Vitiligo medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
Topical corticosteroids
- Topical corticosteroids along, with topical calcineurin inhibitors, are considered the first line treatment for limited forms of vitiligo.
- Topical corticosteroids have shown repigmentation rates of up to 75%.
- Best results have been observed in areas exposed to sunlight (neck and face), dark skin and new lesions.
- No difference has been observed between the efficacy of potent (mometasone) versus superpotent (clobetasol) topical corticosteroids, then potent corticosteroids should be the first option.
- Two schemes are recommended by the European Dermatology Forum consensus for the treatment of facial and extrafacial lesions:
- Discontinuous scheme (preferred scheme): Daily application of a potent topical corticosteroid during 15 days a month for a total of 6 months.
- Continuous scheme: Daily application of a potent topical corticosteroid during 3 months.
- Photographs should be taken to evaluate the response to the treatment.
- Both schemes are recommended for children and adults.
- If large areas are affected and risk of systemic absorption is a concern (specially in children), then mometasone furoate or methylprednisolone aceponate are the preferred options as this drugs present less systemic side effects.