Unconventional Treatments for Vitiligo: Are They (Un) Satisfactory?

  • Serena Gianfaldoni University G. Marconi of Rome, Dermatology and Venereology, Rome 00192
  • Georgi Tchernev Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior (MVR-Sofia), General Skobelev 79, 1606 Sofia; Onkoderma - Policlinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia
  • Jacopo Lotti University G. Marconi of Rome, Dept. of Nuclear, Subnuclear and Radiation Physics, Via Plinio 44, Rome 00193
  • Uwe Wollina Städtisches Klinikum Dresden, Department of Dermatology and Allergology, 01067 Dresden
  • Francesca Satolli Department of Dermatology, University of Parma, Via Gramsci 14, Parma, Parma 43126
  • Miriam Rovesti Department of Dermatology, University of Parma, Via Gramsci 14, Parma, Parma 43126
  • Katlein França University of Miami School of Medicine, 1400 NW 10th Avenue, Miami, Florida 33136-1015
  • Torello Lotti University G. Marconi of Rome, Dermatology and Venereology, Rome 00192
Keywords: vitiligo, oxidative stress, melanocytes stimulation, repigmentation, uncommon therapies, efficacy, safe-profile


The authors show a brief overview of the vitiligo’s unconventional therapies. A part for well-documented effectiveness of L-phenylalanine, PGE2 and antioxidant agents in the treatment of vitiligo, for the other therapeutical approaches more investigations are needed.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


Eken ZE. Antioxidants. Pigmentary Disorders. 2015; 2(163):2376-0427.

Li L, Li L, Wu Y et Al. Triple-combination treatment with oral α-lipoic acid, betamethasone injection, and NB-UVB for non-segmental progressive vitiligo. J Cosmet Laser Ther. 2016; 18(3):182-5. https://doi.org/10.3109/14764172.2015.1114646 PMid:26735264

Dell'Anna ML, Mastrofrancesco A, Sala R et Al. Antioxidants and narrow band-UVB in the treatment of vitiligo: a double-blind placebo controlled trial. Clin Exp Dermatol. 2007; 32(6):631-6. https://doi.org/10.1111/j.1365-2230.2007.02514.x PMid:17953631

Namazi MR, Chee Leok GO. Vitiligo and diet: a theoretical molecular approach with practical implications. Indian J Dermatol Venereol Leprol. 2009; 75(2):116-8. https://doi.org/10.4103/0378-6323.48654

Jeong YM, Choi YG, Kim DS et al. Cytoprotective effect of green tea extract and quercetin against hydrogen peroxide-induced oxidative stress. Arch Pharm Res. 2005; 28:1251-1256. https://doi.org/10.1007/BF02978208 PMid:16350851

Guan C, Xu W, Hong W et al. Quercetin attenuates the effects of H2O2 on endoplasmic reticulum morphology and tyrosinase export from the endoplasmic reticulum in melanocytes. Mol Med Rep. 2015; 11(6):4285-90. https://doi.org/10.3892/mmr.2015.3242 PMid:25625855

Vicentini FT. Quercetin in w/o microemulsion: in vitro and in vivo skin penetration and effiacy against UVB-induced skin capers damages evaluated in vivo. Eur J Pharm Biopharm. 2008; 69:948-957. https://doi.org/10.1016/j.ejpb.2008.01.012 PMid:18304790

Szekeres E, Morvay M. Repigmentation of vitiligo macules treated topically with Efudix cream. Dermatologica. 1985; 171(1):55-9. https://doi.org/10.1159/000249389 PMid:4029463

Tsuji T, Hamada T. Topically administered fluorouracil in vitiligo. Arch Dermatol. 1983; 119(9):722-7. https://doi.org/10.1001/archderm.1983.01650330014006 PMid:6614958

Anbar T, Westerhof W, Abdel-Rahman A et Al. Treatment of periungual vitiligo with erbium-YAG- laser plus 5-flurouracil: a left to right comparative study. J Cosmet Dermatol. 2006; 5(2):135-9. https://doi.org/10.1111/j.1473-2165.2006.00240.x PMid:17173588

Tavares-Bello R.Capecitabine-induced hand-foot syndrome and cutaneous hyperpigmentation in an elderly vitiligo patient. J Eur Acad Dermatol Venereol. 2007; 21(10):1434-5.https://doi.org/10.1111/j.1468-3083.2007.02242.x PMid:17958867

Paravar T, Hymes SR. Longitudinal melanonychia induced by capecitabine. Dermatol Online J. 2009; 15(10):11. PMid:19951629

Schäfer M, Dütsch S, auf dem Keller U, et al. Nrf2 establishes a glutathione-mediated gradient of UVB cytoprotection in the epidermis. Genes Dev. 2010; 24:1045-1058. https://doi.org/10.1101/gad.568810 PMid:20478997 PMCid:PMC2867209

Zhu M, Bowden TG. Molecular mechanisms for UV-B irradiation-induced glutathione depletion in cultured human keratinocytes. Photochem Photobiol. 2004; 80:191-196. https://doi.org/10.1562/2004-02-26-RA-091.1 PMid:15244506

Grainger KM. Pigmentation in Parkinson's disease treated with levodopa. Lancet. 1973; i: 97–8. https://doi.org/10.1016/S0140-6736(73)90490-X

Goolamali SK. Levodopa in vitiligo. Lancet. 1973; 1(7804):675-6. https://doi.org/10.1016/S0140-6736(73)92250-2

Woolfson H, Finn OA. Topical levodopa in vitiligo. Lancet. 1972; 1(7750):598. https://doi.org/10.1016/S0140-6736(72)90398-4

Sabaté M, et al. Vitiligo associated with tolcapone and levodopa in a patient with Parkinson's disease. Ann Pharmacother. 1999; 33:1228–9. https://doi.org/10.1345/aph.19090 PMid:10573327

Goldstein G. Mode of action of levamisole. J Rheumatol Suppl. 1978; 4:143-8. PMid:310464

Pasricha JS, Khera V. Effect of prolonged treatment with levamisole on vitiligo with limited and slow-spreading disease. Int J Dermatol. 1994; 33(8):584-7. https://doi.org/10.1111/j.1365-4362.1994.tb02903.x

Khondker L, Khan SI. Efficacy of levamisole for the treatment of slow spreading vitiligo. Mymensingh Med J. 2013; 22(4):761-6. PMid:24292309

Gerigk M, Bujnicki R, Ganpo-Nkwenkwa E et Al. Process control for enhanced L-phenylalanine production using different recombinant Escherichia coli strains. Biotechnol Bioeng. 2002; 80(7):746-54. https://doi.org/10.1002/bit.10428 PMid:12402320

Schallreuter KU, Zschiesche M, Moore J, et Al. In vivo evidence for compromised phenylalanine metabolism in vitiligo. Biochem Biophys Res Commun. 1998; 243(2):395-9. https://doi.org/10.1006/bbrc.1997.8107 PMid:9480820

Greiner D, Ochsendorf FR, Milbradt R. [Vitiligo therapy with phenylalanine/UV A. Catamnestic studies after five years]. Hautarzt. 1994; 45(7):460-3. https://doi.org/10.1007/s001050050104 PMid:7928339

de Leeuw J, van der Beek N, Maierhofer G, et Al. A case study to evaluate the treatment of vitiligo with khellin encapsulated in L-phenylalanin stabilized phosphatidylcholine liposomes in combination with ultraviolet light therapy. Eur J Dermatol. 2003; 13(5):474-7. PMid:14693493

Antoniou C, Schulpis H, Michas T, et Al. Vitiligo therapy with oral and topical phenylalanine with UVA exposure. Int J Dermatol. 1989; 28(8):545-7. https://doi.org/10.1111/j.1365-4362.1989.tb04613.x PMid:2583897

Camacho F, Mazuecos J. Oral and topical L-phenylalanine, clobetasol propionate, and UVA/sunlight--a new study for the treatment of vitiligo. J Drugs Dermatol. 2002; 1(2):127-31. PMid:12847735

Lotti T, Buggiani G, Troiano M, et Al. Targeted and combination treatments for vitiligo. Comparative evaluation of different current modalities in 458 subjects. Dermatol Ther. 2008; 21(Suppl 1):S20-6. https://doi.org/10.1111/j.1529-8019.2008.00198.x PMid:18727812

Buggiani G, Tsampau D, Hercogovà J, et Al. Clinical efficacy of a novel topical formulation for vitiligo: compared evaluation of different treatment modalities in 149 patients. Dermatol Ther. 2012; 25(5):472-6. https://doi.org/10.1111/j.1529-8019.2012.01484.x PMid:23046028

Nordlund JJ, Halder R. Melagenina. An analysis of published and other available data. Dermatologica. 1990; 181(1):1-4. https://doi.org/10.1159/000247848 PMid:2394297

Zhao D, Li Y, Wang P et Al. Melagenine modulates proliferation and differentiation of melanoblasts. Int J Mol Med. 2008; 22(2):193-7. PMid:18636173

Xu AE, Wei XD. Topical melagenine for repigmentation in twenty-two child patients with vitiligo on the scalp. Chin Med J (Engl). 2004; 117(2):199-201.

Miyares CM, Hollands Barca I, Miyares Diaz E et Al. Effectiveness of human placental extract with calcium (Melagenina Plus) for the treatment of vitiligo. Medicina cutánea ibero-latino-americana. 2009; 37(5):207-212.

Bagherani N, Yaghoobi R, Omidian M. Hypothesis: zinc can be effective in treatment of vitiligo. Indian J Dermatol. 2011; 56(5):480-4. https://doi.org/10.4103/0019-5154.87116 PMid:22121258 PMCid:PMC3221203

Yaghoobi et al. Comparison of therapeutic efficacy of topical corticosteroid and oral zinc sulfate-topical corticosteroid combination in the treatment of vitiligo patients: a clinical trial. BMC Dermatology. 2011; 11 :7. https://doi.org/10.1186/1471-5945-11-7 PMid:21453467 PMCid:PMC3079655

Varothai S Bergfeld WF. Androgenetic alopecia: an evidence-based treatment update. American journal of clinical dermatology. 2014; 15 (3): 217–30. https://doi.org/10.1007/s40257-014-0077-5 PMid:24848508

Srinivas CR, Shenoi SD, Balachandran C. Acceleration of repigmentation in vitiligo by topical minoxidil in patients on photochemotherapy. Int J Dermatol. 1990;29(2):154-5. https://doi.org/10.1111/j.1365-4362.1990.tb04096.x PMid:2323875

Malakar S, Dhar S. Leucoderma Associated with the Use of Topical Minoxidil: A Report of Two Cases. Dermatology. 2000; 201:183-184. https://doi.org/10.1159/000018450 PMid:11053933

Jalel A, Soumaya GS, Hamdaoui MH. Vitiligo treatment with vitamins, minerals and polyphenol supplementation. Indian J Dermatol. 2009; 54(4):357-60. https://doi.org/10.4103/0019-5154.57613 PMid:20101338 PMCid:PMC2807713

Tsiskarishvili NI, Katsitadze A, Tsiskarishvili NV et Al. [Efficacy of combined use of antioxidative and phototherapy in the treatment of vitiligo]. Georgian Med News. 2016;52-57. PMid:28009316

Grimes PE, Nashawati R. The Role of Diet and Supplements in Vitiligo Management. Dermatol Clin. 2017; 35(2):235-243. https://doi.org/10.1016/j.det.2016.11.012 PMid:28317532

Kotwal S, Jun M, Sullivan D, et Al. Omega-3 Fatty Acids and Cardiovascular Outcomes: Systematic Review and Meta-Analysis. Circ Cardiovasc Qual Outcomes. 2012; 5(6):808–18. https://doi.org/10.1161/CIRCOUTCOMES.112.966168 PMid:23110790

Miles EA, Calder PC. Influence of marine n-3 polyunsaturated fatty acids on immune function and a systematic review of their effects on clinical outcomes in rheumatoid arthritis. The British journal of nutrition. 2012; 107(Suppl 2) (S2): S171–84.

Kapoor R, Phiske MM, Jerajani HR. Evaluation of safety and efficacy of topical prostaglandin E2 in treatment of vitiligo. Br J Dermatol. 2009;160(4):861-3. https://doi.org/10.1111/j.1365-2133.2008.08923.x PMid:19014395

Parsad D, Pandhi R, Dogra S et Al. Topical prostaglandin analog (PGE2) in vitiligo--a preliminary study. Int J Dermatol. 2002; 41(12):942-5. https://doi.org/10.1046/j.1365-4362.2002.01612.x PMid:12492997

Lotti T, Berti S, Moretti S. Vitiligo therapy. Expert Opin Pharmacother. 2009; 10(17):2779-85. https://doi.org/10.1517/14656560903357509 PMid:19929701

Grimes PE. Bimatoprost 0.03% Solution for the Treatment of Nonfacial Vitiligo. J Drugs Dermatol. 2016; 15(6):703-10. PMid:27272076

Schallreuter KU, Moore J, Behrens-Williams S, Panske A, Harari M. Rapid initiation of repigmentation in vitiligo with Dead Sea climatotherapy in combination with pseudocatalase (PC- KUS). Int J Dermatol. 2002; 41(8):482-7. https://doi.org/10.1046/j.1365-4362.2002.01463.x PMid:12207762

Schallreuter KU, Salem MA, Holtz S et Al. Basic evidence for epidermal H2O2/ONOO(-)-mediated oxidation/nitration in segmental vitiligo is supported by repigmentation of skin and eyelashes after reduction of epidermal H2O2 with topical NB-UVB-activated pseudocatalase PC-KUS. FASEB J. 2013; 27(8):3113-22. https://doi.org/10.1096/fj.12-226779 PMid:23629861

Bakis-Petsoglou S, Le Guay JL, Wittal R. A randomized, double-blinded, placebo-controlled trial of pseudocatalase cream and narrowband ultraviolet B in the treatment of vitiligo. Br J Dermatol. 2009; 161(4):910-7. https://doi.org/10.1111/j.1365-2133.2009.09252.x PMid:19523170

Patel DC, Evans AV, Hawk JL. Topical pseudocatalase mousse and narrowband UVB phototherapy is not effective for vitiligo: an open, single-centre study. Clin Exp Dermatol. 2002; 27(8):641-4. https://doi.org/10.1046/j.1365-2230.2002.01142.x PMid:12472535

Becatti M, Fiorillo C, Barygina V et Al. SIRT1 regulates MAPK pathways in vitiligo skin: insight into the molecular pathways of cell survival. J Cell Mol Med. 2014. https://doi.org/10.1111/jcmm.12206 PMid:24410795 PMCid:PMC3955157

Doppalapudi S, Mahira S, Khan W. Development and in vitro assessment of psoralen and resveratrol co-loaded ultradeformable liposomes for the treatment of vitiligo. J Photochem Photobiol B. 2017; 174:44-57. https://doi.org/10.1016/j.jphotobiol.2017.07.007 PMid:28753523

Wei H. Isoflvone genistein: photoprotection and clinical implications in dermatology. J Nutr. 2003; 133:3811S-3819S. PMid:14608119

Leong LY. How I use coal tar in dermatology. Singapore Med J. 1990; 31(6):614-5. PMid:2281360

Jalel A, Soumaya GS, Hamdaoui MH. Vitiligo treatment with vitamins, minerals and polyphenol supplementation. Indian J Dermatol. 2009; 54(4): 357–360. https://doi.org/10.4103/0019-5154.57613 PMid:20101338 PMCid:PMC2807713

Eberlein-Konig B. Protective effect against sunburn of combined systemic ascorbic acid (vitamin C) and d-alpha tocopherol (vitamin E). J Am Acad Dermatol 1998; 38:45-48. https://doi.org/10.1016/S0190-9622(98)70537-7

How to Cite
Gianfaldoni S, Tchernev G, Lotti J, Wollina U, Satolli F, Rovesti M, França K, Lotti T. Unconventional Treatments for Vitiligo: Are They (Un) Satisfactory?. Open Access Maced J Med Sci [Internet]. 2018Jan.21 [cited 2020Oct.22];6(1):170-5. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2018.038

Most read articles by the same author(s)

1 2 3 4 5 > >>