Dr. Josiane Lederman


Vitiligo is a skin condition which involves complete loss of melanin, the primary skin pigment. It appears to occur when immune cells destroy the cells that produce brown pigment (melanocytes). This destruction is thought to be due to an acquired autoimmune problem, but the cause is unknown. Vitiligo may appear at any age and affects about 1 out of every 100 Americans.

Although vitiligo is usually not harmful medically and causes no physical pain, its emotional and psychological effects on well-being and self esteem can be deeply disturbing, particularly if the condition develops on visible areas of the body. Adolescents, who are often especially concerned about their appearance, can be devastated by widespread vitiligo.

Fortunately, Excimer treatments can minimize and, in many cases, even eliminate Vitiligo depigmented patches. The Excimer laser delivers a targeted beam of UVB light and only the areas of skin affected by vitiligo receive the laser energy.Though the laser spot size measures only 18mm x 18mm, due to rapid exposure times, relatively large, discrete areas can be treated in just five to 10 minutes, which is much quicker than the duration of conventional phototherapy light sessions. And most importantly,

Excimer treatments achieve complete response rates faster in a higher proportion of patients. In one clinical study, 32 patients with 55 vitiligo patches were treated with the Excimer 308nm laser. All areas were treated until 75% or greater repigmentation was achieved or for a total of 30 semiweekly sessions, whichever occurred first. The final analyses showed that of 21 facial spots treated, 71.5% achieved 75% or greater repigmentation. The next best responses were attained treating neck and scalp areas, of which 60% benefited with 75% or greater repigmentation.

Other studies have concluded that when Excimer is used as monotherapy, repigmentation rates of more than 75% are seen in more than 50% of patients but response rates as high as 95% have been achieved, It has also been noted that repigmentation can be seen in as few as 11 treatments. “ Using our Excimer twice-a-week regimen, the majority of patients with vitiligo areas of involvement on the face, neck, and scalp began to show repigmentation within one or two months and achieved an excellent result within three to four months.

Those who develop Vitiligo usually first notice white patches (depigmentation) on their skin, most commonly on sun-exposed areas of the body, including the hands, feet, arms, face, and lips. Other commonly affected areas are the armpits, groin and around the mouth, eyes, nostrils and navel. The disorder generally appears in one of three patterns:

In addition to white patches on the skin, vitiligo patients may have premature graying of the scalp, hair, eyelashes, eyebrows, and beard.


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