What are the treatment options for vitiligo?

From the Guidelines

The most effective treatment for vitiligo is a combination of intradermal platelet-rich plasma (PRP) injection and narrowband UVB (NB-UVB) phototherapy, as it has been shown to significantly improve repigmentation and shorten the duration of follow-up 1. This approach is supported by a recent study published in 2025, which demonstrated a statistically highly significant improvement in repigmentation in the combination group compared to NB-UVB alone 1. The study found that 34.6% of patients in the combination group showed an excellent response, compared to 0% in the placebo group.

Treatment Options

Other treatment options for vitiligo include:

• Topical corticosteroids, such as betamethasone or clobetasol, applied once or twice daily for limited periods
• Calcineurin inhibitors, such as tacrolimus 0.1% or pimecrolimus 1% ointment, applied twice daily
• Oral corticosteroids, such as prednisone 0.3-0.5 mg/kg/day, for short courses in rapidly progressing disease
• JAK inhibitors, such as ruxolitinib 1.5% cream, applied twice daily
• Surgical options, such as skin grafting or melanocyte transplantation, for stable vitiligo
• Depigmentation therapy with monobenzyl ether of hydroquinone, for widespread vitiligo

Phototherapy

Phototherapy, particularly NB-UVB, is an effective treatment for vitiligo, especially for patients with darker skin types 1. However, it should be used in preference to PUVA due to its greater efficacy and safety 1. The treatment should be monitored with serial photographs every 2-3 months, and safety limits should be strictly adhered to, with an arbitrary limit of 200 treatments for skin types I-III 1.

Quality of Life

Vitiligo can significantly impact a patient's quality of life, and psychological support should be considered as part of the treatment plan. Sun protection is also essential during treatment to prevent further skin damage. Combining therapies often yields better results, and treatment should be maintained for at least 3-6 months to evaluate effectiveness.

From the Research

Treatment Options for Vitiligo

The treatment options for vitiligo include:

• Narrow band ultraviolet B (NB-UVB) phototherapy 2, 3
• Topical immunomodulators such as pimecrolimus and tacrolimus 2, 4, 5, 3
• Topical corticosteroids such as clobetasol propionate 4, 6
• Calcipotriene and corticosteroid combination therapy 6

Efficacy of Treatment Options

The efficacy of these treatment options varies depending on the anatomical location of the lesions and the type of vitiligo. For example:

• NB-UVB phototherapy may be more effective for lesions on the face and neck 2
• Topical immunomodulators such as pimecrolimus and tacrolimus may be more effective for lesions on the face and trunk 2, 4, 5
• Calcipotriene and corticosteroid combination therapy may be effective for patients who have failed previous treatments with topical corticosteroids alone 6

Combination Therapy

Combination therapy, such as the use of NB-UVB phototherapy and topical tacrolimus, may also be effective for treating vitiligo 3. This combination therapy has been shown to be well tolerated and effective in promoting repigmentation, especially for lesions on the face, trunk, and limbs.

Response to Treatment

The response to treatment can vary depending on the age of the patient, the duration of the disease, and the location of the lesions. For example:

• Children may have a better response to treatment than adults 5
• Patients with a disease duration of 5 years or less may have a better response to treatment 5
• Lesions on the face and trunk may respond better to treatment than lesions on the extremities and genital areas 3