My 12 year old daughter was just diagnosed with vitiligo. The dermatologist gave her Vectical for her small patches on her knees, elbows and small dots on top of her feet. The dermatologist said to use it for 2 months in tiny amounts. What do you think of the treatment? Will it work? She just started today.
Is Vectical Effective for Treating Vitiligo?
Doctor Answers 2
Vectical for Vitiligo
I agree that a trial of Vectical may be worth a try, although I remain skeptical regarding effectiveness for vitiligo, a rather difficult to treat condition. The immunomodulating agents tacrolimus or pimecrolimus should be considered, as well as bursts of topical steroids. If the areas remain resistant to topical therapies, phototherapy can be considered. If your daughter is self conscious, cover-up makeup such as "dermablend" which is available at certain JC Penny and Macys stores can be wonderful to camouflage the depigmented areas.
Worth a Try
When a new medication comes out, it is quite common for a physician to try it in hopes it might cure or reverse a condition for which there is no one good treatment. Such may be the case with your dermatologist.
Vecical is a topical form of Vitamin D3 wlich recently approved by the FDA for the treatment of psoriasis. The active ingredient of this product is calcitrol. In trials calcitrol was found to be quite safe for extended periods of time. It can also be used in places that steroids would be inadvisable such as the groin or armpits.
Vectical has some immunomodulating effects. It reduces the levels of some pro-inflammatory proteins (cytokines) and increases the levels of some anti-inflammatory proteins (cytokines). Since vitiligo is a condition in which inflammation plays a crucial role, treatment with vectical makes sense. Although this is an off-label indication, I applaud your dermatologist for thinking outside the box.
Vectical, in limited areas especially, should be very safe. You do have to be careful in the sun. Obviously, with a new drug such as this, I have no idea whether it will work in your daughter's situation. I hope it does, but we physicians are trained not to promise our patients anything.
Other topical treatments, which also intercept the inflammatory processes, include tacrolimus ( Protopic) and pimecrolmius ( Elidel) and, of course, topical steroids.