How effective are topical corticosteroids for vitiligo?

Vitiligo happens when pigment-producing cells are lost from areas of skin. A topical corticosteroid can reduce local immune inflammation, which may allow pigment to return around hair follicles or at the edge of a patch. Treatment tends to be more useful for active or limited disease than for every long-standing patch, and hands, feet, and areas without hair can be harder to repigment. Colour may return unevenly, and treatment does not change the tendency for new patches to appear. Thin skin, acne-like spots, visible small blood vessels, and colour changes are possible with unsuitable or prolonged use.

Use only the prescribed strength and schedule, applying a thin layer to the intended patches. Keep follow-up appointments so the clinician can check pigment return and the condition of the skin. Do not extend treatment to the eyelids, face, skin folds, or large areas unless instructed. Daily broad-spectrum sun protection helps reduce contrast and protects depigmented skin from burning; cover the areas during strong sunlight.

Contact your clinician if treated skin becomes thin, painful, bruised, infected, or develops persistent spots or marked colour change. Arrange review if patches spread quickly, involve the eyes or mouth, or affect your wellbeing, because the treatment plan may need adjustment.

Ask whether your vitiligo appears active, which body sites are suitable, how progress will be assessed, and whether a non-steroid option or light-based treatment should be considered.