What you need to know about excimer laser for treating vitiligo
What is excimer laser?
The excimer laser is a highly focused beam of UVB light which is also used in laser eye treatment and the treatment of other skin conditions. It may be used to stimulate re-pigmentation in the skin by focusing the laser directly on de-pigmented areas using a wand-like device. It is often combined with topical therapies to enhance response, such as calcineurin inhibitors and topical steroids.
Research Trials
In a study supported by a research grant from the British Skin Foundation and the Vitiligo Society, the efficacy of the 308-nm excimer lamp was investigated in treating vitiligo and to assess patient satisfaction with treatment [1]. The treatment was administered for a duration of twenty weeks with graduated weekly dosing. Photographs of the treatment area were taken before and after for comparison purposes and patient satisfaction was assessed using pre- and post- treatment Dermatology Quality of Life Index (DLQI) questionnaires.
Of the nine patients being treated, eight showed positive responses with a recorded benefit to qualify of life. The degree of re-pigmentation observed varied with levels up to 25%, or at most 50%. The level of response may be higher in certain areas such as facial lesions. In another study by Hadi [2], higher degrees of re-pigmentation were achieved but the study used a larger number of treatments administered twice per week. In any case, these preliminary findings demonstrates that weekly treatment can be effective and is encouraged for longer than 20 sessions, perhaps combined with topical tacrolimus, as muted by Passeron et al [3].
Figure 1 – A modest degree of repigmentation in two patients: (a,c) before and (b,d) after 20 treatments with the excimer light source, on the chin area [(a,b)] and posterior neck [(c,d)].
Where can I get treatment in the UK?
Although excimer laser is not available on the NHS, there are several dermatology clinics offering this treatment under private practice. For more information or any questions, please feel free to reach out on our general mailbox general@vitiligosociety.org.uk.
References
[1] Ayob S, Cockayne SE, Gawkrodger DJ. Once weekly targeted excimer light produced modest repigmentation of vitiligo over a 20-week period. J Eur Acad Dermatol Venereol. 2018 Aug;32(8):e307-e308. doi: 10.1111/jdv.14853. Epub 2018 Mar 5. PMID: 29419905.
[2] Hadi S, Spencer JM, Lebwohl M. The use of the 308-nm excimer laser for the treatment of vitiligo. Dermatol Surg 2004; 30: 983–986.
[3] Passeron T, Ostovari N, Zakaria W, Ortonne J-P. Connection of tacroli- mus and 308 nm excimer laser in treatment of vitiligo. J Am Acad Dermatol 2004; 50: 138.
