Modern Medicines

Topical Steroids

• Mechanism: They reduce inflammation and calm the immune system’s attack on the skin.
• Usage: Often used in limited courses and rotated to ensure safety.
• Important: Must be used strictly under dermatologist guidance, as the strength used depends heavily on the body site.

Topical Calcineurin Inhibitors (Non-Steroid)

• Mechanism: Non-steroidal creams (like Tacrolimus) that regulate local skin immunity.
• Best For: Extremely useful for the face, eyelids, neck, and other sensitive areas where steroids cannot be used long-term.
• Usage: Suitable for longer, continuous use under doctor supervision and often combined with phototherapy for enhanced results.

JAK Inhibitors

• Mechanism: A new class of medicines targeting specific immune pathways (JAK/STAT) involved in vitiligo.
• Usage: Used in selected patients under strict specialist supervision. Availability and suitability vary by individual patient profile.

Other Immunosuppressants and Add-Ons

• Purpose: Includes oral medications or other topicals used to aggressively halt the active immune attack.
• Oral Medicines: Reserved for highly active, rapidly spreading vitiligo cases, often prescribed as short-course or weekend-only strategies (e.g., mini-pulse therapy). These require baseline blood tests and regular monitoring.
• Topical Add-ons: Vitamin D analogs, barrier repair creams, and antioxidants may be used to stimulate pigment cells, maintain skin health, or combat oxidative stress in skin cells.