Conventional Therapies Used in Vitiligo

EP: 1.Vitiligo Presentation in Different Patient Populations

EP: 2.Importance of Early Diagnosis of Vitiligo

EP: 3.Impact of Vitiligo on Quality of Life

EP: 4.Comorbidities and Unmet Needs Associated With Vitiligo

EP: 5.Optimizing Multidisciplinary Care in Vitiligo

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EP: 6.Conventional Therapies Used in Vitiligo

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Historically, vitiligo treatment relied exclusively on off-label therapies including topical corticosteroids, topical calcineurin inhibitors (tacrolimus and pimecrolimus), phototherapy, and targeted laser treatments for limited areas. These conventional approaches formed the foundation of vitiligo management before any FDA-approved treatments became available. The treatment landscape has evolved significantly with the recent approval of topical ruxolitinib 1.5% cream, marking a milestone in vitiligo therapy.

Today’s vitiligo treatment approach combines traditional therapies with the newly approved ruxolitinib cream, either as monotherapy or in combination with phototherapy and laser treatments. Practitioners frequently use potent or ultrapotent corticosteroids alongside noncorticosteroid agents to suppress the upregulated immune response within vitiligo lesions. A common protocol involves alternating 2 weeks of corticosteroid treatment with 2 weeks of topical calcineurin inhibitor therapy, serving as a steroid-sparing technique to minimize long-term corticosteroid exposure risks.

The introduction of topical ruxolitinib has reduced dependence on corticosteroids while providing an efficacious and safer noncorticosteroid option. However, practical limitations exist for extensive disease, particularly when vitiligo affects more than 10% of the body surface area. In such cases, topical treatments alone prove insufficient, necessitating total body phototherapy combined with targeted topical applications to high-priority visible areas such as the head, neck, and hands.