Vitiligo involves paler, less-pigmented skin patches Getty Images
A first-of-its-kind cream that targets the underlying cause of vitiligo will be made available on the National 午夜福利1000集合 Service in England. In clinical trials, the cream significantly increased pigmentation in the white skin patches caused by the condition, but the treatment , as vitiligo isn’t painful or dangerous.
鈥淯sually, people [with vitiligo] are asymptomatic in terms of physical symptoms, but it can cause a lot of emotional hardship,鈥 says at Indiana University, who led two trials of the new ruxolitinib cream treatment.
The cream, which is already available in the US, is sold under the name Opzelura. It treats non-segmental vitiligo, which occurs when symmetrical white patches appear on both sides of the body. This is thought to be caused by the immune system attacking melanocytes, the cells that make the pigment melanin, which gives skin colour.
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The treatment is the first drug to be robustly tested that acts directly on the pathway that causes vitiligo, says at Vitiligo Support UK. 鈥淭hat鈥檚 why this [decision] is such a landmark,鈥 she says.
Ruxolitinib works by inhibiting two enzymes that cause . Existing treatments, like steroid creams, can restore some pigment, but suppress immune function more broadly.
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, published in 2022, found that the drug increased pigmentation and reduced the noticeability of vitiligo patches compared with a placebo cream. This occurred (vitiligo is more noticeable on darker skin), and in more than a third of those who came off the drug after the trial.
The National Institute for 午夜福利1000集合 and Care Excellence (NICE) weighed up these results in the past, but judged ruxolitinib to for use on the NHS. Now, it says the cream should be made available to people aged 12 and older with non-segmental vitiligo when other topical treatments haven鈥檛 worked or are unsuitable.
Vitiligo, which , varies in severity. Some people have just a few small patches, while for others they can be large, red, inflamed or discoloured.
鈥淧atients and clinicians sometimes think we shouldn鈥檛 treat vitiligo, [because] it doesn鈥檛 kill you [and] it鈥檚 not painful,鈥 says at the British Association of Dermatologists. But vitiligo can have serious complications, such as a higher risk of .
Natalie Ambersley 鈥 a vitiligo ambassador for the charity , which supports people with physical differences 鈥 says that people shouldn鈥檛 feel judged for treating the condition, but adds that after spending years using existing treatments, she won鈥檛 be seeking out ruxolitinib. 鈥淚鈥檝e learned to accept my skin,鈥 she says. 鈥淲e鈥檙e [all] unique and we can embrace what we look like.鈥
鈥淚t鈥檚 great that there are people who love the skin they鈥檙e in, but that鈥檚 not for everyone,鈥 says Rush.
An oral version of ruxolitinib, which is used to treat some cancers and rheumatoid arthritis, , including lymphoma, heart problems and serious infections. But these have not been reported with the topical version. In the two vitiligo trials, ruxolitinib caused only mild side effects, including acne and itchiness. 鈥淭here is super minimal systemic absorption,鈥 says Eleftheriadou.
Ruxolitinib is also thought to be safer than steroid creams, which can cause skin thinning with long-term use. People with severe vitiligo may also be offered ultraviolet therapy, but this isn鈥檛 widely accessible.
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