The effectiveness of microneedling and cosmetic camouflage in the treatment of vitiligo

BACKGROUND: Treatment of vitiligo is one of the most difficult problems in dermatology. Despite the availability of various safe and effective methods of treatment, there are problems with combining and correctly applying techniques for the most effective result. Vitiligo has an impact on the psycho-social aspects of patients' daily life. This makes it necessary to use additional techniques, such as cosmetic camouflage to improve the quality of life of patients with vitiligo.

AIM: to assess the effectiveness of microneedling and cosmetic camouflage for the treatment of vitiligo.

MATERIALS AND METHODS: The study included 78 people with vitiligo aged 28–46 years. At the first stage of the study, 49 patients underwent microneedling in combination with ultraviolet B therapy and local tacrolimus. The subjects of the control group (n=29) were affected only by ultraviolet B therapy and tacrolimus. Phototherapy with ultraviolet B rays of 311 nm was carried out according to the method of 3-fold irradiation per week (Monday, Wednesday, Friday) with an initial dose of 0.05 J/cm². 0.1% tacrolimus ointment was applied twice a day during the course of therapy. The treatment lasted for 2–5 months; 2 courses of 2 months were carried out with a break of 3 months (in total 5 months). On average, for therapeutic effect (complete or partial repigmentation), patients received 60–64 sessions. Patients of the studied groups underwent a comparative analysis of repigmentation 2 and 5 months after treatment. At the second stage of the study, patients after microneedling were divided into the main group (n=33) and the comparison group (n=16). The subjects of the comparison group underwent cosmetic camouflage of vitiligo sites. Before and after treatment, the dermatological index of quality of life was determined for patients.

RESULTS: After 1 month from the start of treatment, 67.4% of patients after microneedling and 6.1% of patients in the control group showed moderate improvement (26–50% repigmentation). There was a good improvement with 51–75% repigmentation in 26.5% of patients after microneedling. After 5 months from the start of treatment, 67.4% of the subjects after microneedling showed an improvement in repigmentation of more than 51%. It was found that the average indicators of the dermatological quality of life index after treatment in patients of the main group (9.6±0.3 points) and the comparison group (7.0±0.3 points) corresponded to the values of "moderate effect of the disease on quality of life" and were significantly (p=0.018) lower than the baseline level (20.8±0.2 points and 19.9±1.1 points). This was not determined in the control group (18.2±0.4 points and 22.4±0.1 points). In the comparison group, this indicator was significantly (p=0.001) lower in comparison with the scores of other study groups.

CONCLUSION: The combination of microneedling, ultraviolet B therapy and tacrolimus is an effective method of treating patients with vitiligo. It increases repigmentation and quality of life. Additional cosmetic camouflage improves various aspects of the life of patients with vitiligo.