How is vitiligo treated?
Thereโs no cure for vitiligo. Instead, treatment for vitiligo tends to be either repigmentation (restoring color) or depigmentation (removing remaining color) to create an even skin tone. Treatment for vitiligo is long-term and personalized. It can include light therapy, topical, and oral medications.
Your treatment options will also vary based on your subtype. In the early stages of SV, topical treatments and light therapy are usually used. But in the stable stages, surgical treatment is often the preferred option. In the stable stages of NSV, topical treatments and light therapy are often recommended, but surgery may be recommended if these donโt work.1 Lastly, if your vitiligo is spreading quickly, then oral steroids can be prescribed.
Topical treatments
Topical treatments include steroids and calcineurin inhibitors.
Corticosteroids
Clobetasol propionate (Clobex), for example, is a corticosteroid that โre-pigmentsโ skin. It works by suppressing the immune system so it cannot destroy melanocytes.2
Medications that affect your immune system
Elidel and Protopic are topical calcineurin inhibitors (TCIs). TCIs also prevent the immune system from overreacting, so that it doesnโt destroy your melanocytes.2 However, as with all drugs, they do have side effects and most cannot be used long-term.
Another option is a medicine called ruxolitinib (brand name Opzelura). Itโs a type of Janus kinase (JAK) inhibitor that works by blocking the immune enzymes that mistakenly attack and destroy your melanocytes.3 Upadacitinib (brand name Rinvoq) is another JAK inhibitor thatโs been proven effective in patients with NSV, but it hasnโt been approved for vitiligo yet.4
Light therapy
Light therapy is another option to repigment the skin.5 While light therapy is a popular option, it can be pricey and time-consuming because it requires regular visits to the clinic over an extended period to see major results.6ย Itโs also not safe for children or pregnant women, and the treatment may not always produce the desired outcome.
Surgery
Surgery is another option for SV or localized vitiligo. Two of the most common options include tissue grafting and cellular grafting. With tissue grafting, a small piece of skin is taken from an area of your body that has pigmentation and then transferred to the affected site.7 Cellular grafting involves the transfer of cells, like melanocytes, to the affected area. But surgery can cause some side effects, such as the Koebner phenomenon. This is when previously healthy skin experiences physical changes as a result of the surgery.7
What medications are there for vitiligo?
There are several treatment options for vitiligo. For example, corticosteroids like clobetasol (Clobex) โrepigmentโ skin by suppressing the immune system. Elidel and Protopic are both TCIs but contain different active ingredients. When applied, they suppress the immune system. All of these treatments repigment the skin. If one doesnโt work, you can always try another.
Opzelura is a recent popular vitiligo treatment that can restore color in patients with NSV.8ย It suppresses the immune system while also repigmenting skin on all body parts. However, it can cause serious side effects for some people.
Is there a โbestโ treatment for vitiligo?
Because each person will have a personalized treatment plan depending on their condition, so there is no โbestโ treatment. Some treatments will work better for one person and not work for another. The main deciding factor for the treatments is the type of vitiligo you have. After that, there are many options you can choose from.
Does vitiligo always need treatment?
No, treatment is optional in the majority of cases. Vitiligo doesnโt usually cause any physical discomfort or pain, but it can affect people’s self-esteem and confidence. Having an uneven skin tone or being in skin that doesnโt feel like your own can be difficult, so itโs okay to get some type of treatment. However, if youโre comfortable with yourself, then no, you donโt need treatment.
