Depigmentation Therapy with Q-Switched Nd: YAG Laser in Universal Vitiligo

BACKGROUND: Any residual pigment left in patients of universal vitiligo is managed with topical treatments, cryotherapy, and lasers. AIM: The study aims to assess the efficacy and safety of Q-switched Nd: YAG laser in treating the residual pigmentation in patients with universal vitiligo. MATERIALS AND METHODS: Fifteen patients of universal vitiligo with residual pigmentation on the face, hands, or feet, resistant to topical treatments, were treated with single or multiple sessions of Q-switched Nd: YAG laser treatment. Topical treatments were continued in between the laser sessions and the depigmentation achieved was monitored by clinical examination and repeat digital photographs. Response to the treatment was labelled as excellent if the residual pigment could be reduced by at least 90% while 50–90% resolution of pigmentation was labelled as a partial response. Adverse effects to the treatment offered were also monitored. RESULTS: Thirteen of the 15 patients enrolled for the study showed an excellent response to the treatment offered. Two other patients showed a poor response with less than 50% resolution of pigmentation. The number of laser sessions needed at a particular site ranged from 1 to 3 and no patient was offered more than three sessions of laser treatment at any site. No significant adverse events were reported by any patient. CONCLUSIONS: Residual pigmentation in patients with universal vitiligo that does not respond to topical treatment options alone can be managed quite effectively with Q-switched Nd: YAG laser without any significant adverse effects.