What is the first treatment tried for vitiligo?

Vitiligo occurs when areas of skin lose pigment-producing cells, creating lighter patches. A topical corticosteroid may be used on selected body areas to reduce inflammation, while a topical calcineurin inhibitor can be useful for delicate sites such as the face or skin folds. The choice depends on location, age, skin sensitivity, and whether patches are changing.

Have the patches assessed before starting treatment because several skin conditions can look lighter than surrounding skin. Follow the prescribed application schedule and protect depigmented areas from sun exposure. If topical treatment is insufficient or more extensive areas are involved, a dermatologist may discuss narrowband UVB phototherapy, excimer laser therapy, or a JAK inhibitor treatment when suitable. Surgical melanocyte transplant is reserved for selected stable cases.

Arrange an assessment for new, spreading, or rapidly changing pale patches, especially when the diagnosis is uncertain. Seek prompt care for painful, blistered, crusted, or infected-looking skin. Contact your prescriber if treatment causes marked irritation, thinning, worsening redness, or eye-area discomfort, so the plan can be adjusted safely.

Which topical medicine suits this body area? How should I apply it near the eyes or on thin skin? When should colour change be reviewed? Would light treatment or another option be more appropriate if these patches continue to spread?