The efficacy of excimer laser (308 nm) for vitiligo at different body sites

BACKGROUND: The treatment with XeCl-excimer laser generated 308-nm UVB radiation has shown promising results in patients with vitiligo. OBJECTIVE: In this controlled, prospective trial we studied the primary efficacy (start and grade of repigmentation) and patient's satisfaction of XeCl-excimer laser for treatment of vitiligo patches at different body sites and re-evaluated the achieved repigmentation 12 months after the end of therapy. METHODS: Twenty-five patients with generalized or localized vitiligo with a total of 85 lesions at different body sites were enrolled in this study. Vitiligo patches were treated with 308-nm XeCl-excimer laser 3 times a week for 6 to 10 weeks. The overall repigmentation grade of each treated lesion was evaluated once a week on a 5 point scale rating from 0 (no repigmentation), 1 (1-5%), 2 (6-25%), 3 (26-50%), 4 (51-75%), to 5 (76-100%). RESULTS: Twenty-four patients completed the study. Within 6 to 10 weeks of treatment 67% of the patients (16/24) developed follicular repigmentation of at least one of their vitiligo lesions. Lesion repigmentation started after a mean of 13 treatments in lesions located on the face, trunk, arm, and/or leg (high-responder location), and after a mean of 22 treatments in lesions located on the elbow, wrist, dorsum of the hand, knee, and/or dorsum of the foot (low-responder location). Untreated control lesions and lesions located on the fingers did not achieve any repigmentation. After 10 weeks of treatment repigmentation of more than 75% was found in 25% (7/28) of lesions of the high-responder location group versus 2% (1/43) of lesions of the low-responder location group. In most cases, laser-induced repigmentation was persistent, as determined 12 months after the end of treatment. CONCLUSIONS: 308-nm excimer laser is an effective modality for the treatment of vitiligo. However, similar to other non-surgical treatment modalities, the therapeutic effect is mainly dependent on the location of vitiligo lesions.     

Combination of 308-nm xenon chloride excimer laser and topical calcipotriol in vitiligo

BACKGROUND: A large variety of therapeutic agents are being used for the treatment of vitiligo, but treatment remains a challenge. Recently, monochromatic phototherapies such as 311-nm narrowband ultraviolet B therapy and 308-nm xenon chloride excimer laser have been reported to be an effective and safe therapeutic option in children and adult patients with vitiligo. Single reports stipulate that the addition of topically applied calcipotriol to phototherapy increases its effectiveness. OBJECTIVE: The purpose of the present pilot study was to determine if the addition of topical calcipotriol increases the efficacy of the 308-nm xenon chloride excimer in the treatment of vitiligo. METHODS: Ten patients with vitiligo with essentially bilateral symmetrical lesions were enrolled in this prospective right/left comparative, single-blinded trial conducted over a 15-month period. All patients received 308-nm XeCl excimer laser therapy three times weekly. Calcipotriol ointment (Daivonex) was applied to lesions on one side of the body twice daily. RESULTS: After 24 treatments (8 weeks), nine patients were evaluated. Eight patients showed evidence of repigmentation on both body sides, with no significant difference between the body side treated with calcipotriol and excimer laser and the side treated with excimer laser alone. The mean repigmentation rate was 22.4% (1-37%). CONCLUSION: The addition of calcipotriol ointment to 308-nm xenon chloride excimer laser phototherapy does not significantly enhance its efficacy. Small additive effects must be investigated in a larger trial.     

Treatment of vitiligo with the 308 nm excimer laser

Several therapeutic modalities have been proposed for the treatment of vitiligo either to achive repigmentation in the lesions or to stabilize the disease. Narrow-band UVB therapy has been shown to be effective and safe for use in the management of vitiligo; its wavelength is not so different from 308 nm XeCl excimer laser radiation. We present an open and uncontrolled pilot study of 24 patients (12 men, 12 women) in whom vitiligous patches were treated twice a week, for 9 months with 308 nm XeCl laser radiation. Seven of the 24 patients showed greater than 75% repigmentation, six patients showed repigmentation of between 25 and 75% and six patients showed less than 25% repigmentation. In five patients no signs of repigmentation were noted. The therapeutic benefit was stable during the 12-month follow-up period. Although these results are promising, treatment has so far been limited to small numbers of patients and a short follow-up period. Other prospective studies are needed to assess the efficacy of this treatment modality.     

The 308-nm excimer laser: a promising device for the treatment of childhood vitiligo

Background: Numerous modalities have been used to treat vitiligo in children. Up to now, phototherapy and topical corticosteroids are the most commonly used treatments for adult vitiligo but studies evaluating the efficacy of these treatments in the pediatric population remain insufficient. Objective: This study was a retrospective review to evaluate the efficacy and safety of 308‐nm excimer laser treatment in 30 childhood vitiligo patients. Methods: Thirty vitiligo patients with 40 vitiligo patches were evaluated after the cessation of 308‐nm excimer laser treatment. Results: Seventeen patients (56.7%) with 20 patches (50%) achieved an acceptable degree (>50%) of repigmentation at the end of the treatment, with five patches (12.5%) showing >75% of repigmentation. The treatment response showed anatomical preferences, favoring the face, neck and trunk. However, the treatment response did not correlate to the cumulative dose or duration of treatment. Side effects occurred in nine patients, but were transient and minimal. Conclusion: The results of this study shows that the 308‐nm excimer laser can be an effective and promising device for the treatment of various vitiligo types, other than generalized, in childhood.     

Monochromatic excimer light 308 nm in the treatment of vitiligo: a pilot study

OBJECTIVE: To study the efficacy and safety of monochromatic excimer light (MEL) on 37 vitiligo patients referred to our clinic. METHODS: In a pilot study, 37 patients (17 males, 20 females) with acrofacial (n=21), focal (n=11), segmental (n=1), and generalized (n=4) vitiligo were treated twice weekly with MEL for a maximum period of 6 months. RESULTS: Thirty-five patients (95%) showed signs of repigmentation within the first eight treatments. The treatment resulted in good repigmentation in 16 patients, and excellent repigmentation in 18 patients. Adverse events were limited to transient erythema. In addition, some patients (n=3) not responding to prior narrow-band UVB (NB UVB) phototherapy showed good results with MEL in our series. CONCLUSIONS: Treatment with 308 nm MEL for vitiligo may be more effective in obtaining rapid repigmentation than phototherapy with NB UVB. The results in this study are similar to those recently reported with a 308 nm excimer laser, but 308 MEL could present some advantages: the possibility of treating larger areas compared to the 308 nm excimer laser, with shorter treatment times and better patient compliance. The overall good results and the early appearance of repigmentation contribute to reducing the cumulative exposure to UV radiation.     

准分子激光治疗白癜风的临床疗效与安全性研究

目的 探讨308 nm准分子激光治疗不同类型及病期的白癜风的疗效和不良反应.方法 对128例白癜风患者的317处皮损进行局部照射,每周1次,8次为1个疗程.每个疗程结束及治疗结束后对色素恢复程度进行评估,并记录不良反应.结果 共治疗皮损317片,总体应答率为97.5%,有效率为71.3%,显效率为50.8%.色素恢复程度随着治疗次数增加而增加.面颈部疗效优于躯干四肢,躯干四肢优于肢端部位.短病程(<1年)的白癜风皮损疗效优于长病程(≥1年)的皮损.成人和儿童、活动期和稳定期的皮损疗效无明显差异.患者耐受性较好.结论 308 nm准分子激光治疗白癜风起效快,疗效及依从性好,不良反应少.     

Targeted broadband ultraviolet b phototherapy produces similar responses to targeted narrowband ultraviolet B phototherapy for vitiligo: a randomized, double-blind study

Narrowband ultraviolet B (NB-UVB) phototherapy, with a 308-nm xenon chloride excimer laser, and targeted UVB phototherapy have produced encouraging therapeutic results for vitiligo. However, very few studies employing broadband UVB exist. Moreover, there has been no direct comparison study between broadband UVB and NB-UVB for the treatment of vitiligo. The aims of this study were to compare the repigmenting efficacy of targeted broadband UVB phototherapy with that of NB-UVB in an equi-erythemogenic manner. Twenty identical vitiliginous lesions from 10 patients were randomly allocated to receive either targeted broadband UVB or targeted NB-UVB phototherapy. UV fluences were started at 50% of the minimal erythema dose detected within the vitiliginous patches, then increased gradually, in the same manner, to ensure equi-erythemogenic comparison. Treatments were carried out twice weekly for 12 weeks. The results show that grade 1, i.e. 1-25% repigmentation, to grade 2, 26-50% repigmentation, occurred in 6 of 10 subjects. Responses in terms of repigmentation, de-pigmentation, or lack thereof, were similar between lesions receiving broadband and NB-UVB phototherapy. Onset of repigmentation occurred as early as 4 weeks of treatment in most subjects. Treatments were well tolerated, with only minimal erythema and hyperpigmentation. LIMITATIONS: The study was carried out in a small number of patients with skin types III, IV and V. The irradiation device was a targeted UVB device and thus the results may not be applicable to other light sources, such as the excimer laser or total-body irradiation cabinets. In conclusion, targeted broadband UVB produces similar clinical responses to targeted NB-UVB in the treatment of the non-segmental type of vitiligo.     

Comparative study between excimer light and topical antioxidant versus excimer light alone for treatment of vitiligo

Background: Vitiligo is an acquired idiopathic cutaneous disease characterized by pearly white patches of variable shapes and sizes. Various medical and surgical therapeutic options have been proposed to achieve repigmentation; phototherapy is one of the most efficient options. Topical therapies have been a mainstay of vitiligo treatment, with or without phototherapy. Aim of the work: To compare the efficacy of combined topical antioxidant hydrogel and excimer light versus excimer light alone in treating vitiligo. Patients and Methods: Thirty patients were included in this comparative, prospective, randomized study. For each patient, at least 2–4 vitiliginous macules were randomly selected and treated while an untreated vitiliginous macule served as control. Lesions were divided into two groups: Group A received combination therapy of daily topical antioxidant plus excimer light, while Group B received only excimer light. Lesions were treated twice a week for a maximum of 24 sessions. Initial fluencies were adjusted individually according to the minimal erythema dose in vitiliginous skin. Efficacy based on repigmentation percentages were blindly evaluated by two independent physicians. Results: Group A lesions showed significant efficacy than group B (p < 0.001), specially on treating UV-sensitive lesions with no side effects. Conclusion: Topical antioxidant and excimer light represents a valuable, effective therapy for localized vitiligo.     

Treatment of Vitiligo with 308-nm xenon-chloride excimer laser: therapeutic efficacy of different initial doses according to treatment areas

Many preliminary data suggest that the 308-nm excimer laser can be a highly effective therapeutic alternative for treating vitiligo, inducing rapid repigmentation with minimal ultraviolet irradiation. We evaluated the clinical efficacy of the 308-nm excimer laser treatment for various body areas, using different initial UV doses. One hundred forty vitiligo patches from 69 patients were assigned to 4 groups; face and neck, trunk, extremities, and acral and joint areas. They were then treated twice a week, using different initial UV doses. The rate of repigmentation continued to increase with the number of treatments up to 20 sessions, and then showed plateaus between 20 to 30 sessions. On the other hand, the lesions in acral and joint areas showed the worst responses throughout the treatment sessions. Our findings extend previous observations that the 308-nm excimer laser is an effective treatment option for patients with vitiligo. However, further studies will be needed to determine the optimal dosing and administration method, especially for acral and joint areas.     

The effectiveness of topical therapy combined with 308‐nm excimer laser on vitiligo compared to excimer laser monotherapy in pediatric patients

We evaluated the efficiency of using a 308‐nm excimer laser with either tacrolimus, pimecrolimus, or halometasone for the treatment of childhood vitiligo. Patients who received combined treatments had significantly higher rates of repigmentation in comparison with individuals who underwent excimer laser alone therapy. Moreover, patients who received treatment with excimer laser and halometasone had significantly higher rates of repigmentation, even higher than individuals who were treated with tacrolimus combined or pimecrolimus combined. This regimen was more effective on the face, neck, and limbs. We conclude that the use of a combined excimer laser and halometasone cream has a greater therapeutic effect than laser alone.     

Clinical efficacy of a 308 nm excimer laser in the treatment of vitiligo

Objective: To investigate the clinical efficacy and safety of the treatment of vitiligo using a 308 nm excimer laser. Method: Thirty‐six patients with 44 vitiligo patches were treated using a 308 nm excimer laser, which was performed twice a week, for a total of 30 treatments. The therapeutic efficacy and safety were then evaluated. Results: After 30 treatments:
(1) 27/44 patches (61.4%) achieved more than 75% repigmentation, 4/44 lesions (9.1%) showed 51–75% repigmentation, 10/44 (22.7%) showed 26–50% repigmentation and 3/44 (6.8%) showed 1–25% repigmentation.
(2) Of the 44 patches of vitiligo, 20/27 (74.1%) lesions on the face/neck, 9/9 (100%) on the trunk and 2/8 (25.0%) on the extremities showed ≥50% repigmentation. The repigmentation (≥50%) in face/neck and trunk were much higher than that in the extremities (P<0.05).
(3) The repigmentation (≥50%) in disease duration of ≤2 years and >2 years were 100.0% and 46.2% (P<0.05).
(4) The average cumulative doses in the face/neck, trunk and extremities were 7.92±5.26, 9.93±7.36 and 22.13±8.15 J/cm². The doses in the face/neck and trunk were much lower than those in the extremities. (P<0.05). Side effects were limited mainly to symptomatic erythema. Conclusion: The clinical data indicate that the treatment of vitiligo using a 308 nm excimer laser is safe and effective. However, lesion location and disease duration may be the key factors affecting the clinical outcome.     

Clinical study of repigmentation patterns with either narrow‐band ultraviolet B (NBUVB) or 308 nm excimer laser treatment in Korean vitiligo patients

Background Various repigmentation patterns such as perifollicular, marginal, diffuse, and mixed configuration can occur in vitiligo. The aim of this study was to clinically assess the types of repigmentation patterns obtained with narrow‐band ultraviolet B (NBUVB) phototherapy or targeted phototherapy using a 308 nm excimer laser and to reveal whether the repigmentation patterns have any relationship to the location of lesions, patient’s age, duration of lesions, or speed of improvement. Methods This study enrolled 51 patients who had effective responses as compared with baseline when treated with NBUVB alone and 52 patients who had effective responses as compared with baseline when treated with excimer laser alone. We evaluated the repigmentation patterns when the responses to treatments appeared. Results The most frequent repigmentation pattern was the perifollicular type in both groups treated with NBUVB (42.2%) or excimer laser (51.3%), followed by marginal, diffuse, and combined, in that order. There was no significant difference in the repigmentation pattern according to the location of lesions, patient’s age, or duration of lesions. The marginal pattern was predominant in both NBUVB and excimer laser‐treated groups when excellent responses (more than 75% repigmentation achieved at 12 weeks) appeared. Conclusions The repigmentation patterns according to location, age, duration of lesions, and speed of response showed similarities in both the NBUVB and excimer laser‐treated groups.     

Targeted Broadband UVB Phototherapy forthe Treatment of Localized Vitiligo

Background

Several new treatments appear to have higher success rates than previous therapies for the treatment of vitiligo, and targeted phototherapy is an alternative that may prove to be time-efficient and an effective therapeutic option for the management of this condition.

Objective

The aim of this study was to evaluate the efficacy of targeted broadband UVB phototherapy for the treatment of localized vitiligo.

Methods

Fifty-three vitiliginous patches on thirty-five patients (16 males, 19 females) were treated using a targeted broadband UVB phototherapy device. Treatment was started at 70% of the minimal erythema dose, and then gradually increased. Lesions were treated twice a week for a maximum of 60 treatment sessions.

Results

Subjects tolerated treatment well. Forty-one of the fifty-three patches (77.4%) achieved repigmentation on ≤75% of the treated areas. Best results were obtained on the face and neck; 20 of the 24 patches (83.3%) concerned achieved ≤75% repigmentation. The least response was on the hands and feet; 3 of 6 patches (50%) showed ≤75% repigmentation. The results were better for focal type than segmental type vitiligo.

Conclusion

Targeted broadband UVB phototherapy appears to be highly effective at restoring pigmentation in patients with localized vitiligo.     

Photo(chemo) therapy for vitiligo

Vitiligo has always been difficult to treat. Several modes of treatment are available, but the therapeutic effect varies greatly, and rarely does one achieve complete repigmentation. One of the most efficient treatment methods is photo(chemo) therapy. Already in ancient Egypt, vitiligo lesions were treated with extracts of the Ammi maius plant followed by exposure to the sun. This principle is at the basis of the photochemotherapy or PUVA therapy, whereby UVA irradiations are given 2 h after administration of 8-methoxypsoralen, a photosensitizer. Another efficient treatment form is UVB phototherapy, particularly narrow-band UVB. This not only gives good therapeutic results but also has the advantage of eliminating the need for a photosensitizer. All these treatments must be applied for many months to be efficient. They can also be combined with various surgical skin-grafting techniques. A newer approach is targeted UVB phototherapy, whereby xenon-chloride lasers or monochromatic excimer light is used.     

中波高能紫外线与308 nm准分子激光治疗白癜风的短期疗效比较

【摘要】 目的 比较中波高能紫外线和308 nm准分子激光治疗白癜风的短期疗效。 方法 中波高能紫外线组患者40例,每周照射2次;308 nm准分子激光组40例,每周1次。评估两组治疗8周后的皮损复色情况。 结果 经过8周的阶段治疗,中波高能紫外线组有83.6%皮损可出现不同程度的复色反应,达显效以上复色为42.1%;308 nm准分子激光组86.1%有皮损不同程度色素生成,达到显效以上为50%。对于面部白癜风皮损中波高能紫外线的疗效低于308 nm准分子激光（χ2 = 4.32,P < 0. 05）,在其余部位两组有效率差异无统计学意义。在皮损起始复色的累积剂量方面,两者差异无统计学意义（t = 0.89,P > 0.05）,在达到显效以上复色方面,高能中波紫外线的治疗次数和累积剂量明显多于308 nm准分子激光（P < 0. 01）。两者均适用于儿童患者及活动期皮损。 结论 中波高能紫外线或308 nm准分子激光治疗白癜风均可在短期内起效且安全,308 nm准分子激光疗效更明显。     

308-nm excimer laser for the treatment of localized vitiligo

BACKGROUND AND OBJECTIVE: Vitiligo is commonly treated with PUVA, and more recently, narrow-band UVB (NBUVB) phototherapy. Given the proximity of the wavelengths of NBUVB (311 nm) and the excimer laser (308 nm), we undertook a clinical trial to test the efficacy of this device. METHODS: Twice-weekly 308-nm UV-B radiation was given to selected vitiligo lesions for a maximum of 60 treatments. These lesions had been unsuccessfully treated previously with at least one other method of treatment. Initial doses were 100 mJ/cm2 with increments of 10-25%. Improvement was assessed on a visual scale via serial photographs. RESULTS: Subjects tolerated the treatment well. Improvement varied with body site. After 60 treatments, lesions on the hands and feet showed grade 2 improvement in 2/10 subjects and grade 1 in 8/10. For the axillae, there was grade 4 improvement in 1/3 subjects and grade 2 improvement in 2/3 by treatment 60. The face demonstrated the most rapid repigmentation with grade 4 repigmentation seen in 3/5 subjects by 40 treatments and grade 3 in 2/5 by 30 treatments. There were no adverse effects. CONCLUSIONS: The user-friendly 308-nm excimer laser allows targeted treatments of localized vitiligo.     

Optimal weekly frequency of 308-nm excimer laser treatment in vitiligo patients

BACKGROUND: Recently the beneficial effect of excimer laser treatment has been reported for patients with vitiligo. The influence of treatment frequency on this effect is not clear. OBJECTIVES: To determine the optimal frequency of 308-nm excimer laser therapy for vitiligo. METHODS: In this prospective, university-based hospital study over 12 weeks we enrolled 14 patients. Each had at least three stable vitiligo lesions in the same body area. The three stable vitiligo lesions in each subject were randomly assigned to receive excimer laser treatment once (1 x), twice (2 x) and three times (3 x) weekly, respectively. The initial ultraviolet (UV) dose was 50 mJ cm(-2) less than the 308-nm minimal erythematous dose in vitiligo skin. The UV dose was increased at each treatment session according to the erythematous response to the previous treatment. RESULTS: Thirteen subjects were treated for at least 6 weeks; seven were treated for all 12 weeks. At 6 weeks, the repigmentation rates for treated lesions were 8% (1/13) after 1 x weekly treatment, 23% (3/13) after 2 x weekly treatment and 62% (8/13) after 3 x weekly treatment (P = 0.0134; 3 x vs. 1 x weekly); at 12 weeks, these rates were 46% (6/13), 62% (8/13) and 69% (9/13), respectively (P = NS; 3 x vs. 1 x weekly). Repigmentation initiation correlated with treatment number, regardless of frequency (P = NS). As shown by Kaplan-Meier analysis, repigmentation occurred earliest in the most frequently treated lesions (P = 0.0336). At 12 weeks, the projected repigmentation rates for 1 x, 2 x and 3 x weekly treatment approached each other (60%, 79% and 82%, respectively); the mean repigmentation grades (on a scale of 0-5) for 1 x, 2 x and 3 x weekly treatment were 1.7, 2.4 and 3.3, respectively (P = 0.018; 3 x vs. 1 x weekly). Laser-induced repigmentation persisted in most cases over the entire follow-up of 12 months after the end of treatment. CONCLUSIONS: 308-nm excimer laser therapy is effective against vitiligo. Although repigmentation occurs fastest with 3 x weekly treatment, the ultimate repigmentation initiation seems to depend entirely on the total number of treatments, not their frequency. However, treatment periods of more than 12 weeks may be necessary to obtain a satisfactory clinical repigmentation, particularly when vitiligo lesions are treated only 1 x or 2 x compared with 3 x weekly.     

A randomized comparison of excimer laser versus narrow‐band ultraviolet B phototherapy after punch grafting in stable vitiligo patients

Background Ultraviolet radiation following punch grafting may stimulate the migration of melanocytes from the grafts into the vitiliginous skin, thereby increasing the rate of repigmentation. We compared the effects of the 308‐nm xenon chloride excimer laser (EL) vs. narrow‐band ultraviolet B (NB‐UVB) after punch grafting in patients with vitiligo. Objectives The aims of this study were to evaluate (i) repigmentation (%); (ii) treatment satisfaction; and (iii) patient preferences for EL vs. NB‐UVB therapy after punch grafting in vitiligo. Methods Fourteen patients were treated with the punch‐grafting technique on two symmetrical vitiligo patches. Starting 1 week after the punch grafting, the vitiligo patches were treated twice a week during 3 months, with EL on one side and with NB‐UVB on the other side. Repigmentation (%) was measured by a digital image analysis system. Patients’ satisfaction and preference for treatment were also assessed. Results Whereas both treatment modalities induced repigmentation, no statistically significant difference was found in grade of repigmentation after 3 months. With EL, 71.4% lower cumulative dose was reached. Patients were significantly more satisfied with NB‐UVB and preferred it over EL. Conclusions The choice between EL and NB‐UVB cannot solely be based on repigmentation, but rather on other factors, such as patients’ preferences. However, given the lower UV dose of EL, we recommend its use in vulnerable populations, such as in small children and patients with sun‐damaged skin with a history of long‐term UVB treatment.     

Treatment of localized vitiligo with targeted broadband UVB phototherapy: a pilot study

BACKGROUND: Narrowband ultraviolet B (UVB) phototherapy and 308 nm excimer laser have produced encouraging therapeutic results for vitiligo. Repigmentation of various degrees was obtained in different studies. Materials and methods: Twenty-nine vitiliginous lesions from six patients were treated with targeted, broadband UV-B phototherapy. UV fluences were started at 50% of the minimal erythema dose, then increased gradually. Treatments were carried out twice weekly for 12 weeks. RESULTS: Some degree of repigmentation occurred in all subjects. Responses varied among the different anatomic locations, with acral lesions achieving the least improvement. Onset of repigmentation was as early as 3 weeks of treatment in some subjects. Treatments were well tolerated, with only minimal erythema and hyperpigmentation. LIMITATIONS: This study was carried out in a smaller number of patients with skin types III and IV. The irradiation device was a broadband UVB device, and thus the results may not be similar to those obtained from a more monochromatic system such as an excimer laser. CONCLUSIONS: Targeted broadband UVB is an efficacious and safe modality for the treatment of localized vitiligo.     

A review of monochromatic excimer light in vitiligo

Phototherapy is a mainstay of vitiligo treatment and has varying rates of efficacy. Narrowband ultraviolet (UV) B (NB‐UVB) and UVA have been used for decades, but it is only recently that monochromatic excimer light (MEL) was developed for use in dermatology and adapted for the treatment of vitiligo. The specific 308‐nm radiation wavelength is delivered in a targeted form by the xenon‐chloride excimer laser and is also available in an incoherent form that is commonly referred to as the excimer lamp. MEL administered by both laser and lamp has shown efficacy superior to NB‐UVB for the treatment of vitiligo and induces more changes at the cellular level than conventional UVB modalities. The excimer laser is effective in adults and children with vitiligo in all skin types as monotherapy or in combination with other established vitiligo therapeutics. Treatment regimens studied included excimer laser two to three times weekly for up to 36 weeks. Patients commonly achieved > 75% repigmentation. The laser has also been used in combination with topical corticosteroids, calcineurin inhibitors and vitamin D analogues, as well as surgery, thus further expanding treatment options for patients with vitiligo. The excimer lamp has been used for treatments one to three times a week for up to 24 weeks and was found to be equal to excimer laser in a head‐to‐head comparison. It has also been used in combination with topical corticosteroids and oral vitamin E. Both MEL modalities have a limited adverse side‐effect profile. Long‐term effects are yet to be determined; however, based on available data on UVB phototherapy as well as the properties of MEL devices, there is probably only a minimal increased malignancy risk.