Is There a Cure for Vitiligo? 4 Types of Treatments Reviewed

Vitiligo (pronounced vi-tuh-lie-go) is a skin condition that causes patchy loss of skin pigment (color). Millions of people around the world have vitiligo. It can affect anyone, regardless of age, gender, or race. Vitiligo is not life-threatening or contagious, but it can affect self-esteem and mental health.

There is no cure yet for vitiligo, but there are ways to treat it. Unfortunately, treatments for vitiligo don’t always work, and even when they do, vitiligo can come back. Some body areas are very difficult to treat. The good news is there are now promising therapies on the horizon. 

Is there a cure for vitiligo?

No treatments can cure vitiligo. For most people, the goal of treatment is to stop vitiligo from spreading and to bring color back to affected areas of skin. The existing treatments can help, but it is rare for them to reverse vitiligo and make it go away permanently. 

While there’s no cure for vitiligo, understanding its causes and the treatment options can help people manage vitiligo as best as possible. 

What causes vitiligo skin disorder?

We don’t know exactly what causes vitiligo, but it’s most likely an autoimmune disease. This means the body’s immune system attacks melanocytes (pigment-producing cells in your skin). Genetics also play a role. Up to 20% of people with vitiligo have an affected relative. Different triggers — like sunburn or stress — might also cause vitiligo in some people, especially if it runs in your family. 

What are the best treatments for vitiligo?

There are many treatment options for vitiligo. A dermatologist (skin specialist) can help find the best one for you. Treatment can: 

• Restore lost skin color

• Keep new patches and spots from forming

• Remove the remaining color from your skin, to even out skin tone

Here is a closer look at some of the most effective treatments for vitiligo.

1. Creams and ointments (topicals) 

Topical Janus kinase (JAK) inhibitors

This is a new class of medications that works by blocking signals in the immune system that cause inflammation. Opzelura (ruxolitinib), a medication in this class, is the first FDA-approved treatment for vitiligo that repigments skin. Opzelura is also used to treat eczema. 

People ages 12 and older can use Opzelura twice a day on up to 10% of their skin, including their face. For reference, the area of your palm without the fingers is about 1% of your skin surface.

In studies, some people experienced side effects from Opzelura, like skin redness or itching, and headaches. Opzelura also has a boxed warning that says people who take the pill form of this medication may have a higher risk of serious infections, heart problems, or blood clots. So far, studies show that using the cream form doesn’t have these risks. 

Topical steroid creams and ointments

These creams and ointments work by suppressing the immune system’s effects on the skin. For vitiligo on areas like the hands and feet, your dermatologist might prescribe a strong steroid medication like: 

• Clobetasol propionate 0.05% 

• Betamethasone dipropionate 0.05%

For more sensitive areas, such as the face, neck, or body folds, they might give you a lighter option such as hydrocortisone 2.5%. 

It’s important to note that using topical steroids for too long can cause side effects like skin thinning. Overuse on the face can cause glaucoma.

Topical calcineurin inhibitors 

Like topical steroid creams and ointments, topical calcineurin inhibitors also lower the immune system’s activity in the skin. Examples of these include pimecrolimus and tacrolimus creams. They appear to work almost as well as topical steroids without the risk of thinning the skin or glaucoma. The most common side effect is stinging or irritation. 

Calcineurin inhibitors carry a boxed warning that says they might raise the risk of getting certain cancers. But there is much debate around this because studies of over 20,000 people have not shown any link to cancer.

Vitamin D creams and ointments 

These medications regulate the immune system and boost pigment production in the skin. Two examples are: 

• Calcipotriene 0.005%

• Calcitriol 3 mcg/g

By themselves, they do not work as well as topical steroids. But when used together with steroids, the results are better than either alone. This makes them useful in combination or as part of a rotation. 

2. Steroid pills or injections 

Steroids taken by mouth can stop vitiligo that’s spreading quickly. They work best if you take them along with phototherapy. Unfortunately, it’s not safe to stay on steroids long term, because of side effects. 

3. Light therapy (phototherapy) 

If your vitiligo doesn’t get better or if you have too many patches to be able to use creams and ointments, light therapy is the best option. It’s been used as a treatment for vitiligo since the 1800s. Most commonly, clinics use narrowband UVB booths. 

Phototherapy treatments are a commitment. You’ll need to go two to three times a week for several months to see results. The major side effect is a sunburn. The good news is, this type of phototherapy doesn’t seem to raise your risk of getting skin cancer like sun exposure does. 

Excimer

As an alternative to traditional phototherapy, there is a laser (excimer) that delivers a similar light through a small, hand-held device. The excimer has some advantages: You don’t have to go in a closed-off booth, which can make some people feel claustrophobic. In the booth, your whole body is exposed to the light. With an excimer, however, only the skin that has vitiligo comes in contact with the light. 

Since it’s so targeted, your treatment levels can be stronger, which means you might see results faster. The downside is that it can be time consuming if you have a lot of areas affected by vitiligo. And, an excimer doesn’t work as well as phototherapy to prevent new areas of vitiligo.

4. Depigmentation

For people with widespread vitiligo who don’t see improvement, depigmentation can be a last resort. This treatment removes remaining pigment from the skin using a medicine. This process can take years. People who go through depigmentation have to avoid the sun completely. Otherwise, they might get speckled pigmentation. 

Natural treatments for vitiligo

Some dietary supplements may help improve vitiligo, though we don’t know how well they work and what the right doses are. We do know that they work best when taken while doing phototherapy. 

If your levels of vitamin D are low, then you might consider supplementation. Our bodies get vitamin D from sun exposure and certain foods like oily fish, egg yolks, and fortified foods. In a study, people with low levels of vitamin D had more active vitiligo than those whose levels were within the normal range. 

Other supplements that show promise in vitiligo include:

• Phenylalanine

• Alpha lipoic acids

• Ginkgo biloba

• Vitamin C

• Vitamin E

• Polyunsaturated fatty acids

• Polypodium leucotomos

Can vitiligo be stopped from spreading?

If your vitiligo is spreading fast, a short course of steroids taken internally can help. In a study, oral prednisolone (Prelone) stopped pigment loss in 90% of people. About 76% got some pigment back.

Are there any studies or trials underway to help find a cure?

It’s unlikely we’ll have a cure for vitiligo, but there are promising treatment options currently being studied. 

The treatment that holds the biggest hope is the biologic anti-IL-15 monoclonal antibody, currently in clinical trials. If effective, this will be the first targeted biologic for vitiligo. Biologic medicines have changed the lives of many people with psoriasis and eczema. The hope is that vitiligo will be next. 

Other treatments being researched include:

• Apremilast (Otezla): This is a pill that works by lowering inflammation inside of cells. It’s FDA-approved for psoriasis. However, it has shown some promise in vitiligo. 

• Minocycline (Minocin): This is an antibiotic that also works to lower inflammation. Small studies have shown that it can stop vitiligo from spreading. 

• Tofacitinib: Also known as Xeljanz, this is a medicine that’s FDA-approved for arthritis. There are reports that it helps vitiligo. 

How can you prevent vitiligo?

It’s not possible to prevent vitiligo. But if you have it and wonder how to prevent vitiligo from getting worse, here are some steps you can take:

• Protect your skin from the sun by using sunscreen, sun-protective clothing, and staying in the shade.

• Avoid using a tanning bed.

• Protect yourself from skin cuts and scrapes as much as possible (skin injury can trigger new spots of vitiligo skin).

• Find ways to lower stress as much as possible.

Why trust our experts?

Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Samvida Patel, MNSP, INHC

Samvida Patel, MNSP, INHC, is a health editor at GoodRx. She is a nutritionist and integrative nutrition health coach with over 8 years of experience in health communications.

Reviewed by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

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