In some cases, yes, in others no. My usual practice to achieve full repigmentation prior to stopping creams & phototherapy. This is achievable for most cases of vitiligo without hair follicle involvement but is exceptional for white hair & vitiligo.

Grafting, as the name suggests involves transferring pigment cells to the areas devoid of pigment. In cases of poliosis or white hairs, the pigment cells need to migrate from the skin into the stem cells / melanocyte bulb within the hair follicle. Re-pigmentation of skin starts to appear within 2-4 months, however it may take 6-12 months for the hair to re-pigment. Phototherapy speeds up the process.

Surgery is successful in 80-90% of vitiligo patches, meaning skin is easier to repigment from the top down using micrografts. In the context of white hairs, repigmentation requires a time frame of 6-12 months. For faster & more reliable results, follicular unit transplantation of pigmented hairs can be considered as adjunctive treatment.

Repigmentation is dependent on how fast your immune system reacts to transplantation of pigment cells. As a guide, micrografting of skin gives pigmentation within a few months, however for white hairs it can take 6 to 12 months before melanocytes migrate into the hair follicles.

With transplantation of hair follicles or FUE, pigmentation is seen within 2-3 months of the procedure & increases with time.

See the section on diet & supplements. These can be useful in the minority of cases. Eating healthy & reducing stress levels can help. In many cases I will prescribe adjunctive topicals & phototherapy. These treatments accelerate pigmentation production.

This is a natural way of encouraging pigment cells to both migrate & repopulate white patches of vitiligo as well as produce more melanin. Narrowband uses focused filtered light to get this done. Treatments are conducted at Cutis Medical. Treatment takes between 30 seconds to 3 minutes. An ideal regime is 2 to 4 times a week. Treatments are bulk billed as phototherapy is a recognised service through Medicare. 

Vitiligo in hair bearing areas can also be treated with a UVB comb. Scalp margin involvement usually receives enough UV during clinical treatments.

Hair transplantation can be effective in the management of white hairs or poliosis. It involves transplantation of pigmented hair from a donor area, usually the back of the scalp, to the affected area. Each hair follicle is meticulously transplanted by hand.

This procedure is reserved for patients who do not respond to creams & topicals. A test area is conducted to see if further transplantation is useful. It is only useful for stable vitiligo. This is defined as non-progressive depigmentation lasting over 12 months.

Narrowband phototherapy is a medical treatment designed to wake up pigment cells using filtered light. It is considered one of the best ways to treat vitiligo. A device delivers calculated incremental doses of UVB at 311 nm. This wavelength suppresses inflammation & stimulates the melanocyte to migrate as well as produce pigment known as melanin.

Vitamins are useful as adjunctive therapy. They are cost effective with no side effects. A simple supplementation program includes vitamin D, B12, B complex, folate & iron. I normally start patients on ginkgo biloba midway through their repigmentation program.

Dietary supplements & restrictions are increasing in popularity for patients with vitiligo. A sensible diet is as follows-

Eat the following: foods rich in antioxidants including legumes, green leafy vegetables, & omega fish oil. Green tea has antioxidant properties.

Eat less of the following: acidic foods including oranges, limes, lemons, & tomatoes. Consume less gluten & processed foods.

*My job is to treat your skin with topicals, phototherapy & surgical techniques. For a detailed vitiligo dietary plan, you can Google this topic or see a dietician.

I will be more than happy to review your cognition & provide feedback. Note, I will follow the treatment algorithm, meaning you must trial creams & phototherapy, understanding the pros & limitations of this treatment. I only consider surgical techniques if your vitiligo is stable & if you do not respond to conventional therapy.

I am a specialist dermatologist, a referral from your GP is required. Reception can guide you through this process.

Topical creams are less than a dollar a day. In Australia, Medicare pays for all phototherapy sessions, saving patients over $7500 a year. Surgical treatments such as microskin SSG grafting carry a rebate.FUE – follicular unit transplantation is not covered under Medicare. 

The theory is that there are two subtypes of melanocytes that reside in the body (probably more as the eye has melanocytes as do mucous membranes). With this theory, melanocytes in normal skin are more susceptible to destruction from your immune system, hence with repigmentation, resistant pigment cells derived from pigmented hairs replace this population found on the skin.