1.Steroids:
Topical Steroids are mainstay of vitiligo topical treatment during the initial phase. They mainly help in stoping the disease activity. Mainly applied in the morning. Different cream/ointment/lotion used according to type of vitiligo, site of the patches, previous use of steroids and age of patient. Steroids will be gradually removed once desirable results achieved. Should be applied only on the patches in small quantity with out massaging or spreading to surrounding normal area.
2. Vit D Analogues
Topical Vit D analogues are used either alone or in combination with topical steroids once in the morning. These can be continued bit longer than topical steroids. Small quantity to be applied over the patches. Minimal spill over to normal surrounding areas acceptable.
3. Calcineurin Inhibitors
Topical calcinurin inhibitors like Tacrolimus used in the night time as ointment or lotion. This medicine is used for longer time. It mainly achieves stability of the patch with bit of repigmentation inducing property. It can be used for longer duration with out significant side efects. Advisable to apply over repigmented areas to prevent recurrence. Minimal spill over surrounding area is acceptable. Preferrably kept in refregerator to prevent slight irritation especially in initial days.
4. Growth Factors
A concoction of different growth factors used as adjunct with other modalities either daily usage or at regular intervals either at home or in clinic wih interventions to achieve better drug delivery.
5. Anti-oxidants
A concoction of different vitamins and minerals which exerts better antioxidant effects locally are used in adjunct with other modalities. These are used daily basis and used for longer duration. Preferrable to spread over normal surrounding areas along with the patches.
