A new study suggests that topical 5-fluorouracil therapy may be effective in treating segmental vitiligo, says an article published in the Journal of Cosmetic Dermatology.

Vitiligo is an acquired depigmentary condition characterized by depigmented macules caused by melanocyte death. It causes significant social and aesthetic issues. Vitiligo is one of the most difficult dermatological conditions, with few prospects for improvement. Various medicinal and surgical therapy techniques have been utilized to treat vitiligo. Some were effective, some had questionable outcomes, while the others were less effective. Needling followed by topical administration of 5% 5-fluorouracil is a recent improvement in vitiligo therapy. Dermabrasion and topical 5% 5-FU, either alone or in combination, have been shown to be effective in the treatment of vitiligo. As a result, Mohammad Saad and colleagues undertook this study to assess the added impact of topical 5-fluorouracil (5FU) following micro-needling to excimer light (308 nm) in the treatment of non-segmental vitiligo.

The current study comprised 50 patients, although only 33 of them received therapy for 6 months. In each patient, two patches were chosen to be treated: one with microneedling followed by the administration of 5 FU and excimer (Group A), and the other with simply excimer (Group B).
The key findings of this study were:
1. Treatment with micro-needling followed by 5 FU and excimer produced a much faster response than excimer alone.
2. Furthermore, the proportion of re-pigmentation was greater in patches treated with the combination, particularly in the face and trunk.
3. For localized and focal vitiligo, the combination of 5 FU following micro-needling with Excimer is preferable.
In conclusion, the findings of this study clearly states that topical 5 FU following micro-needling is a promising, fast, and cost-effective treatment method for non-segmental vitiligo. It had little adverse effects, and the best results were observed for lesions on the face and trunk.
Reference:
Saad, M. A., Tawfik, K. M., & Abdelaleem, H. L. (2022). Efficacy and safety of micro‐needling combined with topical 5‐fluorouracil and excimer light vs. excimer light alone in treatment of non‐segmental vitiligo: A comparative study. In Journal of Cosmetic Dermatology. Wiley. https://doi.org/10.1111/jocd.15481