Topical Treatments

Topical treatment, when used immediately after the condition initially emerges, may promote repigmentation of afflicted skin. Based on the size, pattern, and position of the vitiligo patches, your dermatologist will prescribe the right topical medication, which may be used in conjunction with phototherapy or laser therapy to improve the efficacy of both treatments.

 

Topical Corticosteroids

Corticosteroid creams are anti-inflammatory drugs that may help melanocytes return or reduce the progression of vitiligo.   Vitiligo requires a powerful corticosteroid combination, dermatologists meticulously monitor its use when it is recommended. Skin thinning, stretch marks, and acne are all possible adverse effects.

In a few months, many people start to see effects. Topical corticosteroids are frequently administered as part of a long-term treatment strategy that involves two to four annual visits to your dermatologist.

Topical Calcineurin Inhibitors

Calcineurin inhibitors are immune-modulating drugs that prevent the body’s immune system from attacking pigment-producing melanocytes. Calcineurin inhibitors are usually used when topical corticosteroids are ineffective or when vitiligo affects delicate parts of the skin that can’t be treated with them. The eyelids, lips, and genitals are among them.

Topical calcineurin inhibitors come in the form of a tacrolimus ointment or a pimecrolimus cream. These drugs are applied to the affected areas of skin once or twice a day and can take several months to take action. They are frequently part of a long-term therapy plan if they are beneficial.

For more than a decade, topical calcineurin inhibitors have been used safely. They have less long-term negative effects than corticosteroids and can be used for months or years with no problems. A stinging feeling may occur when first applied, however this usually subsides with time.

Topical Calcipotriene

Calcipotriene is a vitamin D synthetic derivative that was originally created to treat psoriasis. It comes in the form of a cream or an ointment. This medicine, when used twice daily, may help to increase the creation of pigment in vitiligo-affected areas of the skin. Results are usually visible after a few months of treatment.

After taking the drug, some patients have moderate skin irritation, but further side effects are uncommon. Calcipotriene may be most helpful in the treatment of vitiligo when used in conjunction with other topical medicines, phototherapy, or laser therapies.

Topical Treatments

Vitiligo causes skin depigmentation, which is not harmful, but many individuals find the look of white patches distressing. If you decide to seek treatment, dermatologists at NYU Langone can advise you on the best alternatives for you.

Topical treatment, especially when used immediately after the problem initially emerges, may promote repigmentation on afflicted skin. Based on the size, pattern, and location of vitiligo patches, your dermatologist will prescribe the right topical medication, which may be used in conjunction with phototherapy or laser therapy to effectiveness of both treatments.

Type Name, if any Effectiveness
Topical Corticosteroids Cortizone and Temovate Effective with possible side effects
Topical Calcineurin Inhibitors Tacrolimus and Pimecrolimus Effective in young people and lesions in face and neck
Topical Calcipotriene Dovonex and Sorilux Not always effective – sometimes leads to repigmentation
Topical Depigmentation Monobenzyl Effective but slow
Topical Tacrolimus (immunosuppressive) Protopic Effectiveness varies by age group

Topical Depigmentation

If your vitiligo has spread to more than 50% of your skin and various topical or light therapies have failed to repigment it, your dermatologist may suggest using topical medication to remove pigment from the remaining skin. Depigmentation, or the loss of skin color, can leave you with a light skin tone that is constant all over your body.

Depigmentation is a more intensive form of therapy, and our dermatologists will work with you to make this decision and ensure that you have all of the information you need. If you want to undergo depigmentation, our specialists will give medical as well as emotional assistance.

Monobenzone is a drug that dermatologists use to erase color from the skin. This drug is applied to pigmented areas of the skin twice a day. This drug gradually fades pigmented spots, bringing them closer to the lighter patches of skin caused by vitiligo. It could take years to accomplish complete depigmentation.

Depigmented skin is extremely sun-sensitive. Every time you spend time outside, you must use a broad-spectrum sunscreen with an SPF of 30 or greater and wear protective clothes. Sun exposure can cause spotting by activating pigment cells in hair follicles beneath the skin. Monobenzone can cause skin irritation and redness as a side effect.

Topical Tacrolimus (Immunosuppresive)

Medications known as calcineurin inhibitors, such as pimecrolimus and tacrolimus, are commonly used to treat eczema. Although tacrolimus is not approved to treat vitiligo, it can help restore skin pigment in adults and children with the disease.

They can cause side effects,  such as:

  • When applied to the skin, it causes a burning or unpleasant sensation.
  • Increasing the skin’s sensitivity to sunlight
  • If you drink alcohol, you may have facial flushing and skin irritation.

Unlike steroids, tacrolimus do not promote skin thinning.

OTC Topical Treatments

A dermatologist may suggest combining several treatments, such as phototherapy and a topical treatment. Other therapeutic options include:

  • Excimer lasers are high-energy light beams that are commonly employed in laser eye surgery but can also be utilized in phototherapy (not available on the NHS)
  • Analogues of vitamin D, such as calcipotriol, which can be used in conjunction with phototherapy.
  • azathioprine is an anti-inflammatory drug that suppresses the immune system.
  • prednisolone pills – a steroid that has been used in conjunction with phototherapy; it has the potential to create negative effects.

Join Our Vitiligo Community

Are you dealing with a recent diagnosis or know someone who has vitiligo? We’re here to help you figure out what works best to manage symptoms and improve overall day-to-day life whether you or someone you love is affected.

Stay up-to-date on the latest news about treatments and managing symptoms. Sign up to get important email updates with relevant information.

This field is for validation purposes and should be left unchanged.