Vitiligo care moves beyond one size fits all as experts emphasize tailored approaches | AAD 2026

Vitiligo took center stage during a three-hour symposium at the 2026 meeting of the American Academy of Dermatology, where nine experts outlined the evolving understanding of the disease and the expanding treatment landscape.

Despite representing a range of clinical perspectives, panelists aligned on two key themes: treatment should be tailored to disease phase, and combination therapy often yields the best outcomes.

The session opened with a patient perspective from Josh Hampton, who first noticed a vitiligo macule at age 15 during a period marked by stress, hormonal changes, alopecia and shingles. What began as a small patch quickly progressed.

“It was all over my cheek, and in a matter of weeks, it blew up — my neck, back and scalp—like wildfire,” Hampton said.

Due to the rapid and widespread onset, he was diagnosed with both generalized and segmental vitiligo.

Experts emphasized that treatment decisions are highly individualized, with some patients choosing to pursue repigmentation while others opt to embrace their appearance.

The treatment of vitiligo is a personalized choice, with some patients choosing to embrace their identity and others pursuing treatment. The course of treatment largely depends on the type of vitiligo and disease stage someone is diagnosed at.

For example, segmental vitiligo, which accounts for approximately 5% to 16% of cases, follows a distinct course with an initial rapid progression phase lasting up to a year, followed by a stable phase in which depigmentation stops spreading.

“Because of the distinct differences between these two phases, we really have to pay attention to what phase the patient in front of us is in, both for managing expectations and determining treatment,” Richard Huggins, M.D., a dermatologist from the Henry Ford Vitiligo Treatment and Research Center in Detroit, said during his presentation.

Hampton described undergoing phototherapy three times a week and relying heavily on hair dye and cosmetic products to mask depigmentation. These efforts ultimately became emotionally and physically exhausting. He has since chosen to embrace his appearance rather than conceal it.

On the therapeutic front, advancements in immunology are reshaping the vitiligo treatment paradigm. Systemic and immune-modulating therapies increasingly target vitiligo, an autoimmune disease. Oral Janus kinase inhibitors are currently in late-stage trials and may soon provide an option for patients with extensive, active disease.

Other research methods are looking at the IL-15 pathway and resident memory T cells, with the goal of not just bringing back skin color but also stopping the disease from coming back by interfering with the immune memory that causes it.

Beyond pharmacologic interventions, speakers highlighted the growing role of holistic care. Nada Elbuluk, M.D., an associate professor at the University of Southern California Keck School of Medicine, emphasized the importance of addressing lifestyle factors, including diet, exercise and supplementation.

Vitamin D, for example, may support melanocyte function due to the presence of vitamin D receptors on these cells.

“I have really evolved to a more holistic approach, where I ask my patients about their occupation, lifestyle and what they take—not only medications but also vitamins, minerals and supplements, as well as their quality of life and disease burden,” Elbuluk said.