Innovations in Treating Vitiligo

Vitiligo is believed to be an autoimmune condition where the body attacks its own healthy melanin-producing skin cells by mistake. It may be hereditary or triggered by a particular event like childbirth, severe skin damage, hormonal changes like puberty, liver or kidney problems, or exposure to certain chemicals. There is no cure for vitiligo, but there are a variety of innovative treatments that your doctor may prescribe once you've been diagnosed.

It's a really exciting time to be treating vitiligo because there's been huge advancements in understanding actually what's happening down on an immunological level, and so we've been able to fine tune our treatments. I think two of the biggest discoveries are the chemokine pathway and the JAK/STAT pathway. In the JAK/STAT pathway, we currently have some new treatments, topically, to treat vitiligo that have been shown to be very effective, especially on the face, which is, of course, one of the most stigmatizing areas to have vitiligo. The JAK/STAT pathway oral medications are currently in clinical trials and the chemokine therapies are just behind them. So for our patients with vitiligo, stay tuned. We have really exciting therapies on the not-so-distant distant horizon.

Researchers have long sought out ways to use light as an effective tool against vitiligo. Light therapy is a common treatment that exposes your skin to a type of ultraviolet light that can help stop or slow the progression of active vitiligo and restore your natural skin color. Phototherapy is a type of light therapy that uses narrow-band ultraviolet B light from a special lamp.

You'll need two or three sessions a week over 3 to 6 months to see results. Phototherapy may be more effective when it's paired with corticosteroids or calcineurin inhibitors, which the FDA warns may increase the risk of skin cancer. So be sure to talk to your health care provider to see if it's right for you.

The most common surgical option that's used for vitiligo is something called graft therapy, where we make superficial epidermal blister and then we can transfer that skin with the intact melanocytes, the pigment-producing cells, onto areas of vitiligo. Now, we can't do this for extensive disease. But for really stigmatizing areas like the hands or the face, that kind of grafting therapy can be done. A big limitation is it's not covered by insurance, it's expensive, and there's actually not a lot of people who know how to do it.

If medications and light therapy haven't worked, surgery is another option for patients looking for ways to even out their skin tone by restoring color. Skin grafting is a procedure where a doctor transfers small sections of your healthy pigmented skin to areas where the pigment has been lost. This is most commonly used if vitiligo affects small areas of your body.

Skin disease in general and vitiligo in particular have huge impacts on mental health because you can't hide it. For my vitiligo patients, particularly those who are having significant mental health impacts, there's a couple of things I encourage them to do. One is that there are patient-driven organizations that can make them feel less alone. The second is find a doctor that really wants to advocate for you. We're so excited about the new treatments. The old treatments also still work. So we have ways of treating vitiligo, and there's more coming on the horizon. Don't despair.

Although not life threatening, vitiligo can affect your quality of life by causing stress or low self-esteem. So talk to your doctor about the personalized treatment plan that may be right for you.