What Vitiligo Treatments Work? A Look at 7 Effective Options

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, sex, 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 many different ways to treat it. For most people, the goal of treatment is to stop vitiligo from spreading and bring color back to affected skin. In some situations, people choose to remove the remaining natural skin color to even out their skin tone.

Here’s a closer look at some of the most effective treatments for vitiligo. A dermatologist (skin specialist) can help find the best approach for you. 

1. Creams and ointments (topicals)

Topical treatments are medicated creams, lotions, and ointments applied directly to the skin. There are many different types available. 

Topical Janus kinase (JAK) inhibitors

JAK inhibitors are a new class of medications that work by blocking signals in the immune system that cause inflammation. 

• Examples: Ruxolitinib (Opzelura) is the first FDA-approved JAK inhibitor for vitiligo.

• How to use: 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.

• Side effects: 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

Steroid creams and ointments work by suppressing the immune system’s effects on the skin. 

• Examples: Clobetasol propionate 0.05%, betamethasone dipropionate 0.05%, and hydrocortisone 2.5%

• How to use: Apply twice a day on limbs and torso. Milder steroids (like hydrocortisone) are used for a shorter period on sensitive areas, like the face, neck, or body folds. 

• Side effects: 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. They appear to work almost as well as topical steroids without the risk of thinning the skin or glaucoma.

• Examples: Pimecrolimus and tacrolimus  

• How to use: Apply twice a day. For sensitive areas like the face or groin, calcineurin inhibitors are preferred over steroids. 

• Side effects: 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 haven’t shown any link to cancer.

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• Skin bumps that aren’t acne: From cysts to skin cancer, learn how to identify common facial bumps (with photos).

Vitamin D creams and ointments 

Vitamin D-related medications regulate the immune system and boost pigment production in the skin. By themselves, they don’t 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. 

• Examples: Calcipotriene 0.005% and calcitriol 

• How to use: It’s used once or twice a day, and it’s most effective when combined with other treatments (like steroids or light therapy).

• Side effects: These may cause redness, itching, or burning. 

2. Systemic treatment (pills)

When vitiligo is severe or spreading quickly, stronger treatments that work throughout the body may be used. Many of these treatments can have more serious side effects so they’re usually only used for a few months at a time. Some examples include:

• Corticosteroids can stop vitiligo from spreading and help repigmentation of vitiligo spots. They work by decreasing the immune system. Examples include betamethasone, dexamethasone, and prednisone. 

• Methotrexate also works by lowering the immune system response and can help stop vitiligo from spreading. It also promotes repigmentation of vitiligo spots. 

• Minocycline is an antibiotic that people often use to treat acne. It has anti-inflammatory effects and has been shown to help treat vitiligo in some people. 

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 a good option. This treatment exposes the skin to specific wavelengths of light in a controlled manner. The main phototherapy treatments include:

• Narrowband ultraviolet B (NBUVB) treats the whole body. 

• Psoralen and ultraviolet A (PUVA) can treat the whole body or just the hands and feet. Psoralen is a medication that makes the skin more sensitive to ultraviolet light. 

• Excimer laser is a handheld device that can treat small areas of skin. 

For best results, phototherapy treatments are done 2 to 3 times a week for several months. NBUVB can be done at the office or at home (with a home unit). PUVA and the excimer laser have to be done at the office. 

One potential 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. 

4. Surgery and skin grafting

Surgery is a treatment option that can help restore skin color. It may be a good option if other treatments haven’t worked and if the vitiligo spots are small. Surgery can only be used if vitiligo isn’t active (meaning no new spots have appeared in the past year). The two main types of surgery include:

• Tissue graft: During this procedure, healthy skin is surgically removed and transplanted to an area with vitiligo. There are different types of tissue graft procedures, and they’re all usually done with local anesthesia in the office. 

• Cellular transplant: An area of healthy skin is removed and then cells from that healthy tissue are placed into skin with vitiligo. The healthy cells grow, and the area can repigment over the next 6 to 12 months. This procedure is also usually done in the office with local anesthesia. 

Surgery and skin grafts can cause scarring, so it may not be a good option for people who develop keloids. 

5. Depigmentation

For people with widespread vitiligo who don’t see improvement, depigmentation can be a last resort. This irreversible treatment removes remaining pigment from the skin using a medicine called monobenzyl ether of hydroquinone (MBEH). The cream is applied twice a day to pigmented areas. Skin pigment is usually removed within 1 to 4 months, but it can take up to a year. 

MBEH can cause skin irritation or an allergic skin reaction. People who go through depigmentation should protect their skin from the sun to avoid speckled pigmentation and skin cancer. 

6. Cosmetic camouflage

Some people decide to cover their vitiligo spots so they blend in with unaffected skin. This may be because they don’t want treatment or treatments didn’t work. Some popular vitiligo creams people use to match healthy skin include:

• Covermark 

• Dermablend

7. 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. Studies show that many of them 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 one 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

How is vitiligo diagnosed?

A healthcare professional can usually diagnose vitiligo just by examining your skin. They may use a Wood’s lamp, which is a handheld device that uses black light to highlight skin areas that have lost color. Sometimes a skin biopsy (a minor surgical procedure done in the office) is done to confirm that diagnosis. 

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, wearing 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.

Can vitiligo be stopped from spreading?

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

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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:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

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