Systemic treatments

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It is difficult to find a systemic treatment for vitiligo at the moment. Dr Szczurko et al have looked at ginkgo biloba (BMC Complement Altern Med. 2011 Mar 15;11:21). Twelve participants 12 to 35 years old were recruited to a prospective open-label pilot trial and treated with 60 mg of standardized Ginkgo biloba two times per day for 12 weeks. Effectiveness was assessed using the Vitiligo Area Scoring Index (VASI) and the Vitiligo European Task Force (VETF), which are validated outcome measures evaluating the area and intensity of depigmentation of vitiligo lesions.

Ingestion of 60 mg of Ginkgo biloba BID was associated with a significant improvement in total VASI vitiligo measures and VETF score spread, and a trend towards improvement on VETF measures of vitiligo lesion area and staging. However, proper clinical trials are needed before this can be generally recommended as a treatment.

Piperine, derived from black pepper, has been mooted as a potential treatment for vitiligo.  So far there have only been studies in animals, which have shown an increase in pigmentation in mice treated with a piperine derivative (Faas et al. Br J Dermatol 2008; 158: 941-50). With regard to cosmetic camouflage treatment, Tanioka and colleagues from Kyoto Japan discovered that this improves quality of life (J Cosmet Dermatol 2010; 9: 72-5). New European guidelines have been introduced (see Taieb et al. Br J Dermatol. 2013; 168: 5-19).