Vitiligo, Reimagined: Practical Tools and Promising Treatments

At the Masterclasses in Dermatology APP Institute, David Rosmarin, MD, delivered an illuminating session titled “Vitiligo Treatment Update,” giving attendees a timely, evidence-based look at both foundational care and emerging therapies for an often-misunderstood condition that affects millions.

“Vitiligo is a chronic autoimmune disease, and it’s time we stop treating it like an afterthought,” Dr Rosmarin said.

With prevalence estimates of up to 2% of the population and a disproportionate psychosocial burden on teens and patients with facial involvement, Dr Rosmarin urged providers to recognize vitiligo as a legitimate medical condition that deserves targeted care, not just cosmetic concern.

He reviewed diagnostic best practices, including the Wood’s lamp, which can be especially helpful in fair-skinned patients to define disease extent and activity. Recognizing active disease through signs like the Koebner phenomenon, trichrome lesions, or confetti depigmentation is crucial, as timely treatment can prevent progression.

Dr Rosmarin outlined a practical, stepwise approach to vitiligo care:

• Topicals: High-potency corticosteroids and tacrolimus remain first line for localized disease.
• Phototherapy: Narrowband UVB, still the gold standard, can deliver durable results with consistent use.
• Newer options: Ruxolitinib cream, now US Food and Drug Administration approved, showed robust results in clinical trials, with nearly half of patients achieving ≥75% facial repigmentation by week 52.

He also touched on oral minipulse steroids for rapidly progressing cases and maintenance strategies like twice-weekly tacrolimus to prevent relapse.

Dr Rosmarin highlighted a wave of emerging therapies, including oral Janus kinase inhibitors like ruxolitinib, ritlecitinib, and upadacitinib, all showing encouraging results in early trials. He also previewed investigational strategies targeting IL-15 and regulatory T cells, opening the door to possible remission, not just control.

“The goal isn’t just stabilization anymore,” he said. “We’re talking about real, sustained repigmentation.”

Vitiligo management is entering a new era—one where early diagnosis, smart treatment, and patient-centered care can deliver meaningful change.

And for clinicians ready to move beyond makeup and myths, this session served as a reminder: treating vitiligo is not just possible; it is essential.

Reference

Rosmarin D. Vitiligo treatment update. Presented at: Masterclasses in Dermatology APP Institute; October 11–12, 2025; Dallas, TX.