Lasers in the Treatment of Vitiligo

Abstract

Vitiligo is an acquired cutaneous hypopigmentary disorder characterized by multiple depigmented macules and patches. There are numerous therapy modalities consist of topical corticosteroids and calcineurin inhibitors, phototherapy, surgical interventions and laser treatments are evaluated. Last 10 years, firstly excimer laser treatment has showed good results in repigmentation rates. "Excited dimers" produces a 308-nm ultraviolet (UV) monochromatic coherent wavelength, which lies within the UVB spectrum that absorb DNA as a chromophore to breakage DNA chain that causes a decrease in T-lymphocyte proliferation. Some articles have shown different responses depends on the type of vitiligo, number of sessions, interval periods and localisation. Researchers have also compared efficacy and also side effects of excimer laser between other methods. Combination therapies with excimer laser will be also treatment of choice via topical steroids or topical calcineurin inhibitors. Some of the patients developed delayed-onset permanent hypopigmentation need resurfacing methods such as CO 2 or Er:YAG laser which mainly aims to ablate the epidermis in specific coagulation columns to promote the penetration of externally applied agent. As an alternative treatment modality in vitiligo, lasers may help to raise patient compliance and reduce potential risk for skin cancer. Its convenience is limited by high cost and accessibility.