Moreover, vitiligo also favors sites of skin injury from various causes (Koebner phenomenon). Typically, the colorless spots gradually increase in size, leading to a significant aesthetic problem, particularly in people with dark skin.
Vitiligo may arise from genetic (hereditary) causes. It is often associated with thyroid diseases and other autoimmune diseases.
Non surgical treatments
Phototherapy with ultraviolet UVB rays, photochemotherapy (PUVA) – Can lead to re-pigmentation in more than 70 % of patients with a recent onset of the disease or localized (focal) disease.
UVB phototherapy, PUVA phototherapy
Vitiligo treatment with laser excimer: It is effective in stable, small lesions which occupy less than 30% of the total body surface. It can be combined with topical use of calcineurin inhibitors or with short-term oral administration of corticosteroids.
Topical corticosteroids: It is the most frequently applied treatment with moderate efficacy.
Topical use of calcineurin inhibitors: It is an alternative effective treatment, particularly if the lesions are located on the head and the neck. It may be combined with Laser or nb UVB treatment.
Topical use of vitamin D analogues: They act trough the suppression of the immune system; they particularly act on T‑lymphocytes. It may be combined with nb-UVB or PUVA treatment.
Systemic corticosteroids: The orally administered prednisolone may be used. However, long-term treatment may be required with several side effects.
Depigmentation of healthy skin with monobenzyl ether of hydroquinone: It is performed in cases where the healthy areas occupy a small area. In this case the treatment also includes the depigmentation of the healthy skin in order to achieve a uniform skin color. It is recommended in very special cases.
They are used in highly localized lesions and only if the disease has been stabilized, and does not show signs of progression for at least 2 years. The unilateral (segmental) vitiligo appears to be the one exhibiting the least progression, and is therefore the most suitable for surgical treatment.
Use of topical cosmetic camouflage creams
Avoid injuries in order to prevent the occurrence of new lesions.
The use of sunscreen is essential both for the protection of the white areas due to lack of melanin, and for the protection of normal skin from burns on the ground of which new vitiligo lesions may develop.