Topical, light and laser treatments

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Treatments in the form of creams or ointments are the usual place to start with treatments for vitiligo, although it does depend on where it is on the body and its extent. They are known as topical immunomodulator s because they can suppress the immune response in vitiligo patches.

Current research suggests that topical tacrolimus is effective for localised vitiligo. (Tacrolimus is also known as protopic).  Further details can be found in the study by Bhuvana et al (Indian Journal of Dermatology 2001; 56: 445-6)

Researchers have also found that pimecrolimus  (also known as elidel)  might be useful for people with vitiligo.  There was a study on this by Eryilmaz and colleagues (Journal of the European Academy of Dermatology and Venereology 2009; 23: 1347-8).

The use of tacrolimus and pimecrolimus is included in already published guidelines for medical practitioners.

The use of targeted narrow-band ultraviolet B (UVB) light treatment is now well known for treating localised vitiligo.  This is usually given in the form of the Excimer laser.  The treatment has been advocated by researchers ( see Le Duff et al (British Journal of Dermatology 2010; 163: 188-92).  However, this therapy is not available to most dermatologists in the UK at the moment.

People with vitiligo often question whether lasers (other than the Excimer) will help their condition. Research suggests that some lasers can help with depigmentation, on the rare occasions when this is indicated. Hossani-Madani et al (of Washington DC, USA) have shown that the Q-switched ruby laser does seem to have the advantage of inducing depigmentation more quickly than the usual topical depigmentation treatment of monobenzyl ether of hydroquinone, but with more discomfort (Giornale Italiano Di Dermatologia e Venereologia 2011; 146: 373-95).