Vitiligo therapy reference (2026)

Vitiligo therapy in 2026 organises around several tiers.

Topical: ruxolitinib cream is the first specifically-approved repigmentation therapy for non-segmental vitiligo. Topical corticosteroids and topical calcineurin inhibitors (tacrolimus, pimecrolimus) remain widely used, particularly for facial involvement.

Phototherapy: narrowband UVB phototherapy is highly effective for repigmentation, particularly for facial and trunk involvement; targeted excimer laser is used for limited-area disease. Combination of phototherapy with topical therapy (including topical JAK inhibition) is emerging as a higher-efficacy approach.

Systemic: oral corticosteroids in pulse regimens have been used for active progressive disease; systemic JAK inhibitor programs (povorcitinib, others) are in late-stage trials with the proposition of being the first specifically-approved systemic therapy for vitiligo.

Surgical: melanocyte transplantation for stable, refractory disease in selected patients.

The diagnostic-pathway and care-pathway question matters. Vitiligo identification is straightforward, but access to specialty dermatology care, phototherapy delivery, and topical-and-systemic-therapy management defines the addressable population for modern repigmentation therapy.