title: Vitiligo: an update on current pharmacotherapy and future directions.
abstract: BACKGROUND
  Vitiligo is a common pigmentary skin disorder, characterized by the appearance of white macules on the skin, mucosal or hair. Treatment is often a tough challenge and involves a wide range of therapies.
  
  
  METHODS
  This review focuses on available first- and second-line pharmacological treatments for vitiligo. In particular, the mechanisms of action, the main indications, the efficacy and the most important side effects are reviewed. Moreover, a brief discussion is provided, regarding other nonpharmacological treatments, such as phototherapy and surgical options, due to their importance and successful outcomes in vitiligo treatment. Finally, a concise overview regarding the future directions in vitiligo therapy is presented.
  
  
  CONCLUSIONS
  The promising outcomes reported here demonstrate that it is possible to achieve a satisfactory and often stable repigmentation of vitiligo lesions. Topical corticosteroids, calcineurin inhibitors, phototherapy and photochemotherapy represent the first-line therapeutic options, due to their safety and efficacy, whereas vitamin D analogues, targeted phototherapy, oral corticosteroids and surgery should be used as second-line therapies. Other therapies, such as antioxidants, can be used in association with other therapeutic options, whereas depigmenting agents should be used only in cases of extensive vitiligo, recalcitrant to other treatments.
authors: University of Florence, Section of Clinical, Preventive and Oncologic Dermatology, Department of Critical Care Medicine and Surgery, Florence, Italy. roberta.colucci21@gmail.com
authors: Roberta
authors: R
authors: Colucci
authors: Torello
authors: T
authors: Lotti
authors: Silvia
authors: S
authors: Moretti
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D010778:Photochemotherapy / Q000379:methods; D010789:Phototherapy / Q000379:methods*; D062327:Skin Lightening Preparations / Q000627:therapeutic use; D012880:Skin Pigmentation; D016896:Treatment Outcome; D014820:Vitiligo / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy
chemical_list: D000975:Antioxidants; D003879:Dermatologic Agents; D062327:Skin Lightening Preparations