Topical corticosteroids for Vitiligo

Overview
Corticosteroids are a class of prescription drugs approved by the U.S. Food and Drug Administration (FDA) to treat inflammation. In cases of vitiligo, topical corticosteroids are typically used as a first-line treatment for adults and children with localized vitiligo.¹ Localized vitiligo is one type of vitiligo that is limited to smaller areas of skin, usually on one side of the body.

The most common topical corticosteroids for vitiligo include Hydrocortisone, Clobetasol Propionate, Betamethasone Valerate, Diflucortolone Valerate, Triamcinolone Acetonide, Methylprednisolone, Fluticasone, and Mometasone.^1,2 It’s believed that topical corticosteroids work by suppressing immune system activity to reduce inflammation associated with depigmentation in vitiligo.

Topical treatments for vitiligo work best to reduce disease progression and increase repigmentation when used on the upper body, dark skin, and new lesions, particularly in sun-exposed areas.³

How do I take it?
Topical corticosteroids are administered as creams or ointments in mild, moderate, potent and super-potencies, and applied to affected areas of skin in limited courses.¹ Mild topical creams or ointments may be prescribed for children with vitiligo under 10 years of age. Stronger forms can be used by adults. Topical corticosteroids for vitiligo may be used in combination with oral medications or phototherapy to increase effectiveness.¹ Topical corticosteroids should be used exactly as prescribed by the physician.

Side effects
Side effects of topical corticosteroids are rare when used under medication direction. Severity of side effects increases with potency and long-term use.¹

Long-term use (for instance, over months) of topical corticosteroids can cause skin atrophy – skin changing to become thin, dry, and papery – and stretch marks. Other rare side effects from long-term use include bruising, increased hair thickness and length, dermatitis, rosacea, and psoriasis.²

External resources

References

1. Matin R. (2011). Vitiligo in adults and children. BMJ clinical evidence, 2011, 1717


2. Topical steroid. (n.d.). Retrieved December 2, 2019, from https://dermnetnz.org/topics/topical-steroid/


3. DoctorsTreatment Guidelines. (n.d.). Retrieved December 2, 2019, from https://vrfoundation.org/treatment_guidelines