Depigmentation Treatment for Vitiligo: Bleaching Cream, Laser, and Cryotherapy

Repigmentation occurs often in a perifollicular pattern. This reflects the melanocyte reservoir which is believed to be present around the hair follicle containing immature melanocytes and melanocyte stem cells. It is known that the presence of remaining pigmented areas can cause pronounced cosmetic disfigurements, especially when located on visible areas such as the face and the hands. Remaining pigmented patches can be removed using topical bleaching creams, laser therapy, or cryotherapy. This chapter describes and compares different techniques for depigmentation. Before starting any depigmentation treatment, it might be helpful to evaluate the clinical signs of Koebner's phenomenon (KP), which can be more pronounced in active than in stable vitiligo. It can be used as a predictive value for the successful-ness of laser- and cryotherapy-induced depigmentations. It is concluded that, for cost-effective, rapid and easily available depigmentation, cryotherapy should be considered first but it should be performed by an experienced physician/dermatologist.