Management of vitiligo: a promising future

Abstract

Vitiligo is an autoimmune disorder marked by progressive depigmentation due to the destruction of melanocytes. Affecting 0.5-1% of the global population, vitiligo significantly impacts patients' quality of life due to its visible and psychological burden. Current treatments, such as topical agents, phototherapy, and novel immunomodulatory therapies, aim to halt depigmentation and promote repigmentation, though many patients face challenges with relapse and inadequate treatment response. A comprehensive review of literature from dermatological and immunological studies was conducted, focusing on recent advancements in topical, systemic, and physical therapies for vitiligo. Both established and emerging treatments, such as Janus kinase (JAK) inhibitors, were examined. Topical corticosteroids (TCS), calcineurin inhibitors, and novel agents like ruxolitinib have shown efficacy in managing localized vitiligo, with oral JAK inhibitors emerging as promising treatments for more extensive disease. Phototherapy, particularly narrowband UVB (NB-UVB) and excimer light devices, remains the gold standard for repigmentation, often enhanced by combining topical agents. Surgical interventions, such as melanocyte transplants, offer additional options for refractory cases, while systemic immunosuppressants and biologics require further exploration. Advances in vitiligo treatment, particularly with targeted therapies like JAK inhibitors, offer new hope for patients. However, challenges remain in achieving sustained repigmentation and preventing relapse. Future research should focus on optimizing combination therapies and exploring novel biologic agents to improve long-term outcomes.