Exploring New Possibilities in the Treatment of Vitiligo

An estimated 2 million patients in the United States suffer from vitiligo, which is a dermatological condition defined by depigmentation of the skin.

Although there is currently no cure, recent medical advances have helped patients and providers gain a broader perspective on the condition of the skin. Likewise, prominent cultural figures with vitiligo have also helped fight the stigma surrounding the condition.

Despite this, vitiligo is still considered by many to be a purely cosmetic condition, although it is also a medical condition.

Sarah Asch, MD, FAAP, FAAD, Pediatric Dermatology Society The chair of the teledermatology committee explained how the public perception of vitiligo has evolved in recent years, as well as how vitiligo affects adults and pediatric patients differently and the myriad of promising new therapies that are currently being explored.

“We know that vitiligo really has a very big impact on people’s quality of life, both in children and adults, and we know that the impact is not the same for each person,” said Ash. “So it was really important for us to provide resources to people affected by vitiligo in terms of advocacy and making sure they have access to support groups and other resources that might be helpful to them.”

Asch noted that a stronger focus on treating pediatric patients — who make up about 25 to 30 percent of those affected by vitiligo — has been adopted in recent years.

“Children tend to respond better to therapies than adults, and so we treat them more aggressively, and that’s really a new way of thinking about vitiligo,” Asch said. “Ten years ago there was a lot less pressure to treat early and aggressively because we didn’t understand the difference we could make in terms of the color returning to the skin.”

Topical steroids such as hydrocortisone and topical calcineurin inhibitors have been used to signal color-producing cells in the body and promote repigmentation. During this time, larger body surfaces will often be treated with phototherapy.

However, perhaps the biggest challenge in implementing phototherapy is that some patients have to visit dermatology offices several times a week. Additionally, home phototherapy units are often not covered by insurance, making it increasingly difficult for some patients to receive treatment.

“It can be very expensive, and it’s another avenue we’re really working in on behalf of our vitiligo patients,” Asch said. “For this to be recognized as more than just a cosmetic issue, that this is a true autoimmune disease that requires treatment.”

Meanwhile, promising new data on ruxolitinib topical cream has indicated that a Food and Drug Administration (FDA)-approved treatment may soon be available for children and adult patients.

“The data was very impressive; one of the things (the data) showed a 75% improvement in facial vitiligo,” Asch said. “It’s amazing. We just don’t have any other treatments that have this kind of response on this kind of timeline. It’s been tested on children aged 12 and up, and so probably the first approvals will come out. for 12+, hopefully even this year.

For more from Dr. Asch, listen to the podcast above.

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