What are the treatment options for vitiligo?
The overall goal of treatment is to return the skin to its normal color or to even out your skin tone. Treatment depends on your age, the amount of skin involved, location of the affected areas, how quickly the disease is progressing, and how vitiligo is affecting your life.
Treatment is important because it can stop or slow the discoloration and return some of your normal color. Treatment results can vary and it’s hard to predict which treatments will work best for each case. Treatment can take many months to determine if it is going to work on your skin. Several treatments or a combination of treatments may be used until your dermatologist finds what works best for you. And, even if treatment is successful, it may not last, or new vitiligo may develop.
Some treatments carry serious side effects. A frank discussion with your dermatologist is essential to understand what may or may not happen with treatment.
Treatment options can include:
- No treatment except for makeup to even skin tone.
- Self-tanning products may be the first recommendation. Self-tanning can be time consuming and the result may not look natural.
- Corticosteroid creams can help control inflammation and restore color. They are most effective if used when vitiligo starts. Treatment may take several months. Side effects include skin thinning or streaks/lines on the skin. Skin also becomes very dry, fragile and easily damaged.
- Corticosteroid injections or pills may be used if vitiligo is progressing quickly.
- Medications that affect your immune system can be effective for cases with small areas of lighter skin. Side effects are a possible link to lymphoma and skin cancer.
- Light-based therapy (phototherapy) can stop or slow the development of active vitiligo. Often used with corticosteroids or immune system medications. It takes months to see an improvement and about six months to see the full effect. Most people require two to three treatments a week. Phototherapy can cause skin redness, itching and burning for a few hours after each treatment.
- Phototherapy with ultraviolet-A light plus psoralen that is taken internally or applied to the skin. Lasers can be used on small areas.
- Depigmentation involves removing any remaining color. It’s used if vitiligo is widespread and/or if other treatments were unsuccessful. Depigmenting medication is applied to the affected skin to gradually lighten it so it blends with discolored areas. This method requires once- or twice-a-day applications for nine months to up to four years. It can cause redness, swelling, itching and very dry skin. This treatment causes permanently white skin.
- Surgery may be used if phototherapy and medications were unsuccessful. Surgery can even out skin tone by restoring color. However, it can also cause an infection, scarring, bumpy skin, spotty color, skin damage that causes more vitiligo patches, or the area may not recolor. Surgical options include:
- skin grafting takes small sections of normal skin and grafts them onto lighter patches
- blister grafting creates skin blisters using suction and transplants the tops of the blisters to lighter skin
- cellular suspension transplant takes normal skin tissue, removes the cells and places them in a solution that is transplanted to the affected areas.
- Developing a coping strategy is an important part of treatment because most people have vitiligo for life. The condition brings unwanted attention or embarrassment that can affect patients’ mental and social health. Support groups and/or counseling therapy can be very helpful in maintaining a positive outlook.
- Lifestyle remedies can help protect skin and improve its appearance. These include wearing sunscreen every day, avoiding tanning beds and sun lamps, avoiding tattoos because they can cause more patches of vitiligo.