Key Points Limited vitiligo usually stops progressing 1 to 2 years after the onset of the disease.
73% of cases of generalized vitiligo are progressive.
Oral or intravenous administration of corticosteroids stops disease progression in 85% of cases.
Progression can be halted in 4/5 of vitiligo cases with systemic corticosteroids, but because of the associated side effects, systemic hormone therapy must be carefully evaluated by a specialist dermatologist before use.
Solution 73% of vitiligo cases are progressive and 1.3% are receding. Usually, we explain to patients that their progression depends on the extent of disease involvement: limited and generalized forms have different presentations. 89% of cases of limited vitiligo have cessation of activity 1-2 years after rapid spread; 52% of cases of generalized vitiligo are less likely to progress if the lesions begin to appear on the face.
In 89% of cases we could stop the expansion of extensively spreading vitiligo lesions by oral low-dose hormone therapy (5 mg betamethasone two days in a row per week). Intravenous application of methylprednisone (8 mg/Kg) for three consecutive days for the treatment of generalized vitiligo resulted in a brief cessation of disease progression in 85% of patients and recoloration in 71% of cases. Other steroid hormone intravenous treatments showed similar effects in limiting disease progression.
Thus, vitiligo progression can be suppressed in 4/5 patients by systemic application of potent hormones. However, systemic hormone application may have associated side effects, so the decision to apply systemic hormone therapy for the progressive phase of limited vitiligo must be made by a professional dermatologist after careful evaluation of the individual’s clinical presentation.