Clinical application of hormones for the treatment of vitiligo has a history of decades, mainly glucocorticoids, which have become the first-line drugs for the treatment of vitiligo. There are also more ways of hormone administration, including topical application, oral administration, local closure, intramuscular injection, etc. In the application of hormone treatment vitiligo, doctors need to choose the type of hormone, the mode of administration and the course of treatment according to the patient’s age, condition, location and other factors, in order to obtain the best treatment effect and try to avoid the side effects of hormone.
The mechanism of action of hormone treatment vitiligo is complicated, some research shows that the development of vitiligo is due to autoimmune damage caused by melanocytes, the system application of corticosteroids to inhibit autoimmune reaction, reduce the level of anti-melanocyte autoantibodies, reduce autoantibody-mediated toxic effects on melanocytes, so as to inhibit the autoimmune reaction of vitiligo patients, control the development of the disease, the role of the white spot re-color. The most important thing is that the patient’s immune system can be controlled.
Some experts suggest that patients with progressive vitiligo and generalized lesions can be treated with systematic application of glucocorticoids. In general, it seems that systematic application of small doses of hormones can effectively control the condition, but the pigmentation of the white spots is slow to regenerate. The application of conventional doses of hormones, although effective in controlling the condition and a greater degree of repigmentation of some white spots, can inhibit the hypothalamic-pituitary-adrenal axis. The doctor needs to determine the individualized medication according to the patient and the condition.
In the repigmentation treatment of vitiligo, topical hormone therapy has the most clinical application and is applicable to all types of vitiligo. The literature reports that the efficacy of local application of hormone therapy for vitiligo varies widely, and the area of repigmentation of white spots is 9% to 92%. The local treatment of hormone includes topical application and local injection method.