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Vitiligo

Vitiligo phototherapy, how long does it take to see results?

Jung Min Bae Jung Min Bae Dermatologist · Heal House Gangnam Branch

Last reviewed

For vitiligo phototherapy, the longer you continue treatment consistently—3 months, 6 months, up to 12 months—the more patients show good repigmentation. In particular, to judge treatment response, it is important to observe progress for at least 6 months rather than giving up too early.

How Many Months of Phototherapy Are Needed to See Results?

The longer the treatment period, the greater the degree of repigmentation tended to be.

Our research team analyzed a total of 35 prospective studies involving 1,428 vitiligo patients. Among them, 1,201 patients received narrowband UVB (NB-UVB) treatment.

Treatment duration25% or more repigmentation75% or more repigmentation
3 months62%13%
6 months74%19%
12 months75%36%

Looking at the treatment results, the proportion of patients who achieved 75% or more clear repigmentation increased from 13% at 3 months to 36% at 12 months.

Therefore, even if the response is not significant during the first 2 to 3 months of treatment, it is important to continue treatment consistently rather than concluding that it is ineffective right away.

Does Phototherapy Work Differently on the Face vs. Hands and Feet?

Yes. The face and neck show a very good treatment response, while the hands and feet show a relatively lower response.

After 6 months or more of treatment, the rates of achieving 75% or more repigmentation were as follows:

- Face/neck: 44%

- Trunk: 26%

- Limbs excluding hands and feet: 17%

- Hands and feet: 0%

On the face and neck, 82% of patients showed 25% or more repigmentation, whereas on the hands and feet, only 11% showed 25% or more improvement.

This difference is related to the distribution of hair follicles (which supply the melanocytes needed for repigmentation) and skin thickness.

The face and neck have abundant hair follicles, making it easier for melanocytes activated by phototherapy to spread to surrounding skin, whereas the hands and feet have fewer hair follicles and thicker skin, so treatment response may be slower.

How Long Should You Continue Phototherapy?

Generally, it is recommended to undergo treatment for about 6 months to 1 year before evaluating the response.

In this meta-analysis, the longer the treatment duration, the more patients showed good repigmentation.

However, not all patients respond the same. Even after 12 months of treatment, about 25% of patients did not show 25% or more repigmentation.

Therefore, what is important is not simply completing a treatment period, but deciding whether to continue treatment by considering both the location of the lesions and the treatment response.

If after consistent treatment for about 6 months to 1 year there is no satisfactory repigmentation or only certain areas remain, other methods such as surgical treatment may be considered together.

References

  • Bae JM, et al. Phototherapy for Vitiligo: A Systematic Review and Meta-analysis. JAMA Dermatology. 2017

Jung Min Bae

Dermatologist · Gangnam Branch

With sincere care and continuous research, I will be a reliable companion for vitiligo patients.