Vitiligo Depigmentation: When And How?

Depigmentation: when and how? 

Key points 

• If after consistent treatment(s) for vitiligo, satisfactory repigmentation is not achieved, one can consider  depigmentation to avoid the skin color contrast. 

• Chemicals, such as hydroquinone and monobenzone, have been used as topical agents, with increasing doubts  as for their safety profile. 

• Many types of lasers (including Q-switched, alexandrite and Ruby Laser) have been used successfully alone or in  combination with topical chemical depigmentary agents. 

• Cryotherapy has been used with promising results, but pigment recurrence is always possible. 

Answer 

Depigmentation is an option for vitiligo  management that can be used when all  repigmentation treatments have failed. The scope  of cutaneous depigmentation is to reach a uniform  (white or very fair) skin color. 

Depigmentation is a process that destroys the  remaining cutaneous melanocytes in the skin:  patients should be aware that they will stay for  the rest of their life with the skin that is not “their  own skin”. 

It may happen that one cannot cope with  extreme photosensitivity. The ideal candidates for depigmentation are  adult patients with few residual dark spots  scattered over the face or on other visible areas of  the body. 

Children should not be considered eligible for depigmentation treatments.