Medical Therapies-

Several medical therapies, most of which are applied topically, can reduce the appearance of vitiligo. It is useful in the early stages. Topical therapy. Creams, including corticosteroids, may be helpful in depigmenting (returning the color to) white patches, particularly if they are applied in the initial stages of the disease.
Light treatment. Light therapy or excimer laser treatments are also used to treat vitiligo, although results may not be permanent. Phototherapy is a medical procedure in which your skin is carefully exposed to controlled ultraviolet light. Phototherapy may be given alone, or after you take a drug that makes your skin sensitive to light.
Psoralen photochemotherapy. Also known as psoralen and ultraviolet A (PUVA) therapy, this is an effective treatment for many patients. PUVA therapy enhances skin re-pigmentation. An oral psoralen compound is given to the patient. Two hours later, the de-pigmented patch on his body is exposed to ultraviolet-A (UVA) rays, for a fixed time duration.

Depigmentation

This treatment involves fading the rest of the skin on the body to match the areas that are already white. For people who have vitiligo on more than 50 percent of their bodies, depigmentation may be recommended.

Surgical Therapies- Surgical techniques may be an option when topical creams and light therapy do not work. These include:

Miniature punch grafting. Multiple thin grafts of 2 – 2.5 mm diameter are taken from the donor site by special punches and grafted onto the dermabraded white patch. Once the grafts are ‘taken up the patient is advised to take PUVA or PUVA SOL. Repigmentation occurs in 3 – 6 months and a good cosmetic result is obtained.

Ultra-thin skin grafting. The white portion of skin is dermabraded or laser ablated very superficially and a very thin skin graft (ultra-thin) consisting of the epidermis is grafted onto the part of stable vitiligo. A very thin skin graft (ultra-thin) consisting of the epidermis is grafted onto the part of stable vitiligo. This is the most satisfactory method of treatment of vitiligo, but vitiligo must be stabled for at least 2 years for any surgical treatment to be useful or effective. The graft falls off by 8 -10 days but there takes place a cellular uptake of melanocytes onto the abraded skin which gradually starts pigmenting, it takes 8-10 weeks for the pigmentation to merge and match with the surrounding skin color.
Suction blister grafting. A prolonged suction is applied to the graft donor site this raises a large blister and a thin graft containing only the epidermis is obtained. This is grafted onto the dermabraded recipient surface.
Melanocyte culture and transplantation. Melanocytes are cultured in a special artificial culture media. The depigmented recipient site is dermabraded or laser ablated and the melanocyte suspension is applied to it. The area is covered with a collagen dressing and immobilized. Large areas can be covered with this method and excellent cosmetic results are obtained.
Micro-pigmentation (tattooing). Tattooing is injecting artificial pigment into the depigmented area. After selecting the pigment shade which matches the surrounding skin color, the pigment granules are implanted into the depigmented patch either with manual or electrically driven needles. It works best for the lip area, particularly in people with dark skin. Tattooing tends to fade over time. In addition, tattooing of the lips may lead to episodes of blister outbreaks caused by the herpes simplex virus. Hence, tattooing is usually not advised unless the patch is in an inoperable site.

Cosmetics

Several cover-up makeups (waterproof skin colors) can mask vitiligo. Some patients with vitiligo cover depigmented patches with makeup or self-tanning lotions. These cosmetic products can be particularly effective for people whose vitiligo is limited to exposed areas of the body. Self-tanning lotions have an advantage over makeup in that the color will last for several days and will not come off with washing.