Vitiligo is a skin condition characterised by the emergence of depigmented patches. Although less common in babies, it is crucial to manage this condition from its onset. Discover the treatment methods suitable for babies suffering from vitiligo.
Library
All Topics
What are the treatment methods for vitiligo in infants?
Summary
Published February 25, 2025,
updated on February 25, 2025,
by
Lilia, Scientific Editor
—
5 min read
Vitiligo in babies: a rare condition.
Vitiligo is an autoimmune disease that leads to depigmentation of certain areas of the body. It results from a dysfunction of the immune system leading to the loss of melanocytes, the cells responsible for the production of melanin, the coloured pigment.
Vitiligo is a condition partly linked to genetic factors and can occur at any point in life, regardless of age and skin type, although vitiligo in babies and infants is less common. Indeed, according to studies, the average age of onset for vitiligo in children is between 4 and 8 years. Vitiligo can be mistaken for hypopigmented naevus, which is quite similar to vitiligo and rather common in children. Hypopigmented naevus is a benign skin lesion characterised by an area lighter than the surrounding skin. Unlike vitiligo, it presents less marked discolouration, often in the form of spots or patches. This anomaly can be congenital or acquired. In infants, skin pigmentation is often incomplete, and pigmentation abnormalities, such as an excess or lack of colour, can appear between 1 and 2 years, especially after sun exposure. However, these abnormalities are usually congenital lesions and it is rare for them to indicate vitiligo.
Can vitiligo be treated in babies?
As stated above, vitiligo in children under 2 years old is rare and data on treatments used for this age group seem limited. Treatments must be chosen carefully, as infants' skin is more sensitive and may react to side effects. Topical treatments exist for children, but they require several months before showing results, as in adults. The calcineurin inhibitors in topical treatment, commonly used to treat vitiligo, reduce pro-inflammatory cytokines. They also promote the migration and proliferation of melanocytes by increasing matrix metalloproteinases and activating the endothelin B receptor, essential for their survival.
This is why a study published in the Clinical Drug Investigation aimed to evaluate the effectiveness and tolerance of calcineurin inhibitors in 46 children under 2 years old with vitiligo. They were randomly selected to receive one of two ointments: Tacrolimus 0.03%, a complex natural macrolide that penetrates deeply due to a strong affinity for calcineurin, and Pimecrolimus 1%, a modified semi-synthetic derivative that primarily acts on the surface with moderate affinity. These treatments lasted 6 months with topical application twice a day. The overall satisfaction of the parents was then evaluated. Efficacy rates of 69.6% for the tacrolimus treatment and 64.2% for the pimecrolimus treatment were revealed. However, a slight adverse effect, similar to redness, was noted in one patient. Although calcineurin inhibitor treatments show effectiveness in treating vitiligo in children under 2 years old, they should be used with caution to limit the risks of side effects.
It is crucial to consult a paediatrician if skin depigmentation appears in a child, to receive appropriate advice and ensure suitable treatment and monitoring.
Sources
XU A. & al. Efficacy of the Topical Calcineurin Inhibitors Tacrolimus and Pimecrolimus in the Treatment of Vitiligo in Infants Under 2 Years of Age: A Randomized, Open-Label Pilot Study. Clinical Drug Investigation (2019).
BHALLA M. & all. A rare case of congenital vitiligo in a neonate with a review of literature. The Journal of Clinical and Aesthetic Dermatology (2021).
Le vitiligo chez l’enfant. Association française du vitiligo.
Comprendre le vitiligo. Association française du vitiligo.
Physiopathologie et mécanismes à l’origine du vitiligo. Vitiligo Bordeaux - Service de recherche clinique.
Diagnostic
Understand your skin
and its complex needs.
