Phototherapy in the management of vitiligo – an updated narrative review

Abstract

Introduction and aim. Vitiligo is a chronic skin disease characterized by progressive loss of melanocytes. Various treatment options have been developed to manage vitiligo, however, phototherapy has emerged as one of the most effective treatment options. Therefore, this review has been written to examine the mechanisms of this particular treatment approach and its optimal implementation. Material and methods. A review of the literature regarding combination of word vitiligo with the following: psoralen ultraviolet A (PUVA), narrowband ultraviolet B (NB-UVB) and excimer laser (EL) was performed using the PubMed database. Analysis of the literature. NB-UVB has demonstrated safety and efficacy in stimulating melanocyte proliferation and melanin synthesis, making it an attractive treatment option for both localized and generalized vitiligo. PUVA therapy, combining psoralen photosensitization with UVA irradiation, has shown remarkable efficacy in repigmentation, particularly in refractory or extensive vitiligo. However, because of possible side effects, it is not recommended as a first line phototherapy. With its targeted and precise approach, EL offers a localized treatment and has produced impressive results in localized and segmented vitiligo. Conclusion. Despite limitations, phototherapy continues to evolve, offering hope for individuals with vitiligo. Further research and advancements in treatment protocols are needed.