How do you treat vitiligo? It’s one of the most commonly asked questions by vitiligo patients. The good news? We have safe and effective methods for treating vitiligo in 2019. The better news? Given the surge of vitiligo research in the past decade, new options for treatment are currently going to clinical trials – which means the future looks bright.
However, there is still work to be done. Results from vitiligo treatments vary and can be unpredictable. Treatments can also require a significant time commitment, have serious side effects and might not be covered by insurance. In addition, most vitiligo treatments are still not approved by the FDA for vitiligo specifically, but are used for other diseases.
As there are many factors that determine the right type of treatment for each person, vitiligo patients should always consult a dermatologist to determine a course a treatment. However, it’s good to have an understanding of the available options on the market.
Here are the top vitiligo treatments being used in 2019:
A common form of treatment, topical steroids are anti-inflammatory creams that are applied to areas of the skin with vitiligo. The results may slow the progression of vitiligo or allow for repigmentation. A typical treatment schedule may include once or twice a day applications. According to the American Academy of Dermatology, about 45% of patients regain some pigment after 4 to 6 months of treatment. The pros? Topical steroids are widely available, often cheap, effective, and easy to use. The cons? This form of treatment can have side effects, including thinning of skin and stretch marks. Ask your dermatologist how to minimize the impact of these side effects.
A relatively new treatment for vitiligo, topical tacrolimus is a calcineurin inhibitor that works to prevent the immune system from attacking the melanocytes that produce pigment. Tacrolimus is usually prescribed only when topical steroids are ineffective and is applied once or twice a day via an ointment. Side effects may include a mild stinging sensation post-application. The pros? It’s almost as effective as topical steroids. The cons? This treatment is expensive and my not be covered by insurance.
Narrowband light therapy
Narrow-band ultraviolet B (nbUVB) therapy is a form of light treatment where patients are treated in a light booth two to three times a week at a dermatologist’s office or using a home unit. Light therapy – also known as phototherapy – involves regular, brief exposure to ultraviolet (UV) light. The UV rays stimulate melanocytes, the cells in the skin responsible for producing pigment. The key to light therapy is that monitored administration is important for safety and treatment success as too much light could burn the skin, while too little light could lack results. The pros? According to the UMass Vitiligo Clinic and Research Center, nbUVB is currently the most successful treatment for patients with vitiligo. The cons? Treatment comes with a significant time commitment and results can disappear if patients do not keep up with treatment.
The excimer laser is a form of light treatment that delivers a highly-focused beam of UVB using a wand-like device. Using a 308nm wavelength of light, which has proven to be effective at treating vitiligo, the laser may stimulate repigmentation in the skin. Although highly effective, it works best when treating small areas of skin. Patients will typically visit their dermatologist’s office for treatments twice a week over four to six months and about 70% of patients see positive results. Pros? It’s highly effective, quick and works well for small areas of vitiligo patches. Cons? It’s time intensive with multiple sessions required over a course of several months.
Surgery and skin grafting
Another option for vitiligo treatment is surgery or skin grafting, which involves replacing the top skin layer on white spots with healthy pigment cells taken from another part of the body. While there are several surgical procedures, the UMass Vitiligo Clinic and Research center reports that cellular grafts, in which the top layer of skin is removed by dermabrasion or laser treatment, provides the best results and can be applied to the largest areas. The pros? This can be an effective treatment for patients with segmental vitiligo. The cons? This form of treatment doesn’t work for everyone, is expensive and may not be covered by insurance.
The only FDA-approved treatment for vitiligo, monobenzone is used to remove pigment from the skin to make color more even, but incredibly pale. The treatment is applied daily as a cream and gradually removes the color from our skin. Physicians recommend this option for patients with widespread vitiligo that have not seen success with other forms of treatment. The pros? This treatment will allow a patient to achieve one color of skin again. The cons? It’s not widely available and is often used only as a last resort.
Disclaimer: This list is provided for informational purposes only. Please consult your dermatologist to determine the best treatment options for you.
Have you tried vitiligo treatment? What was your experience?
Deepa Mistry is a college student from New York studying biochemistry and economics who finds her vitiligo to be a blessing in disguise. What used to be a burden has now become a pillar of strength and she hopes to inspire others to find content with their vitiligo. She enjoys writing and dancing.