What is the best medicine cream for vitiligo?

1. Tacrolimus (Elidel, Protopic):

Tacrolimus is a topical calcineurin inhibitor (TCI) that reduces the activity of T-cells, which play a role in the development of vitiligo. It is applied twice daily and may take several months to see results. Tacrolimus is generally well-tolerated, but it can cause skin irritation and burning sensation at the application site.

2. Pimecrolimus (Elidel):

Pimecrolimus is another topical TCI that is similar to tacrolimus. It is applied twice daily and may take several months to produce noticeable improvement. Pimecrolimus is generally well-tolerated, but it can also cause skin irritation and burning sensation.

3. Corticosteroids:

Corticosteroids are anti-inflammatory drugs that can be used to treat vitiligo. They are available in various forms, including creams, ointments, gels, and lotions. Corticosteroids are typically applied twice daily, and they may take several weeks or months to see results. Common corticosteroids used for vitiligo include clobetasol, fluocinolone, and hydrocortisone.

4. Calcipotriene (Dovonex):

Calcipotriene is a synthetic form of vitamin D3. It helps regulate skin cell growth and differentiation. Calcipotriene is applied twice daily, and it may take several months to see improvement. It can cause skin irritation, dryness, and itching.

5. Methoxsalen with ultraviolet A (PUVA) light therapy:

PUVA therapy involves taking a medication called methoxsalen (Oxsoralen) and then exposing the affected skin to ultraviolet A (UVA) light. This combination helps to repigment the skin. PUVA therapy is usually given two to three times weekly for several months. It can cause side effects such as nausea, vomiting, sunburn, and skin cancer.

6. Excimer laser therapy:

Excimer laser therapy uses a focused beam of ultraviolet B (UVB) light to treat vitiligo. It is used to target specific areas of affected skin and avoid healthy skin. Excimer laser therapy is typically given two to three times weekly for several months. It can cause side effects such as skin redness, swelling, and blisters.

7. Surgery:

Surgical options for vitiligo include skin grafting and melanocyte transplantation. Skin grafting involves taking healthy skin from another part of the body and transplanting it to the affected area. Melanocyte transplantation involves transplanting pigment-producing cells from healthy skin to the affected area. Surgical options are usually considered when other treatments have failed or are not suitable for the patient.