Vitiligo (For Professionals)

Vitiligo affects around 1% of the population and is more visible in darker races.

It is important to follow these steps:

1. See a dermatologist:

-to confirm the diagnosis.

-to classify the vitiligo: extent and distribution.

-to ascertain its behavior (stable for 6 months or evolving?)

-to follow an algorythm of treatment (see below). Monitor improvement

-to evaluate how psychologically impairing the condition is?

2. Follow an algorithm:

-start with mometasone furoate to apply twice a day for 6 months

-after 6months, if there is no improvement, combine with tacrolimus

-if no improvement try NBUVB, PUVA or Multiclear (UVA and UVB); it must be done 2-3 times a week for 4 months. If no time, try photoxic agents like meladinine to stimulate melanogenesis.

-if no improvement try cellular grafting or punch grafting combined or not with NBUVB.

-Janus Kinase (JAK) inhibitors are showing promising results but are not yet approved for Vitiligo (time of the publication)

3. Follow some precautions

-avoid trauma as patients can develop new lesions (Koebner phnomenon)

-if wishing to camouflage the lesions, self tanning agents like dihydroxyacetone may be tried.

-If very extensive, total depigmentation can be better using monobenzyl ether of hydroquinone or para-substituted phenols. However, this must be carefully considered with a dermatologist after evaluation of possible outcome.

This advice is for informational purposes  only and does not replace therapeutic judgement done by a skin doctor.

Source of information: here