When to Initiate Referral

  • Poor response to the above treatments after 3 months
  • Extensive or distressing vitiligo

Treatment Basics

  • Treatment depends on the patient’s age, cultural beliefs, and the location and extent of the affected areas
  • Consider mid to high-potency topical steroids with “steroid holidays”
  • Emphasize importance of sun protection as affected areas at-risk for the sequelae of acute and chronic sun exposure
  • In some patients, cover-up cosmetics may be appropriate (Dermablend, Covermark)
  • An excellent resource and support group is the National Vitiligo Foundation: www.vitiligofoundation.org

Vitiligo on the Face, Axillae, Inguinal Folds or Genitalia

  • Tacrolimus 03% or 0.1% ointment or pimecrolimus 1% cream once to twice daily until clear (medications are approved for children 2 years or older)

Vitiligo on the Trunk or Extremities

  • Triamcinolone 1% ointment once or twice daily on the weekends and tacrolimus ointment or pimecrolimus cream once or twice daily on the weekends