Effects of a preceding fractional carbon dioxide laser on the outcome of combined local narrowband ultraviolet B and topical steroids in patients with vitiligo in difficult‐to‐treat areas

Abstract

This study demonstrates that adding fractional CO2 laser treatment to NB-UVB phototherapy and topical steroids improves the repigmentation rate of vitiliginous lesions on hands in some patients. This technique may be offered to vitiligo patients who are unresponsive to other treatments.

Combination of fractional carbon dioxide laser with narrow band ultraviolet B to induce repigmentation in stable vitiligo: A comparative study

“…found that monthly sessions for 3 months of fractional CO 2 laser treatment followed by 2‐hour sunlight exposure on daily basis result in improvement in vitiligo, which was assessed by the physician and by patient's satisfaction. Another studies reported by Vachiramon et al and Li et al also confirmed the superior result of triple combination of fractional CO 2 laser, NB‐UVB, and topical steroids in improvement of vitiligo in recalcitrant areas when compared to NB‐UVB and topical steroid, without any serious side effects.…”

“…This includes ablative laser and fractional laser devices. According to previous studies, incorporating laser treatment to the conventional treatments of vitiligo such as topical therapy or phototherapy resulted in higher degree of repigmentation than conventional treatment alone …”

“…The acral parts and areas over bony prominence were difficult to repigment because few hair follicle density, which are the reservoir of melanocytes and also thick skin. However, Vachirman et al demonstrated that combined ablative fractional CO 2 laser, NB‐UVB, and 0.05% clobetasol propionate gave significantly higher mean improvement score than the combination of NB‐UVB and 0.05% clobetasol propionate for the treatment of vitiligo in acral areas. This may be explained by the difference in protocol of treatment used in that study as every patient subjected to fractional CO 2 laser at 1‐week interval for 10 sessions combined with narrowband and 0.05% clobetasol propionate.…”

A comparative study of combined treatment with fractional carbon dioxide and targeted ultraviolet B phototherapy for facial vitiligo

“…The result from our study that shows 50 % of lesions treated with combined fractional CO 2 laser achieved more than 50 % repigmentation, compared to 23 % from previous study [10]. This may be due to the differences in anatomical location of the vitiliginous lesions.…”

“…This includes ablative laser and fractional laser devices. According to previous studies, incorporating laser treatment to the conventional treatments of vitiligo such as topical therapy or phototherapy resulted in higher degree of repigmentation than conventional treatment alone, especially in difficult to treat areas such as bony prominence and extremities [8][9][10][11][12][13].…”