Is It Possible To Stop The Progression of Vitiligo?

Is it possible to stop the progression of  vitiligo? 

Key points 

• Localized vitiligo usually stops its progression in 1-2 years after its first manifestation. 

• Generalized vitiligo is progressive in 73% of the cases. 

• Administration of oral or intravenous corticosteroids may lead to cessation of the disease progression in 85% of  cases. 

• Vitiligo progression could be stopped in 4 out of 5 cases by the use of potent systemic corticosteroids, but due  to possible relevant side effects, the decision must be taken by expert dermatologists after careful evaluation. 

Answer 

Vitiligo is progressive in 73% of cases and  regressive in 1.3%. We usually explain to the  patients that progression depends on the modality  of the disease spreading: localized or generalized  forms have different behavior. In 89% of localized  vitiligo cases, disease activity ceases after 1-2  years of rapid spreading over the affected skin  area, while generalized vitiligo shows less  progression only when it starts on the face (52%  of the cases). 

In 89% of cases we can arrest patch extension  in widespread vitiligo with oral minipulse  corticosteroid therapy (5 mg betamethasone on 2  consecutive days per week) . Use of corticosteroid  methylprednisolone 8 mg/Kg intravenously for 3  consecutive days in patients with generalized  vitiligo led to temporary cessation to the disease  progression in 85% of cases and repigmentation in  71% of cases. Other steroids used intravenously  showed a similar degree of limiting the disease  progression.

Thus, it is true that vitiligo progression could  be stopped in 4 out of 5 cases by the use of potent  systemic corticosteroids. However, systemic  corticosteroids might have possible relevant side  effects, hence, the decision of their use for limiting  vitiligo progression must be taken by expert  dermatologists and after careful evaluation of the  individual clinical situation.

UVB Lamp could be used to treat vitiligo.