Heal House Vitiligo Research 61 · Original article
World vitiligo experts gathered to create treatment guidelines — Treatment section
Worldwide expert recommendations for the diagnosis and management of vitiligo: Position statement from the international Vitiligo Task Force-Part 2: Specific treatment recommendations
Final review
In short
Vitiligo experts from around the world gathered to create international treatment guidelines. This section covers the 'treatment' part. It summarizes how to use topical medications, oral medications, and phototherapy depending on the situation.
"So, which medication should I use, when, and how?" This is the most common question encountered in the clinic. Until now, vitiligo treatment has varied slightly by country and by hospital. Therefore, 42 vitiligo experts from around the world and 4 patient representatives gathered to create international treatment guidelines. These guidelines are divided into two parts. One part established the broad framework for diagnosis and management, and this part covers specific treatment methods. It includes how to select and combine actual treatments, from topical medications to oral medications, phototherapy, and procedures. I participated in the discussion as a co-author.
Q1 What specific treatments did they recommend?
They organized the recommendations to combine topical medications, oral medications, and phototherapy according to the situation. For topical medications, they covered steroids, Protopic ointment and ELIDEL cream, and the newly emerged JAK inhibitors. For oral medications, they summarized steroids, oral immunosuppressants, and antioxidants. For phototherapy, they included narrowband UVB phototherapy, photochemotherapy (PUVA), excimer devices, and home phototherapy. They also noted that phototherapy is often used in combination with other treatments. In addition, they included procedural approaches that may be considered in specific situations. They also covered the method of removing color from the remaining normal skin to match the tone (depigmentation) when the white areas are too extensive.
Q2 How will treatment change going forward?
New targeted treatments aimed at vitiligo are being developed, so the range of treatment options is expected to broaden in the future. This recommendation summarizes the latest evidence to date, making it ready for immediate use in clinical practice. However, vitiligo is still a disease with many unmet needs. Therefore, the current status of new treatments under development was also discussed. I participated in this international consensus as a co-author. When better treatments become established in the future, patients will receive practical benefits.
Closing remarks
As a practical guideline that specifically organizes 'what, when, and how' to use, it is immediately helpful in clinical settings. Vitiligo still has many gaps to fill, but with the emergence of new targeted treatments, it is also a disease with a promising future. It was meaningful to be able to organize this trend together with international experts. The part of the same guidelines covering diagnosis and management continues in number 62.
