Can Vitiligo Be Cured?

Can Vitiligo Be Cured?

Can Vitiligo Be Cured?
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Vitiligo, like other autoimmune conditions, cannot be cured. While it isn’t life threatening, it can be life altering. Because the white or light-colored patches of skin that characterize the disease are so obvious, it can lead to low self-esteem, depression, and anxiety for many people, according to research.

Vitiligo is linked to a number of other conditions that are potentially serious, so it’s important to be vigilant about doctor’s appointments and keep an eye out for signs of medical problems known to be related to the condition. Otherwise, managing vitiligo is largely a matter of finding a treatment that works for you among the increasing number of options available.

Why There’s No Cure for Vitiligo

Autoimmune disorders, such as vitiligo, occur when the immune system mistakes healthy cells for dangerous ones and attacks them. In the case of vitiligo, the cells under assault are melanocytes, which are responsible for creating melanin, the chemical that gives skin color. As they die off, the color drains from the affected areas of the skin.

Because the immune system is vital for protecting the body from true threats, such as the pollen that can trigger allergic reactions and the viruses and bacteria that can lead to life-threatening illnesses, broadly suppressing it in the long term is not a viable approach to treating vitiligo, or any other autoimmune disease.

This means managing a disorder such as vitiligo requires maintaining a delicate balance between decreasing the activity of the immune system enough to prevent the loss of pigment, but not so much that the body can’t defend itself, says Shoshana Marmon, MD, an assistant professor of dermatology at New York Medical College in New York City.

John Harris, MD, PhD, the founding director of the vitiligo clinic and research center and chair of the department of dermatology at the University of Massachusetts Chan Medical School in Worcester, likens vitiligo treatment to maintaining a healthy yard. “There are weed killers that kill all plants, but we want a weed killer that kills just the weeds and spares the grass,” he says. That means developing “targeted treatments that are both safe for the immune system and efficacious for vitiligo.”

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The Importance of Managing Vitiligo

Although vitiligo isn’t a deadly disease, it is associated with a number of other conditions that can be serious. So, it’s important to be aware of these and look out for the symptoms.

 Research has found, for example, that people with vitiligo have an increased risk of developing autoimmune conditions that affect the thyroid, particularly Hashimoto’s thyroiditis. The authors recommended thyroid screening, especially for older people with a family history of thyroid disease.

Studies have also found an increased risk of other autoimmune conditions. One research review found a link between vitiligo and rheumatoid arthritis, lupus, and type 1 diabetes, as well as alopecia areata and myasthenia gravis, among others.

What’s more, melanocytes exist in parts of the body other than the skin, leaving those areas vulnerable to vitiligo. “There are pigment cells in the eye, the inner ear, the heart, and the brain,” says Dr. Harris. “There’s evidence that having vitiligo increases the risk of hearing loss and, in rare cases, even blindness and brain inflammation.”

For this reason, if you have vitiligo, it’s important to be mindful of symptoms such as fatigue, sudden weight loss or gain, changes in your vision or hearing, muscle and joint pain, and rashes, which may indicate the presence of another autoimmune condition. You also should see your dermatologist regularly to keep tabs on how your vitiligo is progressing, Dr. Marmon says, and, if there are signs you may have a related condition, get a referral to the appropriate specialist.

Marmon also points out that many people with vitiligo develop depression. “The effect of vitiligo on appearance can lead to stress and self-esteem issues, which negatively affect quality of life,” she says. She recommends seeing a therapist for help dealing with any mental or emotional issues that arise from having a visible skin condition.

How Vitiligo Is Treated

While it’s true there’s no cure for vitiligo, there are a variety of approaches for managing it and making it less noticeable.

Corticosteroids and Calcineurin Inhibitors

These medications are applied directly to affected areas of the skin. They work by blocking the immune system and promoting repigmentation. They’re most often used for small patches of vitiligo.

Janus Kinase (JAK) Inhibitors

Janus kinase (JAK) inhibitors stop the production of certain proteins that immune cells use to communicate with each other, making these drugs a more targeted treatment approach than topical steroids or calcineurin inhibitors. While most are not approved by the U.S. Food and Drug Administration (FDA) for vitiligo, oral JAK inhibitors have been prescribed off-label to treat the condition for some time.

In 2022, the FDA approved the first JAK inhibitor for vitiligo, a topical medication called ruxolitinib (Opzelura) for people 12 and up. It can only be used on up to 10 percent of the body’s surface area, however, so it may not offer adequate results for some people with more extensive depigmentation.

Oral Steroids

When vitiligo is spreading very quickly and JAK inhibitors aren’t working, a doctor may prescribe oral steroids temporarily to suppress the immune system, Harris says. But, due to potentially severe side effects, the recommendation is that they only be used for up to three months at a time (six months maximum), making them a short-term fix at best.

Narrowband UVB Therapy

This type of phototherapy (light therapy) is the oldest treatment for vitiligo. “In India, [ancient] religious texts talk about vitiligo,” says Harris. “People would chew on seeds and then sit in the sun.”

In modern times, phototherapy for vitiligo involves directing ultraviolet B light rays at affected areas of the skin in a medical setting, for 5 to 10 minutes at a time. It may require two to three sessions per week, depending on the severity of the vitiligo, to shrink existing patches and help prevent new ones from forming.

Melanocyte Transplantation Surgery

For someone whose vitiligo is stable, a doctor can surgically transplant melanocytes harvested from healthy skin onto depigmented skin to restore color.

Depigmentation

This treatment was the only one that was FDA-approved for vitiligo until ruxolitinib got the green light. A topical medication called monobenzone ether of hydroquinone (MBEH) is used to lighten unaffected areas of the skin that are adjacent to vitiligo patches to make the differences in color less stark. Harris says not many of his patients like this option, but it is one to consider if other treatments don’t work.

Resources We Trust

EDITORIAL SOURCES
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Resources
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Ross Radusky, MD

Medical Reviewer

Ross Radusky, MD, is a practicing board-certified dermatologist at the Dermatology Treatment and Research Center in Dallas. Originally from New York City, he graduated summa cum la...

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Elizabeth Yun

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Elizabeth Yun has been a writer and editor for over 15 years. Over the course of her career she has covered lifestyle, celebrity entertainment, and tech for a variety of print and ...