Vitiligo Excimer Laser: Is Higher Intensity More Effective?

In facial and neck vitiligo, low-dose treatment showed repigmentation effects similar to standard doses.

Our research team conducted a randomized controlled trial comparing low energy that does not induce erythema with conventional-dose excimer laser in patients with stable vitiligo on the face and neck.

As a result, there was no significant difference in repigmentation effects between the two treatments.

However, not all patients use the same low dose from start to finish. If the treatment response is insufficient, the energy can be gradually increased while monitoring the skin condition.

First, it is important to soothe the skin and allow it to fully recover before proceeding with the next treatment.

Because skin thickness, UV sensitivity, and melanocyte response vary from patient to patient, reactions may differ even with the same energy.

If the following symptoms appear after treatment, caution is needed.

- If strong erythema persists for a long time

- If stinging or pain is severe

- If blisters develop

In such cases, you can soothe the skin with a cold compress, temporarily adjust the ointment you are using as directed by your dermatologist, or receive necessary topical treatment.

It is advisable to pause excimer laser treatment until the skin has fully recovered and then resume.

The occurrence of such an overreaction does not mean that the entire vitiligo treatment has failed. The important thing is to adjust the energy in the next treatment to prevent the same reaction from recurring.

Because skin thickness, UV sensitivity, lesion location, and previous treatment response vary from patient to patient.

Even with the same energy, some patients may show sufficient repigmentation, while others may experience excessive erythema or pain.

Therefore, considering the type of vitiligo, lesion location, skin condition, and treatment response, the energy intensity and treatment interval should be individually adjusted.

Especially in areas with good treatment response, such as the face, rather than increasing energy to the point of causing unnecessary erythema, a strategy of continuing repigmentation while reducing unnecessary skin irritation and hyperpigmentation can be helpful.

Conversely, if sufficient response is not achieved with low energy, the intensity should be gradually increased to find the appropriate dose.

Ultimately, the key to excimer laser treatment is not simply treating with high energy, but carefully observing the patient's skin response and precisely adjusting the appropriate treatment intensity and number of sessions.