Vitiligo is a medical condition that causes skin pigmentation loss. This happens when melanocytes, or the cells that create skin pigment, are destroyed. It can present as patches of white skin on the body.
Whether you’re in the early stages of vitiligo or have had this skin condition for a while, it’s important to know about all the treatment options available.
Prescription creams and ointments
Creams and ointments for vitiligo are available by prescription only. These come in the form of powerful anti-inflammatories, such as corticosteroids and calcineurin inhibitors. Decreasing inflammation may reduce the spread of pigmentation loss. In some cases, your skin may return to its natural color, too.
According to the Mayo Clinic, it can take several months for topical treatments to work. These may also not be ideal for children and older adults because of their thinner, more sensitive skin.
Corticosteroids work best for widespread areas of vitiligo. Calcineurin inhibitors, on the other hand, work better for smaller areas of pigmentation loss.
Possible side effects of corticosteroid creams include:
- increased cancer risk (skin cancer, lymphoma)
- lines of discoloration
- thinning skin
Light therapy (photochemotherapy) involves controlled exposure to ultraviolet rays to correct discoloration. Sometimes UVA light therapy is combined with a plant-based medication called psoralen, which is taken orally or applied topically to smaller areas of affected skin. This treatment is called PUVA.
PUVA combo treatments are up to 85 percent effective. They’re especially helpful in treating patches on your:
According to the Mayo Clinic, you may need to repeat PUVA treatments up to three times a week for at least six months.
Depigmentation is a process where the color of your skin is lightened to match the patches of color loss. This treatment is recommended only if the pigmentation losses are widespread, and if other methods have failed to improve your symptoms.
During the process, you’ll apply a prescribed depigmenting agent to unaffected areas of your skin only. The idea is to match these areas with the depigmented spots you already have from vitiligo. You’ll need to apply the product once or twice per day for at least nine months.
While depigmentation can reduce the look of blotchy skin, there may be some emotional side effects from the loss of your natural skin color. You may also experience sun sensitivity, redness, and swelling from your treatment.
Laser treatment to remove outer layers
Laser treatment involves the use of high-powered beams to remove the outer layers of your skin. This may be helpful for vitiligo by evening out patches of lighter-than-normal skin.
The downside is that laser treatments can be painful and require several weeks of recovery time. You’ll also need several treatments to see results.
Laser treatments tend to work best on hyperpigmentation as an antiaging treatment.
Skin grafting on smaller patches
If light therapy or laser treatments don’t work, your doctor may recommend treating vitiligo with skin grafting. This involves removing a small part of your skin from one area not affected by vitiligo and surgically implanting it to areas of pigmentation loss. It works best with smaller skin patches.
While skin grafting works, it doesn’t come without complications. Sometimes the process can create a cobblestone-like pattern of discoloration. In other cases, the affected patches may fail to regain pigment.
Micropigmentation to implant new pigment
Micropigmentation is a type of tattooing. This treatment works for vitiligo by implanting (or tattooing) new pigment into areas of blotchy skin.
While this process is effective, it will likely have to be repeated every few years so you can maintain natural-looking color. One possible risk is that the tattoo could trigger more pigmentation losses.
Blister grafting to even tone
Like skin grafting, blister grafting involves transplanting small portions of your skin. With this procedure, your doctor uses a suction-like device to make blisters on unaffected areas of skin. These blisters are then transplanted to depigmented areas to help match them with the rest of your skin color.
Blister grafting is yet another option available to help even out your skin tone. Still, there are several side effects to consider, such as:
- a cobblestone-like appearance in your skin
- failure to regenerate color
- more discoloration
Cosmetics to cover up patches
Cosmetics have come a long way in covering up redness, hyperpigmentation, and depigmentation. Self-tanners are just one way you can conceal vitiligo patches. You can also try tinted primers, foundations, and powders. Be sure to choose a color that most closely matches your natural skin tone — choosing colors that are darker than your skin can look fake.
The American Academy of Dermatology recommends cosmetics for children with vitiligo. This can reduce their exposure to possible side effects from medications and procedures.
The benefits of cosmetic cover-ups can be significant in terms of your self-image. You can apply cosmetics relatively quickly before heading out the door. The downside is that cosmetics are only temporary and can wear off from rain, humidity, and sweat.
Ginkgo biloba: A possible herbal treatment?
One herb is of particular interest in possible vitiligo treatment. Known for anti-inflammatory effects, ginkgo biloba is often used as an alternative remedy for circulation issues. One clinical trial saw some regaining of color in 10 people. Still, two other participants in the study took a placebo and had the same effects. This makes the role of ginkgo biloba unclear in the treatment of vitiligo.
While ginkgo biloba isn’t considered a mainstream vitiligo treatment, talk with your doctor if you’d like to learn more about it.
Supplements and lifestyle changes
There’s no single treatment measure that works for everyone with vitiligo. While you’re trying out different medical treatments, there are natural ones you can try, too. You can also consider lifestyle measures that reduce the risk of worsening vitiligo.
Talk with your doctor about the following steps you can take:
- light therapy used in conjunction with vitamin C, folic acid, and other micronutrient supplements
- reduced sun exposure
- sunscreen of at least SPF 30 to prevent uneven tanning and hyperpigmentation
While natural treatments may help, research suggests that they’re most effective during the early stages of vitiligo. More research is needed to determine the efficacy of any homeopathic approach to this condition.
Vitiligo can affect the lips, which is an extremely delicate area to treat. According to the Mayo Clinic, micropigmentation works well around the lip area. However, there are also more natural treatments you can consider that are needle-free, such as cosmetic cover-ups.
You can also help prevent worsening of uneven skin tone by wearing lip balm that contains sunscreen. Look for one with an SPF of 30.
While there’s no cure for vitiligo, treatments can help reduce the course of the disease. There are also ways you can cover up uneven patches so you feel more confident in your skin.
The downside to any of the above treatments is that new depigmented patches may still occur. Work with your doctor to determine the best vitiligo management plan for you.