Vitiligo on the Face

  • Best Results6-12 months
  • Treatment Recovery0 days
  • Procedure TimeVariable
  • Skin SpecialistDr Davin Lim
  • Duration of ResultsVariable
  • AnaestheticNA
  • Back to WorkImmediately
  • Cost$0 (Medicare)

Vitiligo Face Treatment

Though distressing facial vitiligo carries a good prognosis with over 85% of patients re-pigmenting within weeks of therapy. I use the international guides for vitiligo management, namely combining topicals with phototherapy. The majority of vitiligo treatments are covered by Medicare. 

FactsFacts Vitiligo Face Treatment

  • White patches on the face can be due to vitiligo, eczema of other inflammatory skin conditions
  • Each condition will have an optimal treatment algorithm
  • Facial vitiligo carries a good prognosis
  • The vast majority of patients will show evidence of re-pigmentation within week
  • Topicals & phototherapy form the mainstay of treatment
  • Camouflage creams from Dermblend, Covermark, Dermacolor can be useful

What are the chances of getting pigmentation back?

Vitiligo Face Treatment

There’s good news & bad news. The bad news is that vitiligo is on your face, & that’s why you are reading this page.

The good news is that if you do have face involvement, the chances of getting pigment back is very high, in the order of 85% or more (excluding pure mucosal vitiligo). If you have tiny areas of follicular pigment in areas of vitiligo, I have a good chance of helping you.

If you have white hairs (for example in your brows), I still have a good chance of helping you, but treatments are more involved. Refer to the section on FUE eyebrows to understand.

If you have loss of pigment on your lips, it is hard to get pigment back. Failing topicals & phototherapy, you can attempt cosmetic tattooing. 

What is a basic but effective treatment protocol for facial vitiligo?

A basic treatment goes something like this-

  1. Creams, CS & CS sparing topical (see below)
  2. Narrow Band 311 nm UVB phototherapy 2-3 times a week (see below)
  3. Diet & supplements are optional (see below)

What topical creams are prescribed for treating vitiligo?

Topicals, coupled with narrowband phototherapy, is the mainstay for the management of facial vitiligo. The ideal combination depends on the site. Eyelid skin is thinner than skin on the nose or cheeks, hence formulations & concentrations will differ according to facial sites. As a guide-

  1. Corticosteroid creams & ointments.
  2. Calcineurin inhibitors.
  3. Prostaglandin analogues.
  4. Vitamin D derivatives

The above-mentioned accounts for the vast majority of topicals I employ for vitiligo. Occasionally I may use 5 Fluorouracil for recalcitrant vitiligo involving the hands. Given the availability of phototherapy, I do not use methoxy psoralen creams much. Pseudo catalase, popular in the 1990s is outdated

What side effects are there with creams?

If I monitor you & if you follow the instructions I have written on your prescription, side effects are extremely rare. The most common side effect is perioral dermatitis. This is usually secondary to the CS ointment or cream, usually the calcineurin inhibitory cancels out this effect. If needed it can be treated with doxycycline 50 mg bd for 3-6 weeks. (You may get sun sensitivity with this, but the action spectrum is in the UVA, & not UVB).

Why phototherapy for facial vitiligo & how does it work?

Narrowband phototherapy is a special form of delivering clinically prescribed light. It forms the foundation of vitiligo management in Australia & overseas. Phototherapy works by –

  1. Halting the immune attack on pigment cells.
  2. Stimulation of remaining melanocytes (pigment cells) to migrate to areas of vitiligo & to produce pigment.

Phototherapy is conducted at Clinic Cutis. It takes several minutes to perform & is bulk billed on Medicare with no out of pocket expenses to patients. This treatment is best combined with topical creams as part of the 20 week vitiligo challenge.

Davin’s Viewpoint on Facial Vitiligo

The good news is that the vast majority of patients with this pattern of vitiligo do well with treatment. My go to regiment is topicals coupled with narrowband phototherapy. We should expect to see changes within 4- 8 weeks of commencement, though it can take up to 6 to 12 months for full repigmentation.

Having a well-balanced diet, with supplements can help mentally more than physically. The prognosis for facial vitiligo is excellent.

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