Current Management and Emerging Therapies for Pediatric Vitiligo: A Narrative Review

Pediatric vitiligo (PV) accounts for approximately 30% of all vitiligo cases. PV is often associated with unique treatment challenges, including access barriers, prolonged treatment duration, and significant psychosocial impacts on patients and their families. Standard management typically includes topical therapies aimed at clearance of inflammatory cell infiltrates that attack melanocytes and phototherapy aimed at repigmentation through stimulation of pigment cell activity and movement into the depigmented regions. However, some patients may require more intensive interventions, including systemic therapy, surgical procedures, or depigmentation therapy when repigmentation is not likely or desired. The approval of topical 1.5% ruxolitinib cream for individuals aged 12 years and older, following the demonstration of the drug's efficacy and safety, has prompted increased interest in emerging therapies for vitiligo. This article explores current topical treatments, phototherapy, and novel therapeutic approaches specifically in the pediatric and adolescent populations focusing on available published data. Additionally, we highlight the psychological impact of vitiligo on young patients and their families and emphasize practical considerations when managing this condition in this population.