Can we cure vitiligo?

Vitiligo is a dermatosis that manifests as skin depigmentation, due to the destruction of melanocytes, the cells responsible for melanin production. This autoimmune disease affects approximately 0.5 to 2% of the global population and is characterised by the appearance of white patches of varying sizes and shapes. The progression of vitiligo is unpredictable, with the macules potentially remaining localised or spreading across the entire body. Some studies suggest that environmental factors, such as oxidative stress or exposure to mites, could contribute to its progression. Even though vitiligo is neither contagious nor harmful to health, it is a visible dermatosis that can have a significant psychological impact that should not be underestimated.

To date, there is no cure available for treating vitiligo.

The absence of a definitive treatment can be explained by the very nature of the vitiligo, which results from a complex interaction between genetic, immune, and environmental factors. Indeed, as mentioned earlier, it is primarily an autoimmune disease, where the immune system mistakenly attacks the melanocytes. However, as with the majority of autoimmune diseases, it is difficult, if not impossible, to permanently restore normal immune function. Furthermore, the multiple triggering factors of vitiligo, such as stress or skin trauma, which can lead to a Koebner phenomenon, make managing the disease challenging.

However, even though it is currently not possible to cure vitiligo, there are today several treatment options aimed at improving the appearance of the skin and slowing down, or even halting, the progression of the disease. When vitiligo is in its active phase, it is often managed by combining oral corticosteroid therapy with UVB phototherapy. In over 90% of cases, this is sufficient to stop the outbreak. If this does not work, creams containing immunosuppressants, such as tacrolimus or pimecrolimus, or dermocorticoids may be prescribed. Finally, if the vitiligo is of the segmental type or has been stable for several years, a melanocyte skin graft may be considered.

Even though vitiligo cannot be cured, a swift dermatological intervention can help to halt its progression.