Yeongdeungpo Station Dermatology Clinic: Vitiligo Laser Treatment—Does Every Case of Vitiligo Require the Same Treatment?

It is easy to think, “If I have been diagnosed with vitiligo after white patches appeared on my skin, should I receive laser treatment?”

However, not every patient with vitiligo needs the same treatment.

In some cases, white patches appear in only one or two areas, while in others they spread across multiple areas. Some remain unchanged for a period of time, whereas new patches may continue to appear.

Vitiligo treatment is not only about restoring skin color. It is also important to determine whether the current symptoms are progressing and to control further spread.

Therefore, if you are looking into laser treatment for vitiligo, you should first determine where the vitiligo is located, how extensive it is, and what changes it is showing, rather than deciding on laser treatment first.

--Order of the Yeongdeungpo Station Dermatology Clinic column--

1. Is it necessary to check whether vitiligo is progressing before treatment?

2. How is laser treatment for vitiligo performed?

3. Why can the results differ even when the same laser treatment is used?

Yeongdeungpo Station Dermatology Clinic: Vitiligo Laser Treatment—Does Every Case of Vitiligo Require the Same Treatment?

Before Vitiligo Treatment

Is It Necessary to Check Whether It Is Progressing?

Yeongdeungpo Station Dermatology Clinic: Vitiligo

With vitiligo, it is important to consider not only the white patches currently visible, but also whether new lesions have recently appeared or the existing affected area has expanded.

Some cases of vitiligo remain in the same location and maintain the same size for several months, while in other cases new patches appear over a short period or the existing borders gradually expand.

When vitiligo is progressing in this way, it is necessary to consider whether treatment to stabilize the progression of the condition is needed in addition to treatment that simply restores skin color.

If the symptoms of vitiligo are progressing rapidly, treatments other than topical treatment or phototherapy may also be considered.

Accordingly, during a consultation, the following are assessed:

• Whether new white patches have recently appeared

• Whether the existing patches are increasing in size

• Whether the patches are limited to one area or appear in multiple areas

• How the borders of the patches are changing

• What changes occurred after previous treatment

Even when people receive the same diagnosis of vitiligo, their treatment priorities cannot be the same if their current stages of progression differ.

How Is Laser Treatment for Vitiligo

Performed?

Yeongdeungpo Station Dermatology Clinic: Vitiligo

Because a laser can selectively deliver light to the areas where it is needed, it can be used for relatively localized vitiligo treatment.

Targeted phototherapy, such as excimer laser treatment, is characterized by its ability to focus treatment on the areas where white patches have appeared.

On the other hand, if vitiligo is widely distributed across multiple areas, phototherapy that can treat a broader area may be considered instead of treating each individual lesion.

The treatment considerations can be broadly categorized according to the treatment area as follows.

Vitiligo status	What to assess during treatment
Limited to certain areas	Whether the lesions can be treated selectively
Widespread across multiple areas	Whether broad-area phototherapy is needed
The reason new patches continue to appear	Whether treatment to control progression is needed
Little change over a long period	The treatment approach for restoring pigmentation
Insufficient treatment response	Whether the treatment method should be adjusted or combined with another approach

In practice, targeted phototherapy has been presented as an option that can be used for localized vitiligo.

Therefore, rather than simply deciding that “vitiligo means excimer laser,” it is necessary to first distinguish the number and extent of the lesions and whether the condition is progressing.

Why Can Results Differ Even When

The Same Laser Treatment Is Used?

Yeongdeungpo Station Dermatology Clinic: Vitiligo

It is difficult to judge the results of vitiligo treatment after only one or two sessions.

Phototherapy or laser treatment needs to be performed repeatedly over a certain period, while monitoring whether pigmentation reappears inside or around the white patches and how the extent of the lesions changes.

When necessary, topical medication or other treatments may be used together rather than proceeding with laser treatment alone.

Ultimately, what matters is not only which laser is used, but also continuously checking how the skin is responding during treatment.

Vitiligo has the common feature of causing white patches on the skin, but the condition is not the same for every patient.

Lesions may be limited to one or two areas or may appear extensively across multiple areas. There may also be differences in the stage of progression: some cases remain unchanged for a long time, while new patches continue to appear.

Therefore, if you are looking into laser treatment for vitiligo, it is necessary to first assess the current extent and location of the lesions and whether they have recently progressed, rather than deciding on a specific treatment method from the outset.

For localized lesions, targeted treatment such as excimer laser treatment may be considered. If the affected area is extensive or the condition is progressing, other phototherapy or medication may also be considered in combination.

What is important in vitiligo treatment is not repeatedly applying the same treatment to every white patch, but adjusting the necessary treatment while checking the current skin condition and treatment response.

Vitiligo Q&A

Q. Does everyone with vitiligo need excimer laser treatment?

A. No. Excimer laser treatment can be used for localized vitiligo, but depending on the extent, location, and progression of the lesions, other phototherapy or medication may be needed.

Q. Is laser treatment possible even when vitiligo has spread extensively?

A. Whether treatment is possible must be determined on an individual basis. However, when the lesions are extensive, phototherapy that can treat a broad area may be considered instead of a laser that selectively irradiates small areas.

Q. How many laser treatment sessions are needed for vitiligo to improve?

A. It is difficult to set the same number of treatment sessions for everyone. The number varies depending on the areas affected, the extent of the vitiligo, and the treatment response. The process of pigmentation returning must be monitored over multiple treatment sessions.

Yeongdeungpo Station Dermatology Clinic: Vitiligo Laser Treatment—Does Every Case of Vitiligo Require the Same Treatment?

| This post was written for informational purposes in compliance with Article 56, Paragraphs 1–15 of the Medical Service Act. All treatments carry a risk of side effects and complications that may vary from person to person. Before treatment, please consult thoroughly with a medical professional with extensive experience and make your decision afterward. |