There is no satisfactory treatment for vitiligo. Topical steroids (Such as group 2 topical steroid Desoximetasone) or the nonsteroidal anti-inflammatory agent tacrolimus are frequently prescribed. They are marginally effective and produce, at best, minimal repigmentation. These medications can be prescribed for patient’s with early disease involving just a few small areas.
Phototherapy with narrow band UVB or UVA light in conjunction with an oral or topical psoralen (PUVA) are the most effective treatments. Repigmentation is usually not complete. The treatment must be performed for several months. The total amount of light radiation delivered is considerable and most patients elect not to embark on this long process.
Patient’s who have lost more than 50% of the surface pigmentation may for cosmetic purposes eliminate the remaining pigment. This is accomplished by applying monobenzone 20% (Benoquin) 2 or 3 times a day for several months. This chemical causes irreversible depigmentation. This is apparently what Michael Jackson did to achieve total body depigmentation.
There are techniques involving melanocyte transplants. These techniques are only performed and a few teaching centers.
Cosmetic products can effectively hide areas of pigment loss. Self tanning creams containing dihydroacetone can be quite effective. They need to be applied on a regular basis. Cosmetic cover-up of white area can be accomplished with a number of products. These include Covermark and Dermablend. Preparations such as Vita-Dye or DY-O-Derm Vitiligo Stain have been available for years, they are however less effective and only available on the Internet.
People with vitiligo need to protect themselves with sunscreens and clothing. Sunburns make the disease worse.