Topical treatments are the usual place to start with treatments for vitiligo, though it does depend on the site and extent of involvement. Bhuvana et al (Indian J Dermatol 2001; 56: 445-6) suggest that topical tacrolimus is effective for localized vitiligo. Eryilmaz and colleagues find that the other topical immunomodulator, pimecrolimus, might be useful (J Eur Acad Dermatol Venereol 2009; 23: 1347-8). Both of these approaches have been mentioned in already published guidelines.

The use of targeted narrow-band ultraviolet B (UVB) usually in the form of the Excimer, advocated by Le Duff et al (Br J Dermatol 2010; 163: 188-92)  is now well known for treating localized vitiligo, though this therapy is not available to most dermatologists in the UK.