Phototherapy with Topical Minoxidil in Vitiligo: A Randomized Control Trial

Phototherapy is the most commonly used treatment for vitiligo, with initial pigment appearing at the perifollicular site, eventually coalescing into uniform pigmentation due to melanocyte migration from hair follicles. Melanocyte activity is higher during the anagen phase of the hair cycle, which is prolonged by minoxidil.

To assess if topical minoxidil enhances the rate of pigmentation during phototherapy for the treatment of vitiligo.

In this double-blinded, randomized control study, the efficacy of minoxidil in inducing repigmentation was compared with the vehicle used as a placebo. Thirty vitiligo patients with a minimum of 2 patches were included and randomized into 2 groups and treated with phototherapy. Minoxidil 5% solution was randomly applied on one patch and vehicle on the other patch. The vitiligo area severity index (VASI) score of the lesion was measured at baseline and then at 4, 8, and 12 weeks for each lesion. Physician and patient global assessment scores were recorded at week 12.

In minoxidil group, the baseline VASI score of 94 ± 9.68% reduced to 47.76 ± 17.25% at 12 weeks. In the placebo group, the VASI score reduced from 94 ± 9.68% to 67.93 ± 16.88%. Reduction in VASI was found to be greater in minoxidil group as compared with the placebo group ( P value = <0.001). The difference in the physician and patient's global assessment scores in both minoxidil and placebo groups was also statistically significant.

The study had a small sample size and a short follow-up period.

Concomitant use of phototherapy and minoxidil increases the rate of pigmentation with reduction in VASI score.