“There is no cure [for vitiligo],” says Michele Green, MD, a New York City–based dermatologist in private practice. However, many safe and effective treatments can even out the skin tone and make the patches less noticeable.
Cosmetic Options
Using makeup or self-tanning products may help cover the white spots caused by vitiligo.
“A self-tanner stains the skin, so you can stain all the skin and camouflage a little bit of the vitiligo patches,” says Sandy Skotnicki, MD, a Toronto-based dermatologist and the author of Beyond Soap. “That’s a useful suggestion sometimes for people with fairer skin colors, though it can be tricky to find the right shade.”
Applying sunscreen regularly can help prevent the spread of vitiligo. By preventing sunburn, regular sunscreen use may help prevent the spread of vitiligo, and it will lessen the contrast between your natural skin tone and discolored skin.
Medication
Medications don’t stop vitiligo from spreading, but in some cases they can restore some skin color. Anti-inflammatory corticosteroid creams have been shown to help, especially if you start using one soon after your diagnosis. It may take several months to notice a difference; topical steroids may also cause side effects, such as streaky-looking skin.
Topical medications containing tacrolimus (Protopic) or pimecrolimus (Elidel) can help vitiligo that affects small areas, such as the face or neck.
In 2021, the U.S. Food and Drug Administration (FDA) approved a new class of medications known as topical Janus kinase (JAK) inhibitors for the treatment of vitiligo. These medications block a protein that leads to inflammation and pigment cell destruction. The JAK inhibitor ruxolitinib (Opzelura) is applied as a cream twice daily to the affected areas for up to eight weeks.
Light Therapy
With light therapy, the skin is exposed to ultraviolet light to stimulate the growth of pigment-producing cells. It’s an effective treatment, though you may need to repeat the treatments three times a week for up to a year.
Light therapy may also be used in conjunction with psoralen, a plant-derived medication that can help restore color to the area, though this increases the risk of developing a burn and a skin cancer in that area.
Green says one type of laser in particular, the excimer laser, has been effective for treating vitiligo.
Depigmentation
In some cases, depigmentation — a therapy that evens out the skin tone by removing pigment from skin that’s been unaffected — is an option. This treatment is usually needed one or two times per day for about nine months and tends to be the most helpful for people who have very widespread cases and haven’t had success with other treatment options. The change in your skin tone will be permanent. The skin will be sensitive to light going forward, and you may also experience dryness, itching, or swelling.
Surgery
Some people turn to surgery to treat their vitiligo. Surgical options include:
- Skin Grafting This involves removing small sections of normally pigmented skin and attaching them to areas that have lost color.
- Blister Grafting This treatment transplants intentionally created blisters from areas of normally pigmented skin to areas where color is gone.
- Cellular Suspension Transplant In this procedure, your doctor takes some tissue on your pigmented skin, puts the cells into a solution, and then transplants them onto the prepared affected area.
- Micropigmentation Micropigmentation involves implanting small particles of natural pigment under the skin, similar to a tattoo.
All these options aim to bring color back to the skin. Tattooing is particularly helpful for people with dark skin who have vitiligo on their hands or in and around their mouths.
There are some negative side effects to be aware of for each of these surgical options, such as scarring, skin that has a cobblestone appearance, and the potential triggering of vitiligo elsewhere on the body.
It’s also important to know that sometimes these treatments don’t stick, and new patches may appear even if it seems to be working well on existing ones.
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