Pigment Induction with a Fractional Laser for Vitiligo: A Preliminary Study

Cheong, Seung Hyun; Jung, Yun; Whang, Kyu Kwang

Abstract

BACKGROUND: Numerous modalities of treatment for vitiligo have been introduced and have been proposed; however, treatment for vitiligo remains challenging with no adequate solution.
OBJECTIVE
This study was designed to examine the capability of the use of a fractional laser to induce pigmentation for vitiligo and to investigate the therapeutic and clinical parameters that affect therapeutic outcome.
METHODS
A total of 30 lesions in 12 patients with vitiligo were treated clinically with three fractional laser systems with a four-week interval. Simultaneously, all patients were treated with narrow-band UVB (NBUVB) light twice a week. The pigmentation rates were graded based on the use of a five-point scale by a dermatologist. We also investigated the patient satisfaction level and compared the pigmentation rates of the lesions treated with a fractional laser plus NBUVB with control areas treated only with NBUVB. In addition, we analyzed the mean grade of pigment induction for various therapeutic and clinical parameters.
RESULTS
A total of 30 lesions were treated with a fractional laser. The pigmentation grade and satisfaction score were higher in the areas treated with a fractional laser, especially with an Nd:YAG fractional laser, as compared to the control areas. The degree of pigmentation was better achieved for small-sized lesions (<2 cm2). Other clinical parameters that affected the therapeutic outcome were the duration of vitiligo and the existence of poliosis. However, the anatomical location of lesions and the type of vitiligo did not affect the therapeutic outcome. No significant side effects were observed.
CONCLUSION
A fractional laser system offers an increase of overall pigmentation with a minimal risk of discomfort and side effects, especially for a small-sized patch of vitiligo without poliosis and for patients with vitiligo of a short duration (less than one year).