Vitiligo is a chronic skin condition characterized by the loss of melanocytes, the cells responsible for producing melanin, the pigment that gives color to the skin, hair, and eyes. While various treatment options are available to manage vitiligo, some individuals may opt for surgical interventions when other treatments have been ineffective or for cases where the depigmentation is widespread or stable. Surgical options for vitiligo aim to repigment the affected areas by either transplanting melanocytes or altering the pigmentation of the surrounding skin. In this article, we will explore the different surgical options available for vitiligo.

Autologous Melanocyte Transplantation:

Autologous melanocyte transplantation is a surgical procedure that involves harvesting melanocytes from a donor site on the patient’s own body and transplanting them into the depigmented areas. This technique is most suitable for stable vitiligo, where the affected areas have not shown any signs of progression for at least one year. The donor site is typically chosen from an area with pigmented skin, such as the buttocks or thigh. The harvested melanocytes are then isolated, multiplied in the laboratory, and subsequently transplanted onto the depigmented areas. This procedure can be performed using techniques such as suction blister grafting, split-thickness grafting, or cultured melanocyte suspension, depending on the patient’s individual case.

Non-cultured Epidermal Suspension:

Non-cultured epidermal suspension involves removing a thin layer of the patient’s own epidermis (the outermost layer of the skin) from a pigmented area and transplanting it onto the depigmented areas. This procedure is less time-consuming compared to melanocyte transplantation, as it does not require cell culture. The transplanted epidermal cells contain melanocytes that can gradually repigment the depigmented skin. This technique is particularly effective for treating small or localized vitiligo patches.

Microskin Grafting:

Microskin grafting is a surgical technique that involves transplanting small pieces of normally pigmented skin onto the depigmented areas. The donor skin is typically harvested from an inconspicuous area of the patient’s body, such as behind the ear. The harvested skin is divided into tiny pieces and transplanted onto the depigmented areas, creating a patchwork of pigmented skin. This method can provide a natural appearance and is suitable for cases where the depigmented areas are limited in size.

Tattooing:

Tattooing, also known as micropigmentation, is a less invasive surgical option for vitiligo. It involves injecting pigment into the depigmented areas to match the surrounding skin color. This technique can provide immediate and long-lasting results. However, it is important to note that tattooing may not be suitable for all individuals or all areas of the body, and the color may fade over time, requiring touch-ups.

Excimer Laser:

Excimer laser therapy is a non-invasive surgical option that uses targeted ultraviolet (UV) light to stimulate repigmentation in the affected areas. The excimer laser emits a specific wavelength of UVB light, which is directed at the depigmented skin. The targeted UVB light stimulates melanocyte activity, leading to repigmentation over time. This treatment is typically performed in multiple sessions and can be effective for localized vitiligo patches.

An Alternative Cure?

In 2025, 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: