There is no cure for vitiligo, but loss of skin pigment can be managed. There are several medications and other approaches used to treat vitiligo, many of which are also approved to treat other skin conditions. It’s not always necessary to try to change the loss of skin pigment, unless you want to. Some people with vitiligo choose not to pursue treatment at all.

Vitiligo can be very challenging to treat. No one treatment approach is effective for everyone with vitiligo. Researchers estimate that about one-quarter of people with vitiligo do not respond to any treatments. Even if vitiligo treatment is working well on one area of the skin, new white patches may appear in another area. While there is not a lot of evidence on how often white patches return or spread after successful vitiligo treatment, studies suggest that vitiligo returns within four years after treatment is stopped in more than 50 percent of cases.

Treatment options for vitiligo include topical and oral medications, different types of light therapy, and surgical approaches. Some people with vitiligo participate in clinical trials for new treatments or try complementary, natural, or alternative methods.

The goal of most vitiligo treatments is to restore lost skin pigment. Some people with widespread vitiligo choose to undergo depigmentation — removing the remaining color from the skin to even out skin tone. Some people with vitiligo choose not to treat the condition, and others may try to cover or camouflage their patches of lighter skin.

Here are some treatment options for vitiligo. It’s important to work with your doctor to determine the best treatment for your skin.

Topical Medications for Vitiligo

A topical medication is usually the first type of treatment prescribed for someone with vitiligo, particularly those whose condition affects less than 10 percent of their body surface area. In general, topical medications are most effective in treating vitiligo on the face, torso, upper arms, and upper legs. They are least effective at treating light patches on the hands, feet, and genitalia.

Some topical medications cannot safely be used on the face. Topical drugs may work best on more recently developed patches and for people with darker skin. However, they also work on longstanding patches and lighter skin tones for some people.

Janus Kinase Inhibitors

In 2022, the U.S. Food and Drug Administration (FDA) approved the first medication for repigmentation in people with vitiligo. Ruxolitinib (Opzelura) is a topical Janus kinase (JAK) inhibitor cream for individuals ages 12 or older with nonsegmental vitiligo. JAK proteins are responsible for sending signals that are involved in telling your immune system to attack the melanocytes in the skin, which leads to depigmentation, or white patches. By inhibiting the JAK proteins, that signal is blocked, and the melanocytes can regrow, delivering color back to your skin. Ruxolitinib must be prescribed by your healthcare provider, so talk to your dermatologist if you have questions about whether it might be right for you.

Corticosteroids

Corticosteroids (also known simply as steroids) are the most commonly prescribed topical medication for vitiligo. Steroids are usually prescribed in cases of vitiligo that involve small areas of skin. Steroids work by reducing inflammation and modifying the immune system. They can cause side effects, including skin atrophy (skin becoming thin, dry, and papery) and stretch marks, if used for a long period, such as a year or more.

There are seven different classes of steroids with a very wide range of potency. Because of possible side effects, it’s usually best to use the mildest steroid that works, and only for a short time. Mid- to high-potency steroids work best. When using topical steroids as repigmenting agents for vitiligo, the class of agent and frequency of use should be coordinated with your dermatologist.

Other Topical Medications

Tacrolimus is another topical medication that may be used alone or in combination with corticosteroids. It is a calcineurin inhibitor. These drugs work by suppressing local autoimmune responses in vitiligo skin areas. They block inflammation and stimulate repigmentation.

Tacrolimus may be alternated with corticosteroids to avoid steroid side effects like atrophy. Tacrolimus may also be used on sensitive skin such as the face, eyelids, genitals, or breasts, and it is safe for children. Tacrolimus may cause mild burning immediately after application and flushing of the skin after drinking alcohol. Pimecrolimus, also a calcineurin inhibitor, is a related drug that is sometimes prescribed topically for vitiligo.

Calcipotriol, also known as calcipotriene, is a medication derived from vitamin D. Calcipotriol and the related drug tacalcitol are widely prescribed for vitiligo but are only partially effective.

Oral Medications for Vitiligo

In cases where vitiligo is spreading slowly, doctors may prescribe ginkgo biloba extract to be taken orally. Ginkgo biloba has been studied in several clinical trials as a treatment for vitiligo and has shown some effectiveness. Ginkgo biloba is an antioxidant and is believed to help modulate the immune system. Polypodium leucotomos, a supplement made from a Central American fern, is also sometimes prescribed. It has antioxidant and anti-inflammatory properties.

If vitiligo is worsening rapidly — with new patches appearing or existing patches expanding each week — a doctor may prescribe oral corticosteroids. Oral steroids have a higher risk of causing side effects. Unlike topical corticosteroids, side effects from oral steroids may occur throughout the body rather than only on the skin.

Phototherapy for Repigmentation

For many individuals with vitiligo, doctors may recommend phototherapy, also known as light therapy. Phototherapy uses specific wavelengths of ultraviolet light to promote repigmentation of white patches. Phototherapy also alters the abnormal immune response responsible for killing melanocytes in the white patches.

Phototherapy may be considered as an initial treatment for people with widespread vitiligo or as a second approach if topical medications do not work. Phototherapy usually requires a significant time commitment — for instance, two or three treatments each week for eight to 24 months.

Phototherapy can be very effective in some people with vitiligo, with 65 percent to 75 percent of cases treated successfully. However, the results of phototherapy usually don’t last. About 44 percent of people lose the regained color within a year after treatment, and 86 percent lose it within four years if they stop treatment completely. Maintenance treatment may be needed for lasting results.

Narrowband UVB (NB-UVB) phototherapy is the light treatment of choice for generalized, nonsegmental vitiligo, which is the most common type of vitiligo. NB-UVB is considered safe enough to use on children. NB-UVB treatment may be performed in clinics or at home with small, medium, or large devices. NB-UVB may work even better when combined with topical medications.

Lasers may be used to treat a small area of skin affected by vitiligo. Treatment with an excimer laser (a type of ultraviolet laser), a type of targeted phototherapy device, provides effective results in about 70 percent of people with vitiligo.

Psoralen + UVA (PUVA) phototherapy involves taking psoralen either topically or orally, followed by a treatment with UVA light. Because PUVA has many side effects, it is no longer widely used to treat vitiligo.

Surgical Procedures To Treat Vitiligo

In cases where medication and phototherapy are not effective in treating generalized vitiligo, surgical procedures may be considered. In general, surgery will only be considered in adults whose white patches have not changed for at least one year. Surgery is not a good option for people whose skin tends to form keloid (raised) scars. People with limited vitiligo on one side of the body tend to respond best to surgery. Surgery is also more likely to be successful when patches of vitiligo are limited to a few areas rather than widespread, generalized vitiligo.

Several surgical techniques are used to treat vitiligo, most of which involve transferring skin or skin cells from an area of skin that is still pigmented to a depigmented area. In general, there are three types of surgical procedures used to treat vitiligo: punch grafting, tissue grafting, and cellular grafting. In cases of tissue grafting and cellular grafting, the top layer of the nonpigmented skin is usually removed to enable the transplant. However, when 1- to 2-millimeter punch grafts are used, this is not required.

Potential problems with vitiligo surgery include infections, changes in the texture of the skin at the donor site, imperfect color matching, hyperpigmentation (skin becoming darker than intended), and failure to treat white patches.

Vitiligo Clinical Trials

New, experimental treatments for vitiligo are being studied in clinical trials. Clinical trials contribute to medical knowledge about vitiligo and may help doctors treat vitiligo more effectively in the future. In some clinical trials, participants gain access to the experimental treatment, but in others, they do not. ClinicalTrials.gov is a good place to look for clinical trials related to vitiligo.

Complementary or Alternative Treatments

Some people with vitiligo choose to try complementary or natural treatments. Most complementary treatments for vitiligo have not been studied in clinical trials, and there is limited or no proof that they are safe or effective in treating vitiligo. There’s some evidence that the following alternative treatments might help:

• Ginkgo biloba extract has been explored in several clinical trials for vitiligo.
• Dead Sea climatotherapy — a treatment that involves bathing in the Dead Sea and slowly increasing time in the sun — has been shown to help with repigmentation in people with vitiligo.

Vitiligo Maintenance Therapy

After successful treatments produce repigmentation, your doctor may recommend a period of maintenance therapy to prevent a relapse of vitiligo. Without maintenance therapy, 40 percent of vitiligo cases relapse. Topical tacrolimus or corticosteroids are typically prescribed as maintenance therapy. Some doctors only recommend maintenance therapy in people who have had a relapse of vitiligo after successful treatment in the past.

Skin Depigmentation Options

In adults who have little pigment left, and for whom other vitiligo treatments haven’t worked, depigmentation may be an option. The goal of depigmentation is to even out the skin by removing the remaining pigment and creating an even, white tone.

Monobenzone is approved by the FDA to remove pigment in people with vitiligo that covers more than 50 percent of their body. Monobenzone is applied twice daily as a topical cream. Depigmentation with monobenzone, also known as “bleaching,” is usually final and irreversible. This medication is no longer available by prescription in pharmacies. It has to be compounded and ordered by your physician.

The process of depigmentation can take from one to four years. Side effects can include mild temporary skin irritation, allergic contact dermatitis, and permanent increased sensitivity to sunlight.

Sun Protection and Cosmetics for People With Vitiligo

Whether or not you choose to treat your vitiligo, you can take steps to protect your skin and make your white patches less noticeable.

People with vitiligo seem to have a lower risk for developing melanoma, but a similar risk as other people for developing other types of skin cancer. However, white patches can still burn painfully in sunlight. Tanning in the pigmented skin around your white patches can also make them stand out more. Wear sunscreen daily to protect your depigmented skin.

Sunless tanning products may help darken the depigmented skin to more closely match the unaffected skin.

If you choose to cover white patches with makeup, brands including Dermablend and Covermark are formulated in a wide range of skin tones to provide camouflage for marks on the face and body.

Caring for Mental Health

People with vitiligo may face social stigma that can be psychologically difficult. Your mental health is just as important as your physical health. If you are experiencing problems with your body image and self-esteem that impact your quality of life, treatment can help. Several studies have shown that types of psychotherapy, including cognitive behavioral therapy, group therapy, and self-help programs, have benefited people as they adjust to living with a chronic health condition. Support groups specifically for people with vitiligo may also be helpful.

Find Your Team

On MyVitiligoTeam, the online social network for people with vitiligo and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with vitiligo.

Are you exploring treatments for vitiligo? Share your thoughts in the comments below or by posting on your Activities page.

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​In partnership with the Global Vitiligo Foundation, which strives to improve the quality of life for individuals with vitiligo through education, research, clinical care, and community support.