Effectiveness of Excimer Light Combination Therapy in Vitiligo: A Comparison of Tacrolimus and Corticosteroids

Background: Vitiligo is a chronic skin condition characterized by depigmentation due to melanocyte destruction, leading to psychosocial distress. Despite advancements in treatment, achieving satisfactory re-pigmentation remains a challenge. Combination therapies, such as excimer light with topical agents, show promise in enhancing treatment outcomes. Aims: To compare the safety and efficacy of combined 308 nm excimer light with topical tacrolimus ointment (0.1%) versus excimer light with topical corticosteroid (mometasone furoate 0.1% ointment) in the treatment of localized vitiligo. Methods: A prospective, interventional study was conducted on 30 patients with symmetrical vitiligo patches, treated over 12 weeks. Each patient received excimer light therapy twice weekly combined with tacrolimus ointment on one side and mometasone cream on the other. Treatment efficacy was assessed using a standardized re-pigmentation score (graded 0–4) and clinical photographs. Safety was evaluated based on adverse events like erythema or blistering. Statistical analysis included chi-square tests and descriptive statistics, with a significance level of P < 0.05. Results: Significant re-pigmentation was observed in both groups, with superior outcomes for excimer light and mometasone cream on acral areas and excimer light with tacrolimus on photosensitive regions. By Week 12, 76.7% of stable vitiligo cases achieved higher re-pigmentation scores (≥3) than baseline. Adverse effects were mild only in both the groups, with transient erythema in 16.7% of patients 7% of patients. Conclusion: Both combination therapies were effective and safe for treating localized vitiligo, with outcomes varying by lesion location. Excimer light combined with topical corticosteroid showed marginally better overall efficacy, while tacrolimus demonstrated superior results in photosensitive areas. This study highlights the importance of personalized treatment approaches for vitiligo management.