Question: What are the major vitiligo treatments?
Answer: Major medical treatments for vitiligo include creams and ointments, medications, light therapies, skin grafting, blister grafting, and tattooing. Talk to your doctor about each option to make the best informed decision for you. Explanations and fast facts about each major treatment is below:
- Corticosteroid creams – These are creams that control inflammation, the body’s reaction to infections. In the case of vitiligo, the body is reacting to melanocytes (cells that control skin color) as if they are infectious. Using corticosteroid creams is most effective in the early phases of vitiligo. They can slowly return color to the affected skin. However this treatment takes time, and can also cause weakening skin or color streaks.
- Ointments with tacrolimus or pimecrolimus – Tacrolimus and pimecrolimus aso affect immune responses and may have fewer immediate side effects than corticosteroids, however these medications may increase the likelihood of skin cancer. These work best for small areas of skin with vitiligo.
- UVB therapy – UVB light therapy is a common treatment for vitiligo. It can be done at home daily or at a clinic 2-3 times per week.
- Psolaren and light therapy – Psolaren is a natural substance that comes from pants and makes the skin more sensitive to the sun. Psolaren and ultraviolet A (PSUVA) or ultraviolet B light therapy combines taking psolaren pills or applying it to the skin and getting light therapy from a medical professional. The therapy can require treatments up to three times per week for 6 months to a year.
- Depigmentation – Depigmentation is the gradual removal of color from the skin that is not affected by vitiligo to even out the overall skin. This is an option for someone with widespread vitiligo who has not had success with other treatments. It is permanent and side effects include redness, itchiness, dry skin, and sensitivity to sunlight.
- Skin grafting – Skin grafting is the removal of small sections of unaffected skin and placement in areas of white patches. This can leave scars and sometimes the affected area fails to recolor.
- Blister grafting – In blister grafting, the doctor makes tiny suctions, resulting in blister, on the surface of healthy skin, and then removes the tops of the blisters which contain pigment (the cells that control the color of the skin). The doctor transplants the pigments onto white patches. This also can cause scarring and is not always successful in re-coloring the skin. Blisters, like other skin injuries, can cause new vitiligo patches in the healthy area.
- Tattooing – Tattooing, or micropigmentation, implants pigment into the skin with a fine instrument. Doctors need to identify matching pigment to use for this procedure. It is best for people with darker skin. Since tattooing also punctures the skin, it is another risk factor for a new vitiligo patch.
There are many additional treatments and new treatments are being researched. The right treatment for you depends on your skin type, and the type of vitiligo you have and it’s progression, as well as considerations for the risks, costs, and benefits of each treatment.