Are Laser Treatments of Acne Scars Safe for Someone with Vitiligo?

Vitiligo is an autoimmune skin condition where the immune system has mounted a production of proteins (antibodies) that attack pigment-producing cells (melanocytes) along top layer of the skin. Within a vitiligo skin patch, there is a complete depigmentation, perhaps with islands of repigmentation. This condition may run in some family and can be associated with other autoimmune conditions such as thyroid disorder, diabetes, anemia, etc. The best treatment available involves combination of NBUVB (narrow-band ultra-violet B) phototherapy and topical tacrolimus ointment.

Unfortunately, vitiligo can occur in places where the skin may be traumatized, e.g. abrasion on knees. Therefore, there is theoretical risk wherever a laser is performed. Individuals with history of vitiligo should consult with a board-certified dermatologist, weigh risks and benefits before making an informed decision about laser treatments.

In a case like this a test site-trying to treat just a small area-to see if there is a negative response-namely the area turns white. Vitiligo is more likely to cover with our laser that removes tissue like CO2 than with another laser like Smooth Beam or even Fraxel which can also treat acne scarring.

If your vitiligo is currently active, you should stay away from any treatment that can potentially lead to worsening of your vitiligo. Any laser treatment will have the potential to worsen vitiligo unless it is a laser specifically made to treat vitiligo. If the vitiligo you have has not been active for many years, you may consider having this procedure. However, you will do this at the risk of causing your vitiligo to flare.

Laser resurfacing can cause loss of pigment in healthy normally pigmented skin.
Laser resurfacing causes inflammation of the skin and inflammation is part of the underlying cause of vitiligo.
I would not do laser resurfacing on a patient who has active vitiligo