Topical steroids by suppressing inflammation, have been the mainstay of vitiligo treatment for decades. Usually moderate to high potency steroids are required for 3-4 months to elicit a positive response. Despite the concerns that topical steroids may induce skin thinning, broken capillaries and stretch marks, the correct topical steroid applied the correct way seldom causes any side effects.
Topical Calcineurin Inhibitors
Topical calcineurin inhibitors as the name implies, block the activation of calcineurin, which is critical in the activation of lymphocytes, which are stimulated in autoimmune diseases. There are two types of topical treatments pimecrolimus and tacrolimus. These are ideal for areas such as the face, eyelids, neck, armpits and groin where there are concerns that topical steroids may cause side effects such as skin thinning and stretch marks. Topical calcineurin inhibitors take several months to elicit a positive effect