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Treatment guideline
Second-line therapies primarily focus on improving skin appearance with a combination of topical, systemic and UVB phototherapy treatments. Such treatment duration varies from 8 to 24 months of two- to trice-weekly treatments, with an average 65-75% success rate.
Narrowband UVB (NB-UVB) phototherapy is the treatment of choice for non-segmental, generalized vitiligo. NB-UVB produces better repigmentation than PUVA, with better color match and fewer side effects. NB-UVB therapy is also better tolerated, and could be used on expecting or nursing women, and children. Home therapy with portable NB-UVB devices is a viable alternative for most vitiligo patients; eligibility, protocols and precautions are essentially the same as for clinic-based treatments.
Combination interventions are superior to monotherapies, like NB-UVB with 0.1% tacrolimus ointment.
Intermittent oral administration of steroids like betamethasone ⁄ dexamethasone has been sparingly reported as an emergency tool to arrest the activity of fast spreading vitiligo. Within one to three months a progressive disease is usually stabilized, and within four months repigmentation is observed in the majority of patients. However, they are not effective in repigmenting a stable vitiligo, and long-term adverse effects contraindicate their common use. The drawback is a higher relapse when reducing these medications.
FAQOther Questions
- PTSD in Vitiligo?
Living with vitiligo often involves more than managing visible skin changes. Many individuals face discrimination, social stigma, and feelings of isolation, leading to emotional...
- Does vitiligo increase the risk of skin cancer?
No, it does not. Despite common misconceptions, people with vitiligo are actually at a lower risk of developing skin cancer—including both nonmelanoma skin cancer (NMSC) and mal...
- Is there a special diet for vitiligo?
Recent research highlights the potential of diet and nutrition in managing vitiligo, offering an alternative where traditional therapies may be lacking. However, the relationshi...
Though it is not always easy to treat vitiligo, there is much to be gained by clearly understanding the diagnosis, the future implications, treatment options and their outcomes.
Many people deal with vitiligo while remaining in the public eye, maintaining a positive outlook, and having a successful career.
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