Part of Vitiligo: causes and treatment options
NB-UVB phototherapy for vitiligo
Narrowband UVB is a cornerstone treatment for vitiligo. Most patients see some repigmentation, but it takes months, and the face responds far better than the hands and feet.
Updated
Narrowband UVB (NB-UVB) phototherapy treats vitiligo with a narrow band of ultraviolet light that calms the immune attack and stimulates pigment cells to return. It is a cornerstone treatment for extensive vitiligo. Results build slowly over months, and they vary by body site.
How does it work?
Sessions take place in a light cabinet for the whole body, or with a targeted device for smaller areas, usually two or three times a week. The dose is increased gradually according to how the skin responds. Phototherapy is often combined with topical corticosteroids or calcineurin inhibitors, and in fast-spreading vitiligo with short courses of oral corticosteroids.
How well does it work?
A 2017 meta-analysis in JAMA Dermatology pooled 35 prospective studies with 1,428 patients. For NB-UVB:
- At least 25% repigmentation occurred in about 74% of patients at 6 months and 75% at 12 months.
- Marked repigmentation of 75% or more occurred in about 19% at 6 months and 36% at 12 months.
The authors concluded that long treatment courses should be encouraged.
Which areas respond best?
In the same analysis, after at least six months of NB-UVB, marked repigmentation was reached on the face and neck in about 44% of patients, the trunk in 26% and the arms and legs in 17%, and on the hands and feet in none. For those resistant areas, adding fractional CO2 laser or microneedling can help.
How does it combine with newer treatments?
A 2024 review notes that phototherapy combined with JAK inhibitors gives impressive results, suggesting that calming the immune system works best together with a signal that stimulates pigment cells. NB-UVB is also used after cell transplantation to support new pigment. The vitiligo guide covers all the options.
Questions
How long does NB-UVB take to work for vitiligo?
Some colour may return within a few months, but the best results usually need six to twelve months or more of regular treatment.
Is NB-UVB phototherapy safe?
It is a long-established treatment given under medical supervision, with the dose adjusted to the skin's response. The dermatologist explains short-term effects, such as redness, and how long-term exposure is monitored.