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Combined laser, autologous hair transplantation and phototherapy may treat refractory vitiligo

Fractional CO₂ laser pretreatment, along with autologous hair transplantation and narrow-band UVB phototherapy demonstrated efficacy in treating refractory and stable vitiligo, according to published study results.

Amir Feily , MD, of the dermatology department at Jahrom University of Medical Sciences, Jahrom, Iran, and colleagues studied 20 patients (15 women; mean age, 30.6 years) in Iran with symmetrical and stable refractory vitiligo and Fitzpatrick skin type IV. The mean disease duration was 11.9 years.

The patients’ lesions were randomly divided to two treatment regions: Part A included one session of 10,600 nm fractional CO₂ laser pretreatment (MX-7000, Daeshin Enterprise Corp.) followed by autologous hair transplantation and phototherapy and part B included autologous transplantation and phototherapy alone (part B).

The entire lesion underwent autologous hair transplant on day 5 after part A underwent laser treatment. On day 11, the lesions underwent narrow-band UVB phototherapy, with treatment continuing twice a week for 12 weeks.

Monthly measurement with a caliper determined the diameter of perifollicular repigmentation.

There was detectable perifollicular repigmentation around 74% of grafted hair follicles within 3 months.

There was a significantly greater diameter of perifollicular repigmentation with part A treatment (6.6 ± 5.8 mm), which included fractional CO₂ pretreatment, compared with part B treatment (4.3 ± 1.8 mm; P = <.001).

“[The study] suggests that fractional CO₂ laser therapy followed by hair transplant alongside [narrow band] UVB phototherapy could be used as an effective trimodality approach in the management of refractory vitiligo,” the researchers concluded “Despite their promising results, a larger trial is necessary to further characterize the therapeutic efficacy and long-term results of this novel regimen.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.