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A Review of Randomized Controlled Trials for Vitiligo Therapies Published Between 2013 and 2023
Natalia Maverakis Ramirez1, Zachary J Jaeger2, Delphine J Lee3,4
1Medicine, San Juan Bautista School of Medicine, Caguas, USA.
Cureus
|August 8, 2026
Summary
This review of vitiligo treatments found that adding certain therapies to phototherapy, like oral psoralen or topical ruxolitinib, significantly improved skin repigmentation. Systemic monotherapies showed no superiority over comparators.
Area of Science:
- Dermatology
- Clinical Trials
- Evidence-Based Medicine
Background:
- Vitiligo is a challenging depigmentation disorder.
- Topicals and phototherapy are common treatments for generalized vitiligo.
- Randomized controlled trials (RCTs) offer the highest quality evidence for treatment efficacy.
Purpose of the Study:
- To systematically review and summarize RCTs for vitiligo treatment published between 2013 and 2023.
- To identify effective interventions for vitiligo based on high-level evidence.
- To categorize and analyze treatment outcomes for phototherapy, topical, and systemic therapies.
Main Methods:
- Systematic review registered with PROSPERO, adhering to PRISMA guidelines.
- Searched multiple databases (CENTRAL, ClinicalTrials.gov, Embase, PubMed, Web of Science) for RCTs.
- Included 36 RCTs focusing on Vitiligo Area Scoring Index (VASI) outcomes, categorized into phototherapy combinations, topical combinations, and systemic monotherapy.
Main Results:
- Phototherapy combined with oral psoralen, oral minipulsed prednisone, implanted afamelanotide, topical ethyl vanillate, topical bimatoprost, or oral vitamins A and E showed statistically improved VASI.
- Effective topical therapies included ruxolitinib, calcipotriol/betamethasone, tacrolimus/mometasone, and microdermabrasion/tacrolimus.
- No systemic monotherapies demonstrated superiority compared to their respective comparators.
Conclusions:
- Combination therapies, particularly those augmenting phototherapy or topical applications, demonstrate significant efficacy in improving vitiligo.
- Specific topical agents show promise as effective monotherapies or in combination.
- Further research into systemic monotherapy for vitiligo may be warranted to identify effective agents.
