Skip to main content

Pigmentation and Hypopigmentation: Vitiligo and Other Disorders

  • Chapter
  • First Online:
Laser and IPL Technology in Dermatology and Aesthetic Medicine

Abstract

Lasers and light-emitting devices have now taken a key role in the treatment of vitiligo and hypomelanosis. Q-switched depigmenting lasers can be used to treat the residual pigmented spots in the generalized forms of vitiligo. Ablative lasers bring a rapid and reproductive tool to prepare the grafting bed for the segmental and localized forms of vitiligo or for inherited hypochromic disorders such as piebaldism. The 308-nm excimer lasers and lamps are clearly the devices that brought the more progresses for taking in charge hypochromic disorders. With higher rates of repigmentation as compared to conventional phototherapy and with a specific targeting of the lesions sparing the surrounding skin, their main limitation remains the surface to treat. Finally, new wavelengths will certainly be used in the near future to enhance repigmentation. The 632.8-nm helium–neon laser has already brought encouraging results that are worthy of further study.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Anbar TS, Westerhof W, Abdel-Rahman AT, Ewis AA, El-Khayyat MA. Effect of one session of ER:YAG laser ablation plus topical 5Fluorouracil on the outcome of short-term NB-UVB phototherapy in the treatment of non-segmental vitiligo: a left-right comparative study. Photodermatol Photoimmunol Photomed. 2008;24:322–9.

    Article  PubMed  Google Scholar 

  2. Baltas E, Csoma Z, Ignacz F, Dobozy A, Kemeny L. Treatment of vitiligo with the 308-nm xenon chloride excimer laser. Arch Dermatol. 2002;138:1619–20.

    Article  PubMed  Google Scholar 

  3. Bonis B, Kemeny L, Dobozy A, Bor Z, Szabo G, Ignacz F. 308 nm UVB excimer laser for psoriasis. Lancet. 1997;350:1522.

    Article  CAS  PubMed  Google Scholar 

  4. Casacci M, Thomas P, Pacifico A, Bonnevalle A, Paro Vidolin A, Leone G. Comparison between 308-nm monochromatic excimer light and narrowband UVB phototherapy (311–313 nm) in the treatment of vitiligo–a multicentre controlled study. J Eur Acad Dermatol Venereol. 2007;21:956–63.

    Article  CAS  PubMed  Google Scholar 

  5. Chilbert MA, Peak MJ, Peak JG, Pellin MJ, Gruen DM, Williams GA. Effects of intensity and fluence upon DNA single-strand breaks induced by excimer laser radiation. Photochem Photobiol. 1988;47:523–5.

    Article  CAS  PubMed  Google Scholar 

  6. Choi KH, Park JH, Ro YS. Treatment of vitiligo with 308-nm xenon-chloride excimer laser: therapeutic efficacy of different initial doses according to treatment areas. J Dermatol. 2004;31:284–92.

    PubMed  Google Scholar 

  7. de With A, Greulich KO. Wavelength dependence of laser-induced DNA damage in lymphocytes observed by single-cell gel electrophoresis. J Photochem Photobiol B. 1995;30:71–6.

    Article  PubMed  Google Scholar 

  8. Esposito M, Soda R, Costanzo A, Chimenti S. Treatment of vitiligo with the 308 nm excimer laser. Clin Exp Dermatol. 2004;29:133–7.

    Article  CAS  PubMed  Google Scholar 

  9. Falabella R. Surgical approaches for stable vitiligo. Dermatol Surg. 2005;31:1277–84.

    Article  CAS  PubMed  Google Scholar 

  10. Falabella R, Barona MI. Update on skin repigmentation therapies in vitiligo. Pigment Cell Melanoma Res. 2009;22:42–65.

    Google Scholar 

  11. Friedman PM, Geronemus RG. Use of the 308-nm excimer laser for postresurfacing leukoderma. Arch Dermatol. 2001;137:824–5.

    CAS  PubMed  Google Scholar 

  12. Gawkrodger DJ, Ormerod AD, Shaw L, Mauri-Sole I, Whitton ME, Watts MJ, et al. Guideline for the diagnosis and management of vitiligo. Br J Dermatol. 2008;159:1051–76.

    Article  CAS  PubMed  Google Scholar 

  13. Goldberg DJ, Sarradet D, Hussain M. 308-nm excimer laser treatment of mature hypopigmented striae. Dermatol Surg. 2003;29:596–8; discussion 598–9.

    Google Scholar 

  14. Goldinger SM, Dummer R, Schmid P, Burg G, Seifert B, Lauchli S. Combination of 308-nm xenon chloride excimer laser and topical calcipotriol in vitiligo. J Eur Acad Dermatol Venereol. 2007;21:504–8.

    CAS  PubMed  Google Scholar 

  15. Grimes PE, Soriano T, Dytoc MT. Topical tacrolimus for repigmentation of vitiligo. J Am Acad Dermatol. 2002;47:789–91.

    Article  PubMed  Google Scholar 

  16. Guerra L, Primavera G, Raskovic D, Pellegrini G, Golisano O, Bondanza S, et al. Erbium:YAG laser and cultured epidermis in the surgical therapy of stable vitiligo. Arch Dermatol. 2003;139:1303–10.

    Article  PubMed  Google Scholar 

  17. Guerra L, Primavera G, Raskovic D, Pellegrini G, Golisano O, Bondanza S, et al. Permanent repigmentation of piebaldism by erbium:YAG laser and autologous cultured epidermis. Br J Dermatol. 2004;150:715–21.

    Article  CAS  PubMed  Google Scholar 

  18. Gundogan C, Greve B, Hausser I, Raulin C. [Repigmentation of persistent laser-induced hypopigmentation with an excimer laser following tattoo removal]. Hautarzt 2004;55:549–52.

    Google Scholar 

  19. Hofer A, Hassan AS, Legat FJ, Kerl H, Wolf P. Optimal weekly frequency of 308-nm excimer laser treatment in vitiligo patients. Br J Dermatol. 2005;152:981–5.

    Article  CAS  PubMed  Google Scholar 

  20. Hofer A, Hassan AS, Legat FJ, Kerl H, Wolf P. The efficacy of excimer laser (308 nm) for vitiligo at different body sites. J Eur Acad Dermatol Venereol. 2006;20:558–64.

    Article  CAS  PubMed  Google Scholar 

  21. Hong SB, Park HH, Lee MH. Short-term effects of 308–nm xenon-chloride excimer laser and narrow-band ultraviolet b in the treatment of vitiligo: a Comparative Study. J Korean Med Sci. 2005;20:273–8.

    Article  PubMed  Google Scholar 

  22. Hu WP, Wang JJ, Yu CL, Lan CC, Chen GS, Yu HS. Helium-neon laser irradiation stimulates cell proliferation through photostimulatory effects in mitochondria. J Invest Dermatol. 2007;127:2048–57.

    Article  CAS  PubMed  Google Scholar 

  23. Kahn AM, Ostad A, Moy RL. Grafting following short-pulse carbon dioxide laser de-epithelialization. Dermatol Surg. 1996;22:965–7; discussion 967–8

    Google Scholar 

  24. Kawalek AZ, Spencer JM, Phelps RG. Combined excimer laser and topical tacrolimus for the treatment of vitiligo: a pilot study. Dermatol Surg. 2004;30:130–5.

    Article  PubMed  Google Scholar 

  25. Kim do Y, Lee K, Park YK. Use of the 308-nm excimer laser for nevus depigmentosus: a promising treatment for either nevus depigmentosus or vitiligo. J Dermatol. 2007;34:217–8.

    Article  PubMed  Google Scholar 

  26. Kim YJ, Chung BS, Choi KC. Depigmentation therapy with Q-switched ruby laser after tanning in vitiligo universalis. Dermatol Surg. 2001;27:969–70.

    Article  CAS  PubMed  Google Scholar 

  27. Lan C, Wu C, Chen G, Yu H. Helium-neon laser and topical tacrolimus combination therapy: novel treatment option for vitiligo without additional photocarcinogenic risks. J Eur Acad Dermatol Venereol. 2008;23:344–5.

    Google Scholar 

  28. Lan CC, Wu CS, Chiou MH, Hsieh PC, Yu HS. Low-energy helium-neon laser induces locomotion of the immature melanoblasts and promotes melanogenesis of the more differentiated melanoblasts: recapitulation of vitiligo repigmentation in vitro. J Invest Dermatol. 2006;126:2119–26.

    Article  CAS  PubMed  Google Scholar 

  29. Le Duff F, Fontas E, Giacchero D, Sillard L, Lacour JP, Ortonne JP, Passeron T. 308-nm excimer lamp vs. 308-nm excimer laser for treating vitiligo: a randomized study. Br J Dermatol. 2010;163(1):188-92.

    Google Scholar 

  30. Leone G, Iacovelli P, Paro Vidolin A, Picardo M. Monochromatic excimer light 308 nm in the treatment of vitiligo: a pilot study. J Eur Acad Dermatol Venereol. 2003;17:531–7.

    Article  CAS  PubMed  Google Scholar 

  31. Lepe V, Moncada B, Castanedo-Cazares JP, Torres-Alvarez MB, Ortiz CA, Torres-Rubalcava AB. A double-blind randomized trial of 0.1% tacrolimus vs 0.05% clobetasol for the treatment of childhood vitiligo. Arch Dermatol. 2003;139:581–5.

    Article  CAS  PubMed  Google Scholar 

  32. Mulekar SV, Issa AA, Eisa AA. Treatment of halo nevus with a 308-nm excimer laser: a pilot study. J Cosmet Laser Ther. 2007;9:245–8.

    Article  PubMed  Google Scholar 

  33. Njoo MD, Vodegel RM, Westerhof W. Depigmentation therapy in vitiligo universalis with topical 4–methoxyphenol and the Q-switched ruby laser. J Am Acad Dermatol. 2000;42:760–9.

    Article  CAS  PubMed  Google Scholar 

  34. Nordlund JJ, Boissy RE, Hearing VJ, King RA, Ortonne JP. The pigmentary system: physiology and pathophysiology. Edinburgh: Blackwell Science; 2006.

    Google Scholar 

  35. Oh CK, Cha JH, Lim JY, Jo JH, Kim SJ, Jang HS, et al. Treatment of vitiligo with suction epidermal grafting by the use of an ultrapulse CO2 laser with a computerized pattern generator. Dermatol Surg. 2001;27:565–8.

    Article  CAS  PubMed  Google Scholar 

  36. Ortonne JP. Vitiligo and other disorders of hypopigmentation. In: Bolognia J, Jorizzo JL, Rapini RP, editors. Dermatolgy. New York: Mosby; 2007. p. 913–38.

    Google Scholar 

  37. Ortonne JP, Passeron T. Melanin pigmentary disorders: treatment update. Dermatol Clin. 2005;23:209–26.

    Article  PubMed  Google Scholar 

  38. Ostovari N, Passeron T, Lacour JP, Ortonne JP. Lack of efficacy of tacrolimus in the treatment of vitiligo in the absence of UV-B exposure. Arch Dermatol. 2006;142:252–3.

    Article  PubMed  Google Scholar 

  39. Ostovari N, Passeron T, Zakaria W, Fontas E, Larouy JC, Blot JF, et al. Treatment of vitiligo by 308-nm excimer laser: an evaluation of variables affecting treatment response. Lasers Surg Med. 2004;35:152–6.

    Article  CAS  PubMed  Google Scholar 

  40. Pai GS, Vinod V, Joshi A. Efficacy of erbium YAG laser-assisted autologous epidermal grafting in vitiligo. J Eur Acad Dermatol Venereol. 2002;16:604–6.

    Article  CAS  PubMed  Google Scholar 

  41. Passeron T, Mantoux F, Ortonne JP. Genetic disorders of pigmentation. Clin Dermatol. 2005;23:56–67.

    Article  PubMed  Google Scholar 

  42. Passeron T, Ostovari N, Zakaria W, Fontas E, Larrouy JC, Lacour JP, et al. Topical tacrolimus and the 308-nm excimer laser: a synergistic combination for the treatment of vitiligo. Arch Dermatol. 2004;140:1065–9.

    Article  CAS  PubMed  Google Scholar 

  43. Rao J, Fitzpatrick RE. Use of the Q-switched 755-nm alexandrite laser to treat recalcitrant pigment after depigmentation therapy for vitiligo. Dermatol Surg. 2004;30:1043–5.

    Article  PubMed  Google Scholar 

  44. Sassi F, Cazzaniga S, Tessari G, Chatenoud L, Reseghetti A, Marchesi L, et al. Randomized controlled trial comparing the effectiveness of 308-nm excimer laser alone or in combination with topical hydrocortisone 17-butyrate cream in the treatment of vitiligo of the face and neck. Br J Dermatol. 2008;159:1186–91.

    CAS  PubMed  Google Scholar 

  45. Smith DA, Tofte SJ, Hanifin JM. Repigmentation of vitiligo with topical tacrolimus. Dermatology (Basel, Switzerland) 2002;205:301–3.

    Google Scholar 

  46. Spencer JM, Nossa R, Ajmeri J. Treatment of vitiligo with the 308–nm excimer laser: a pilot study. J Am Acad Dermatol. 2002;46:727–31.

    Article  PubMed  Google Scholar 

  47. Taneja A, Trehan M, Taylor CR. 308-nm excimer laser for the treatment of localized vitiligo. Int J Dermatol. 2003;42:658–62.

    Article  PubMed  Google Scholar 

  48. Tanghetti EA. Tacrolimus ointment 0.1% produces repigmentation in patients with vitiligo: results of a prospective patient series. Cutis. 2003;71:158–62.

    PubMed  Google Scholar 

  49. Travis LB, Weinberg JM, Silverberg NB. Successful treatment of vitiligo with 0.1% tacrolimus ointment. Arch Dermatol. 2003;139:571–4; discussion 573.

    Google Scholar 

  50. van Geel N, Ongenae K, Naeyaert JM. Surgical techniques for vitiligo: a review. Dermatology (Basel, Switzerland) 2002;202:162–6.

    Google Scholar 

  51. Westerhof W, Nieuweboer-Krobotova L, Mulder PG, Glazenburg EJ. Left-right comparison study of the combination of fluticasone propionate and UV-A vs. either fluticasone propionate or UV-A alone for the long-term treatment of vitiligo. Arch Dermatol. 1999;135:1061–6.

    Article  CAS  PubMed  Google Scholar 

  52. Whitton ME, Ashcroft DM, Gonzalez U. Therapeutic interventions for vitiligo. J Am Acad Dermatol. 2008;59:713–7.

    Article  PubMed  Google Scholar 

  53. Yu HS, Wu CS, Yu CL, Kao YH, Chiou MH. Helium-neon laser irradiation stimulates migration and proliferation in melanocytes and induces repigmentation in segmental-type vitiligo. J Invest Dermatol. 2003;120:56–64.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Thierry Passeron .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Passeron, T., Ortonne, JP. (2011). Pigmentation and Hypopigmentation: Vitiligo and Other Disorders. In: Raulin, C., Karsai, S. (eds) Laser and IPL Technology in Dermatology and Aesthetic Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03438-1_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-03438-1_11

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-03437-4

  • Online ISBN: 978-3-642-03438-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics