Medical therapies for vitiligo

Abstract

: There are many options available for the treatment of vitiligo, the majority of which have as their goal to restore pigment. Sunscreens not only help prevent sunburn (thus preventing the resulting Koebnerization), but they also lessen the contrast between normal skin and the vitiliginous lesions. There are two major types of sunscreens: chemical sunscreens which function by absorbing the ultraviolet B (UVB) and/or UVA and physical sunscreens which block or scatter the ultraviolet rays. Cosmetics can be used for patients with limited lesions, especially those on the face and neck. An advantage to cosmetics is their limited number of side effects and ease of application. Topical corticosteroids are another option available for treating vitiligo. Lesions on the face, neck and extremities (with the exception of the fingers and toes) appear to repigment better with corticosteroids than other parts of the body. Repigmentation may take 4 months or longer; however, it should be noted that recurrence can occur upon discontinuation. Psoralen plus UVA (PUVA) therapy, both topical and oral, is the most common medical treatment for vitiligo. PUVA therapy is usually administered once or twice a week, but not on two consecutive days. Narrow-band UVB radiation is an alternative to standard PUVA therapy, but without many of its side effects. The frequency of narrow-band UVB treatments is similar to that for PUVA therapy.