Patients with vitiligo can generally pursue one of three options: try to restore pigmentation, camouflage the white patches, or depigment the remaining skin to achieve an all-white appearance.

Vitiligo should ideally be treated within two or three months of its first appearance, as it becomes harder—though not impossible—to treat as the condition progresses. Even spots that have persisted for ten, twenty, or thirty years can sometimes be re-pigmented with enough patience and the right approach.

While various treatments are available, most were originally developed for other diseases and are used to treat vitiligo "off-label," making it difficult to predict which therapy will work best for an individual patient. However, one drug is now licensed specifically for vitiligo in the US and EU, with more treatments currently in development.

Factors to consider include the patient’s age and time of disease onset, the type and location of vitiligo, family and medical history, overall health, living and working environments, travel or military service prospects, financial resources, access to treatments, and—most importantly—personal motivation. Unfortunately, about a quarter of patients do not respond to any therapy.

Symptoms can be temporarily reversed using various treatments, and combination therapies are typically more effective than a single approach. Light therapy remains the gold standard but may require one or two years to restore natural skin color. Dietary supplements and vitamins can mildly enhance the effectiveness of phototherapy but cannot create lasting results on their own. Experimental treatments, such as afamelanotide, HSP70i, prostaglandins, or simvastatin, may show promise for some individuals, though researchers have yet to determine who will benefit most.

White patches often reappear after treatment is discontinued, with relapse occurring in nearly half of all patients within four years. This risk can be significantly reduced with periodic maintenance treatments.

WARNING! Self-diagnosis, self-prescription, or self-treatment is strongly discouraged. The information provided here is for general knowledge and discussion with a specialist only. Treatment must be tailored by a qualified doctor to suit each patient’s unique circumstances. Consulting with an experienced dermatologist—either via telemedicine or in-person—is essential before beginning any treatment for yourself or your child.