Vitiligo is a skin condition where white patches appear on the skin. It appears on one’s hands, forearm, face or feet and can spread all over the body over time. Research indicates that this condition has a prevalence of 0.5-2% globally in adults and children.
The goal of available medical treatments and therapies is to create a skin tone that is uniform by restoring color or getting rid of the remaining color. Here are some of the most common vitiligo medications:
Topical Pimecrolimus or Tacrolimus
Pimecrolimus and tacrolimus are topical, nonsteroidal calcineurin inhibitors used for treating skin conditions such as dermatitis. Both of these creams were FDA approved for use for every person of 2 years and above. The treatments work when the cream is applied to the affected area of the skin over time. This form of treatment has shown repigmentation in affected areas after some time.
However, using topical pimecrolimus or tacrolimus is only effective for the neck and facial regions. It is because other areas (apart from the face and neck) have a high molecular density which makes it hard for the cream to penetrate or get absorbed into the skin. In order to achieve effective regimentation, the treatment has to include carrier-mediated drug delivery that bypasses the stratum corneum barrier.
Also, Topical steroids can be used to treat vitiligo. They are available in creams and ointments applied directly on white patches. Treatment is usually applied once per day and follow-up with a physician from time to time.
Phototherapy uses expertly sourced and filtered ultraviolet light to stimulate repigmentation process by targeting areas affected by vitiligo. This method utilizes psoralen-UV-A (PUVA) and narrowband UV-B (NBUVB) therapy for generalized vitiligo.
This kind of treatment activates repigmentation by increasing the number of melanocytes on the affected parts of the skin and prevents white patches from forming again. Research has shown a number of side effects associated with phototherapy, including skin irritation or sunburn-like skin reaction. If you prefer phototherapy, be sure to approach a qualified doctor in order to avoid more pronounced side effects and ensure effective treatment.
For more information on this treatment mode, check out our article: UV Therapy for Vitiligo
Skin grafting is a surgical treatment approach for vitiligo. During the process of treatment, a healthy skin from an unaffected area of the body is removed and used to cover the affected parts. The treatment is more effective when combined with phototherapy.
The procedure has two approaches; cell grafting and tissue grafting. Both cell and tissue grafting involve transferring healthy skin portions from the body to the areas affected by vitiligo to achieve repigmentation.
It is best to inform your doctor about other medications you might be using because skin grafting treatment can interfere with certain medications like aspirin. Also, smoking tobacco can impair your ability to heal after skin graft so be sure to stop it ahead of the surgery.
Depigmentation therapy is an option for those who suffer from widespread severe vitiligo and have tried a number of treatments or therapies but no results. This form of vitiligo medication aims to remove skin pigments in an attempt to even out the skin tone to one uniform color.
The approved depigmentation agent commonly used is monobenzyl ether of hydroquinone (MBEH). Using MBEH is advisable for patients with more than 50% of their bodies affected by vitiligo. MBEH is a permanent therapy for depigmentation because it kills cells responsible for pigmentation (melanocytes)
There are other remedies that can be used to manage vitiligo, although they are not fully proven to be effective. They include:
Use of cosmetics – Someone can use cosmetics to cover the white patches. Some of the effective ones include self-tanners, tinted primers, foundations, and powders. This method is not technically a treatment, but it can help improve self-image and confidence.
Ginkgo biloba – This is an anti-inflammatory herb that has been used for repigmentation among a smaller number of people. Check out our in-depth article here: Ginkgo biloba for vitiligo
Supplements and lifestyle changes – Certain vitamins that are vital for repigmentation – check out our in-depth article here. Plus, reduced exposure to sun and using sunscreen can help as well as prevent uneven tanning and hyperpigmentation.
An Alternative Cure?
In 2023, vitiligo researcher David Paltrow came out with a bold claim: according to him, the root cause of vitiligo has nothing to do with melanin (the skin pigment). Even bolder, he is claiming that by tackling this root cause, he is able to cure vitiligo in his patients without using any of the above-mentioned medications.
Although not everyone agrees with his claims, I do think his introductory video is worth a watch. Check it out below: