Table 1.
Conclusions on treatment for vitiligo
| Conclusion | Remarks | |
|---|---|---|
| Non-surgical treatments | ||
| Topical corticosteroids | Effective for the treatment of localized vitiligo | Result of meta-analysis |
| Oral corticosteroids | Have an adjunct value, not very effective by themselves | No placebo controlled studies have been performed for oral corticosteroids as a monotherapy |
| (P)UVA | Broadband UVA alone may have a therapeutic value PUVA therapy is as effective as broadband UVB, but with more side-effects | UVA is not studied in RCTs |
| Broadband UVB | Effective for the treatment for generalized vitiligo | |
| Narrowband UVB | As effective as broadband UVB, and sometimes even preferred over broadband UVB. Preferred for generalized vitiligo | Result of meta-analysis |
| Excimer laser | Excimer laser is an effective and safe treatment for vitiligo and gives the best results if used on the face | |
| Calcipotriol | Contradicting results: some authors describe a benefit but others do not | No placebo controlled studies have been performed for topical calcipotriol as a monotherapy |
| Topical immunomodulators | As effective in repigmentation as topical corticosteroids | The effect is mainly restricted to the face and neck |
| Pseudocatalase cream | May have an effect | Few studies performed Few (comparative) studies performed |
| Surgical treatments | ||
| Autologous minipunchgrafting | Success rates of 40%–99% (mean success rate: 57%) Only a small surface can be treated | Lower mean success rate than epidermal suction blister grafting and split-thickness skin grafting |
| Epidermal suction blister grafting | Success rates of 73%–88% (mean success rate: 81%) | Only a small surface can be treated |
| Split-thickness skin grafting | Success rates of 78%–90% | |
| Transplantation of non-cultured epidermal cellsuspension | Success rates of 59%–70% (mean success rate: 63%) Suitable for larger areas | |
| Transplantation of in vitro-cultured epidermis | Success rates of 33%–54% | |
| Transplantation of in vitro-cultured melanocytes | Success rates of 22%–72% | |
| Depigmentation therapy | ||
| Monobenzylether of hydroquinone | Effective as a depigmentation therapy | Few studies performed |
| Mequinol | Effective as a depigmentation therapy | Few studies performed |
| Complementary therapies | ||
| L-phenylalanine | May be used as adjuvant to phototherapy | Few studies performed |
| Ginkgo biloba | May be effective as monotherapy | Only shown in one study |
| Polypodium leucomotos | Can improve narrowband UVB-induced repigmentation | Few studies performed |
| Antioxidants | Can improve the clinical effectiveness of narrowband UVB | Few studies performed |
Abbreviations: PUVA, psoralen ultraviolet-A therapy; RCT, randomized controlled trial.