Even then you may need to switch things up over time. “Sometimes, treatments can lose their efficacy, which can send the doctor and patient back to the drawing board,” Dr. Rodney says. Results from many vitiligo treatments are often temporary. Maintenance therapy—in the form of topical medication—and self-care (think protecting skin from the sun and doing your best to avoid cuts and burns), is usually required to maintain results.
Natasha Pierre McCarthy, founder and executive director of the National Vitiligo Bond Inc. Foundation, tells SELF that she tried several treatment options, including laser therapy and phototherapy, both of which harness UVB light waves to attempt to stimulate re-pigmentation. “I learned quickly that these treatments don’t agree with me,” she says, noting that both caused her skin to blister. (Blistering is a potential side effect of UVB light therapy. Because of this, Dr. Rodney says it’s important for doctors to start these treatments at very low levels and work up from there.)
Brittany LaRue, 38, tells SELF that she’s tried tacrolimus ointment, corticosteroid cream, and UVB phototherapy since being diagnosed with vitiligo about 20 years ago. The first two didn’t restore her skin pigment; the UVB therapy was logistically too difficult to keep up with.
LaRue says that the phototherapy treatments helped to restore pigment in her skin but it was very expensive, and she had to drive over an hour just to get a 30-second treatment. Depending on where you live, it might be hard to find a doctor or medical center that offers UVB therapy—if you’re considering it, check in with your doctor to find out details and if you qualify for at-home phototherapy devices.
LaRue says she ultimately got frustrated with the process. “I just gave up looking for a treatment and accepted vitiligo is a part of me,” she says.
Dr. Ren says it’s important for health care providers and people with vitiligo to be on the same page about treatment, because it can be a bit of a winding journey. “Realistic expectations regarding treatment should be set,” she says. Among other things, Dr. Ren says that treatment could cause re-pigmentation and stability of skin color—but won’t necessarily bring 100% of the pigment back. “Treatment response varies among individuals,” she says.
You probably won’t see results instantly.
It can also take time to see results even when a certain treatment is effective for you. “A minimum of four to six weeks is needed before we can assess if something is working,” Dr. Wassef says. “Because of this, it can be a long process.”
Dr. Rodney additionally cautions that, when undergoing vitiligo treatment, it can take months to get any results. In general, though, she says that dermatologists typically determine if a person’s skin is responding to a treatment by monitoring the re-pigmentation of the affected areas of skin. “Some patients may have rapidly progressing vitiligo and treatment can slow the progress of the condition, which is a success in itself,” she notes.
Ultimately, patience is part of the process.
Every doctor that SELF spoke to used the word “patience” while talking about treatment options. As Dr. Ren puts it: “Effective treatments are available, but they require patience and diligence and are not uniformly effective for all individuals or on all body parts.”
Dr. Wassef says people who want to treat their vitiligo shouldn’t give up hope. “We have more options now than ever,” she says. Some new medications, like the recently FDA-approved ruxolitinib cream, have the potential to “work on patients who have had vitiligo for a long time that has been resistant to treatment,” Dr. Wassef says. If you haven’t seen a dermatologist in a few years, and feel frustrated by your skin, she recommends getting reevaluated. If re-pigmenting your skin is important to you, it could be worth giving it another try.