Heal House Vitiligo Study No. 60 · Original Article
How often do cosmetic laser treatments actually cause vitiligo?
Expert opinion about laser and intense pulsed light (IPL)-induced leukoderma or vitiligo: a cross-sectional survey study
In short
The occurrence of new white spots from cosmetic laser or IPL procedures was rare. It was reported in only 30 out of 11,300 patients (0.27%) treated by experts.
We wanted to go one step further from the previous expert consensus. We were curious: 'How often does this actually happen?' The appearance of new white spots after cosmetic laser or IPL treatments is certainly a concern. However, data summarizing the actual frequency was scarce. So, we asked vitiligo experts from 11 countries about the cases they had each experienced. In this way, we collected the actual incidence rate and related factors. I participated in this international survey as a co-investigator. For reference, the lasers referred to here are not the excimer lasers used to treat vitiligo, but cosmetic lasers for hair removal or skin aesthetics.
Q1 How was the study conducted, and how often did it occur?
To put it plainly, it was very rare. When we asked 15 experts from 11 countries, among the 11,300 vitiligo patients they had treated, only 30 cases (0.27%) of white spots induced by cosmetic laser or IPL treatments were reported. Of these 30, 12 (40%) were individuals who already had vitiligo. Among them, 7 (58%) had been stable for over 1 year before the procedure. In other words, even a stable condition did not mean the risk was completely absent. Conversely, most cases occurred in individuals without vitiligo, which also revealed that it was difficult to prevent beforehand.
Survey results on cosmetic laser/IPL-induced leukoderma
| Item | Content |
|---|---|
| Survey subjects | 15 vitiligo experts from 11 countries |
| Reported induced cases | 30 out of 11,300 patients (0.27%) |
| Those with a history of vitiligo | 12 out of 30 (40%) |
| Accompanying skin damage at the procedure site | Approximately 56.7% |
Q2 So, if you have vitiligo, should you avoid cosmetic laser treatments altogether?
Not necessarily. The induced cases themselves were very rare. Moreover, most occurred in individuals without vitiligo. It was not something that could be prevented simply by not treating vitiligo patients. However, more than half of the cases involved skin damage such as blisters, scabs, or maceration at the procedure site. Therefore, it is advisable to avoid overly aggressive treatments with high settings. Experts recommended a test spot on a small area first. They also advised monitoring for signs of disease spread (such as the Koebner phenomenon or fading borders). Ultimately, the answer is not 'avoidance' but 'doing it carefully and well.'
Closing remarks
Thanks to this survey, we can now tell those who fear cosmetic laser treatments that 'it is actually very rare' with concrete numbers. At the same time, we gained a balanced perspective: although rare, it can occur even in stable vitiligo, so caution should not be neglected. I participated as a co-investigator. I believe it was meaningful just to gather the diverse management approaches of each expert in one place.
