and normal skin.
  • Makeups help camouflage depigmented areas. One well-known brand is Dermablend®.
  • Hair dyes if vitiligo affects the hair.
  • Depigmentation therapy with the drug monobenzone can be used if the disease is extensive. This medication is applied to pigmented patches of skin and will turn them white to match the areas of vitiligo.

Repigmentation therapy:

  • Corticosteroids can be taken orally (as a pill) or topically (as a cream put on the skin). Results may take up to 3 months. The doctor will monitor the patient for any side effects, which can include skin thinning or striae (stretch marks) if used for a prolonged period.
  • Topical vitamin D analogs.
  • Topical immunomodulators such as calcineurin inhibitors.

Light therapy:

  • Narrow band ultraviolet B (NB-UVB) requires two to three treatment sessions per week for several months.
  • Excimer lasers emits a wavelength of ultraviolet light close to that of narrow band UVB. This is better for patients who do not have widespread or large lesions since it is delivered to small, targeted areas.
  • Combining oral psoralen and UVA (PUVA) is used to treat large areas of skin with vitiligo. This treatment is said to be very effective for people with vitiligo in the areas of the head, neck, trunk, upper arms and legs.

Surgery:

  • Autologous (from the patient) skin grafts: Skin is taken from one part of the patient and used to cover another part. Possible complications include scarring, infection or a failure to repigment. This might also be called mini grafting.
  • Micropigmentation: A type of tattooing that is usually applied to the lips of people affected by vitiligo.

Counseling:

  • Vitiligo can cause psychological distress and has the ability to affect a person’s outlook and social interactions. If this happens, your caregiver may suggest that you find a counselor or attend a support group.

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