Topical And Ultraviolet Treatments
Topical treatments are the usual place to start with treatments for vitiligo, though it does depend on the site and extent of involvement. Bhuvana et al (Indian J Dermatol 2001; 56: 445-6) suggest that topical tacrolimus is effective for localized vitiligo. Eryilmaz and colleagues find that the other topical immunomodulator, pimecrolimus, might be useful (J Eur Acad Dermatol Venereol 2009; 23: 1347-8). Both of these approaches have been mentioned in already published guidelines.
The use of targeted narrow-band ultraviolet B (UVB) usually in the form of the Excimer, advocated by Le Duff et al (Br J Dermatol 2010; 163: 188-92) is now well known for treating localized vitiligo, though this therapy is not available to most dermatologists in the UK.