While it’s true there’s no cure for vitiligo, there are a variety of approaches for managing it and making it less noticeable.
Corticosteroids and Calcineurin Inhibitors
These medications are applied directly to affected areas of the skin. They work by blocking the immune system and promoting repigmentation. They’re most often used for small patches of vitiligo.
Janus Kinase (JAK) Inhibitors
Janus kinase (JAK) inhibitors stop the production of certain proteins that immune cells use to communicate with each other, making these drugs a more targeted treatment approach than topical steroids or calcineurin inhibitors. While most are not approved by the U.S. Food and Drug Administration (FDA) for vitiligo, oral JAK inhibitors have been prescribed off-label to treat the condition for some time.
In 2022, the FDA approved the first JAK inhibitor for vitiligo, a topical medication called ruxolitinib (Opzelura) for people 12 and up. It can only be used on up to 10 percent of the body’s surface area, however, so it may not offer adequate results for some people with more extensive depigmentation.
Oral Steroids
When vitiligo is spreading very quickly and JAK inhibitors aren’t working, a doctor may prescribe oral steroids temporarily to suppress the immune system, Harris says. But, due to potentially severe side effects, the recommendation is that they only be used for up to three months at a time (six months maximum), making them a short-term fix at best.
Narrowband UVB Therapy
This type of phototherapy (light therapy) is the oldest treatment for vitiligo. “In India, [ancient] religious texts talk about vitiligo,” says Harris. “People would chew on seeds and then sit in the sun.”
In modern times, phototherapy for vitiligo involves directing ultraviolet B light rays at affected areas of the skin in a medical setting, for 5 to 10 minutes at a time. It may require two to three sessions per week, depending on the severity of the vitiligo, to shrink existing patches and help prevent new ones from forming.
Melanocyte Transplantation Surgery
For someone whose vitiligo is stable, a doctor can surgically transplant melanocytes harvested from healthy skin onto depigmented skin to restore color.
Depigmentation
This treatment was the only one that was FDA-approved for vitiligo until ruxolitinib got the green light. A topical medication called monobenzone ether of hydroquinone (MBEH) is used to lighten unaffected areas of the skin that are adjacent to vitiligo patches to make the differences in color less stark. Harris says not many of his patients like this option, but it is one to consider if other treatments don’t work.
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