For years, many people with vitiligo heard some version of: “There is not much you can do.” That is no longer a fair summary of modern vitiligo care.
Vitiligo is an autoimmune condition in which pigment-producing cells are lost, creating lighter or white patches of skin. It can affect any skin tone, but the contrast may be especially visible in people with more deeply pigmented skin.
Q: Is there now an FDA-approved medication for repigmentation?
A: Yes. Ruxolitinib cream (Opzelura), a topical JAK inhibitor, is FDA approved for the treatment of nonsegmental vitiligo in adults and children age 12 and older. It was the first FDA-approved medication specifically intended to restore pigment in vitiligo.
It is not an overnight treatment. Repigmentation can take months, and some areas respond better than others. The face and neck often respond more readily than fingertips, toes, and some other sites.
Q: Where does phototherapy fit?
A: Narrowband UVB phototherapy remains an important treatment for many patients, particularly when vitiligo involves broader areas. Targeted light treatment, such as Excimer laser treatment, may be useful when disease is more localized. Dermatologists may sometimes combine light-based therapy with topical treatment depending on the situation.
Q: Does treatment “cure” vitiligo?
A: It is better to think in terms of controlling disease activity and encouraging repigmentation. Vitiligo is chronic, results vary, and pigment can sometimes be lost again. Treatment decisions depend on where the vitiligo is located, whether it is spreading, the patient’s age, medical history, treatment burden, and personal goals.
- Topical anti-inflammatory or immune-directed medication
- FDA-approved ruxolitinib cream for eligible nonsegmental vitiligo patients age 12+
- Narrowband UVB for broader involvement
- Targeted Excimer laser treatment for selected localized areas
- Camouflage and sun protection remain useful whether or not active treatment is chosen
Q: Why does sun protection matter?
A: Depigmented skin has less melanin protection and can burn more easily. Sun protection can also reduce tanning of surrounding skin, which may decrease contrast between affected and unaffected areas.
Q: When is a good time to seek treatment?
A: If patches are new, spreading, cosmetically distressing, or affecting areas where repigmentation is especially important to you, a dermatology evaluation can clarify the diagnosis and available options. Not every white patch is vitiligo, so diagnosis comes first.
Learn more about medical dermatology at Borealis. Borealis also offers phototherapy options depending on location and clinical need.
Borealis Dermatology sees patients in Garden City, Syosset, and Bellerose, NY. Visit our locations page or Book Appointment.
Continue reading about what narrowband UVB phototherapy involves.
Related care: Vitiligo treatment · Narrowband UVB phototherapy · Excimer laser treatment