Oral minocycline in the treatment of vitiligo--a preliminary study

For effective treatment of vitiligo, it is as important to arrest the progression of the disease, as it is to induce repigmentation. Epidermal oxidative stress has been documented in vitiligo patients, and there is much support for a free-radical-mediated damage as an initial pathogenic event in melanocyte degeneration in vitiligo. Minocycline possesses a wide repertoire of anti-inflammatory, immunomodulatory, and free-radical scavenging actions in addition to their well-characterized antimicrobial effects. Recently, it has been shown that minocycline can rescue melanocytes from oxidative stress in vitro. Minocycline 100 mg was tried in this study to elucidate its role in arresting disease activity. Thirty-two patients with gradually progressive (slow spreading) vitiligo were enrolled in this study. The patients were advised to take minocycline 100 mg once daily. In 29 patients, the progression of the disease was arrested, and only three patients showed development of new lesions and/or enlargement of existing lesions. Ten patients showed arrest of further depigmentation after 4 weeks of treatment. Thus, minocycline offers a unique and potentially powerful approach to the management of arresting the activity of the disease. The present study showed the effectiveness of minocycline in the treatment of vitiligo. Further controlled studies should be undertaken to confirm its efficacy.