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Recent research suggests that a combination of micro-needling and topical 5-fluorouracil could offer better outcomes for vitiligo patients compared to using topical tacrolimus alone. This may be a vital step towards more effective vitiligo management.

  • Vitiligo is an autoimmune skin disorder characterized by loss of pigmentation, creating white patches on the skin.
  • A recent study compared the effects of micro-needling combined with 5-fluorouracil to the use of topical tacrolimus alone.
  • The combined treatment of micro-needling and 5-fluorouracil showed significant improvement compared to tacrolimus alone.
  • Though promising, this new treatment modality is still being researched and may not work for everyone.

Treatments for Vitiligo

Vitiligo is an autoimmune skin disorder in which the immune system attacks the cells that give the skin its color, resulting in white patches appearing on the skin. Treating vitiligo can be challenging as no definitive cure is currently available. However, a variety of treatment options have shown promise, including topical (applied to the skin) corticosteroids, phototherapy, laser therapy, and graft surgeries.

A New Approach: Micro-Needling Combined With 5-Fluorouracil

A recent study published in the Journal of Cosmetic Dermatology has shown potential for an alternative treatment option. Researchers investigated a combination of two different treatments: microneedling and topical 5-fluorouracil. Micro-needling causes a localized inflammatory response in the skin and stimulates pigment-producing cells to migrate into these areas, while 5-fluorouracil is a drug that encourages the growth of pigment cells. They compared the drug combination to topical tacrolimus, an immune-suppressing drug that is commonly used to treat eczema.

The results were encouraging: the group of patients treated with micro-needling and 5-fluorouracil showed significant improvement, with 32% having a moderate to excellent response. In contrast, those treated with tacrolimus alone showed poor improvement.

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What This Means for You

These findings suggest that combining micro-needling and 5-fluorouracil might be a more effective way to manage vitiligo than tacrolimus. However, it’s important to remember that this treatment didn’t work for everyone. The study noted that patients who’d had vitiligo for more than 10 years didn’t respond to the treatment.

Although the results are promising, the researchers emphasize that more studies are needed to confirm these findings and to explore potential side effects. Some patients in the micro-needling group experienced mild skin reactions such as redness and burning, but these were typically well-tolerated.

This research offers hope for a more effective approach to treating vitiligo. As we gain a better understanding of this complex condition, more targeted and effective treatments could become a reality.


Pazyar, N., Hatami, M., Yaghoobi, R., Parvar, S. Y., Radmanesh, M., & Hadibarhaghtalab, M. (2023). The efficacy of adding topical 5‐fluorouracil to micro‐needling in the treatment of vitiligo: A randomized controlled trial. Journal of Cosmetic Dermatology. https://doi.org/10.1111/jocd.15616