- Diseases, Disorders & Conditions
Have You Considered Vitiligo Creams or Ointments?
High dose topical corticosteroids can be the first line of treatment
Vitiligo is a loss of skin pigment (color) that causes white patches to appear on a person's skin. The cause is unsure though it likely involves a genetic suseptibility to the disease and an autoimmune reaction to something. What that exact "something" is, remains unknown.
There are multiple kinds of vitiligo medications in cream or ointment formulation that are available today. All require presciptions and professional medical supervision.
A cream or ointment containing high dose topical corticosteroids can be the first line of treatment for vitiligo. Steroids decrease the release of proteins that cause inflammation as well as decreasing the production of antibodies. Both can damage the pigment producing cells and kill them. The steroids must be applied for a period of time in order to see an improvement in the skin. Unfortunately there is no guarantee that the drug will stop progression and spread of the vitiligo, or that re-pigmentation will occur. When the areas of de-pigmentation are small, steroids are an easy treatment to use. They can be applied multiple times each day, and they are not very expensive. Ointments are said to be better absorbed into the skin, so you may find that they will work better for you than cream formulations.
Ointments containing tacrolimus or pimecrolimus can be effective treatment for small areas of depigmentation
Topical ointments containing tacrolimus or pimecrolimus can be effective treatment for small areas of depigmentation, especially on the face and neck. As immune system modulators the medications can suppress inflammation and immune response in the treated areas. These drugs can be used with other treatments such as ultraviolet light and they may have fewer side effects than topical corticosteroids. Use of tacrolimus and pimecrolimus has been limited by the concern that they may increase the risk of cancers such as lymphoma and skin cancer.
Phenytoin is being studied for its potential as a vitiligo cure. In laboratory studies, phenytoin shows potential because it can slow premature death of the pigment producing cells, melanocytes. Researchers at the University of Medicine and Pharmacy in Romania have shown that phenytoin prepared as a gel provided the highest concentration of the medication being absorbed into the skin. This produced excellent results. Lower concentrations may be helpful, but it appears that high doses will be best.
Photochemotherapy with ultraviolet A (PUVA)
A fourth cream used in vitiligo treatment is Psoralen. It is used in combination with UV-A phototherapy, creating a treatment that is called photochemotherapy with ultraviolet A (PUVA). First, the Psoalen is applied to the affected patches of skin. Then, the skin is exposed to the UV-A light generated from a special light bulb. The skin will turn pink then slowly fade to a more natural, slightly darker color. PUVA therapy was originally used for psoriasis, but then it was noticed that it could also help vitiligo patients. Many dermatologists prefer this treatment for vitiligo.
Vitiligo Treatment and Psoralens
New drug, SCENESSE is in clinical trials
A sixth cream-based treatment is in the pipeline, Scenesse. It is the first of a new class of drugs that can actually restore color to a person's skin. To date, results in research studies has been good, but it will still be some time before it is available for general patient use.
SCENESSE and its use in vitiligo, Dr Philippe Wolgen
Vitiligo trials of SCENESSE, Dr Philippe Wolgen, Part 2
When a person is working on their vitiligo cure, they many find various vitiligo creams or ointments of use. Stay safe and always work with a health care provider when using any of the medications mentioned above.