Study Suggests Topical 5-Fluorouracil Therapy Promising as Treatment for Vitiligo

A recent study demonstrated the efficacy of topical 5-fluorouracil (5 FU) after microneedling to excimer light (308 nm) in treating patients with non-segmental vitiligo.

Topical 5 FU is primarily used to treat premalignant and malignant skin lesions, but the hyperpigmentation reported after using the treatment led researchers to examine its effect towards vitiligo. The study was led by Mohammad A. Saad, of the Department of Dermatology, Venereology, and Andrology at Al-Azhar University.

“Topical 5 FU after micro-needling is a promising, rapid, and cost-effective therapeutic strategy for treatment of non-segmental vitiligo It had limited side effects, and the best response was reported for lesions affecting face and trunk,” they wrote.

Background

The study recruited 50 patients in the study, although only 33 patients continued to implement the treatment for the span of 6 months. The researchers selected 2 patches in each patient to receive treatment, with 1 patch being given micro-needling followed by an application of 5 FU and excimer in Group A. The other group would receive excimer only, known as Group B.

The investigators took serial photographs for every study participant at baseline prior to beginning their treatment, then every other 2 weeks. The measured the depigmented patches at baseline using Vitiligo Extent Score (VES) and Vitiligo Extent Score-plus prior to patients’ treatment, then after 3 months, then following 6 months of treatment.

Findings

The investigators reported that the patches in patients’ faces and trunks, for both groups, demonstrated the best re-pigmentation response compared to their extremities and acral patches.

Despite this fact, the re-pigmentation response in the face was found to have been affected by the treatment modality. Conversely, the patients’ trunk patches were reported to not be affected by the treatment modality, having shown 66.7% excellent response for both study arms.

“The treatment with the combination of micro-needling then application of 5 FU and excimer showed significant earlier response versus excimer alone,” they wrote. “Also, the percentage of re-pigmentation was higher in the patches treated with the combination especially in the face and trunk. The combination of 5 FU after micro-needling and Excimer is more suitable for localized and focal vitiligo.”

This study, “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,” was published in the Journal of Cosmetic Dermatology.