Vitiligo carries an unfair social stigma in India. The clinical reality is more hopeful: it is one of the more treatable autoimmune skin conditions, with several evidence-based therapies that achieve significant repigmentation in most patients. This page explains how we approach vitiligo at Derma Essence — and what is realistic at every stage.
Setting expectations honestly
We will be straightforward with you: vitiligo is treatable, not curable. With consistent treatment, most patients see:
- 60 to 80 percent repigmentation in face, neck and trunk patches
- Slower / partial response in lips, fingertips, and over bony joints
- Stabilisation of active disease (no new patches) within 3 to 6 months
- Need for ongoing maintenance to prevent relapse
The two questions we answer first
Before treatment plan, we determine:
- Is the disease active or stable? Active = new patches in last 6 months, existing patches expanding. Stable = no change for 12+ months. Treatment differs significantly between the two.
- Are there autoimmune comorbidities? Thyroid disease, type 1 diabetes, alopecia areata, vitamin B12/D3 deficiency. We screen and address these — they affect treatment response.
The treatment toolkit
Topical therapy (always)
Tacrolimus 0.1% ointment — calcineurin inhibitor, safe for face and folds. Mid-potency corticosteroid for body patches (rotated to avoid skin thinning). Ruxolitinib 1.5% cream for facial patches in adults and adolescents — the first JAK inhibitor approved for vitiligo, strong recent evidence.
NB-UVB phototherapy
The cornerstone of moderate-to-extensive vitiligo treatment. Narrowband UVB (311nm) cabinet exposure 2 to 3 times weekly, starting at sub-erythemal doses and increasing over weeks. Sessions are 30 seconds to 5 minutes. Excimer laser (308nm) for small targeted patches.
Oral therapy (selected patients)
Mini-pulse oral steroids for active, rapidly-progressing disease to halt new patch formation. Sometimes immunomodulators in collaboration with rheumatology. Always weighed carefully — these are not first-line.
