Key points Topical and systemic treatments for vitiligo have different side effects in different patients.
Topical potent glucocorticoids are the first line of treatment for vitiligo.
Frequently reported side effects are: erythema, acne-like lesions, epidermal atrophy, capillary dilation, swelling lines and enhancement of hair growth.
Topical calcium-regulated phosphatase inhibitors (tacrolimus, pimecrolimus) often cause erythema, burning sensation and skin irritation. Despite some circulating information, there is so far no convincing evidence that the use of these drugs increases the chances of skin cancer in vitiligo patients.
Vitamin D3 derivatives produce only mild irritation in the treated skin.
Topical psoralen is highly phototoxic and skin blistering and necrosis may occur after UV light exposure even when very low concentrations are used.
Solution The treatment of vitiligo is a complex issue that requires a clear and detailed explanation of the side effects of both systemic and topical treatments.
Every vitiligo patient needs to consult with a dermatologist about the length of treatment and its possible side effects.
The discussion of any systemic treatment of vitiligo should be private, based on clear questions and answers between the patient and the dermatologist in a state of emotionally transposed communication and collaboration.
It is sincerely hoped that this mini-book will help patients with vitiligo to ask clear questions to their dermatologists, thus facilitating understanding and treatment.