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Medically reviewed by Dr. Samuel Sarmiento, M.D., MPH on August 3, 2023

If you’re living with vitiligo and considering laser or intense pulsed light treatments, there are potential risks and safety guidelines that are important to understand. A recent e-Delphi study (a type of research method that uses online platforms to gather and analyze the opinions of experts on a specific topic) offers valuable insights to help you and your dermatologist make appropriate decisions about these treatments.

  • Laser and intense pulsed light treatments can induce new vitiligo in predisposed individuals.
  • Discuss the potential risks with your healthcare provider before undergoing treatment.
  • If your vitiligo has been stable for over a year with no new activity, laser/IPL treatments may be considered.
  • If new vitiligo spots appear after treatment, early intervention is essential.
  • If complications occur after laser/intense pulsed light treatment, preventive measures should be taken within a week.

Vitiligo is a skin condition characterized by progressive loss of skin pigment in patches. Laser and intense pulsed light (IPL) treatments can be beneficial for certain skin conditions, but for individuals with vitiligo, these treatments can potentially cause new vitiligo lesions, also known as the Koebner phenomenon.

Insights from the e-Delphi Study

A study published in The Journal of the American Academy of Dermatology gathered 17 vitiligo experts from 12 countries, forming a consensus on the safety guidelines for laser and IPL treatments in vitiligo patients. They concluded that all laser/IPL treatments carry a risk of inducing new vitiligo, even under ideal circumstances.

The panel strongly recommends that unless your vitiligo has been stable for over a year with no active signs, laser/IPL treatments should be avoided. If new vitiligo spots appear after treatment, early intervention is strongly advised.

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What This Means for You

These guidelines have important implications if you’re living with vitiligo. Your healthcare provider may need to take into account the aggressiveness of the laser/IPL treatment and your individual risk factors. If complications like ulcers, erosions, blisters, or crusts occur after treatment, it’s advised to begin preventive treatment within one week to prevent additional vitiligo.

Laser/IPL-induced vitiligo should be treated similarly to normal vitiligo. This can include topical steroids (for non-facial areas), topical calcineurin inhibitors (for the face), and narrowband UV-B (for extensive depigmentation).

Takeaway

If you’re living with vitiligo, understanding the risks and safety guidelines of laser and IPL treatments may help you make decisions with your healthcare provider about your skincare treatments. This e-Delphi study provides guidelines that may be used in consultation with your dermatologist to improve your care.

Source: 

Post, N. F., Rodrigues, M., Liong-A-Jin, C., Lommerts, A., Abdallah, M. H., Bae, J. M., Bekkenk, M. W., De Castro, C. C. S., Eleftheriadou, V., Esmat, S., Ezzedine, K., Van Geel, N., Hamzavi, I., Leone, G., Pandya, A. G., Passeron, T., Raboobee, N., Seneschal, J., Th’ng, S., & Wolkerstorfer, A. (2023). Consensus on the safety and risks of laser and intense pulse light treatments in patients with vitiligo: An e-Delphi study. Journal of the American Academy of Dermatology, 89(2), 352–354. https://doi.org/10.1016/j.jaad.2023.03.015