Vitiligo phototherapy expectations by body area

Between the four body areas the pooled studies report, what changes most is how complete the result gets, not whether anything happens at all.

In the pooled studies, face and neck repigmented most and hands and feet least.

Body sites this covers: skin.

How often pigment came back, by area

Narrowband UVB after at least 6 months · pooled in one 2017 review

Face and neck
82.0% had at least a quarter of the pigment back and 44.2% had at least three quarters, across 153 people in 5 studies.
Trunk
81.7% and 26.1% at the same two bars, across 134 people in 5 studies.
Arms and legs, hands and feet excluded
79.0% and 17.3% at the same two bars, across 162 people in 5 studies.
Hands and feet
11.0% had at least a quarter of the pigment back. Nobody among 172 people in 6 studies reached three quarters.

Each area rests on 5 or 6 studies and roughly 150 people, so the ranges are wide: face and neck runs from 24.2% to 64.2%. A zero is not proof that hands and feet never repigment, and a pooled area average cannot predict one patch.

Why does body area matter?

Because one whole-body percentage hides the differences that matter to you. I read a 2017 review that pooled narrowband UVB results by area after at least 6 months. At least three quarters of the pigment came back for: Evidence Evidence Evidence

  • Face and neck: 44.2% of 153 people in 5 studies.
  • Trunk: 26.1% of 134 people in 5 studies.
  • Arms and legs, hands and feet excluded: 17.3% of 162 people in 5 studies.
  • Hands and feet: none of 172 people in 6 studies.

What is known

  • Sources cited, not yet graded

I use a home narrowband UVB panel myself, which is why I read this review closely. At the lower bar of at least a quarter of the pigment back, the first three areas sit close together: 82.0%, 81.7% and 79.0%. Hands and feet reach 11.0%. So the areas separate mainly on how complete the result gets, not on whether anything happens at all.

What is uncertain

  • Depends on you

Each area rests on 5 or 6 studies and roughly 150 people, so the ranges are wide. Face and neck runs from 24.2% to 64.2%. A pooled area average cannot predict one patch, and body area alone cannot select a treatment or device. Which areas get treated, and how, is set by your prescriber and the instructions for your exact device.

Questions about the areas you want to treat

  1. What outcome is realistic for each area I want to discuss?

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Can I use a facial result to judge my hands or feet?

No, and the pooled numbers show how far apart they are. Nobody in the hands-and-feet group reached the near-complete bar, against 44.2% for face and neck. A treatment can still be worth it for one priority area while another area carries a different expectation. Evidence Evidence

What is known

  • Sources cited, not yet graded

Whether a treatment works, and where, is one of the questions readers ask most, and face against hands and feet is how it usually arrives. The studies I read often report facial and total-body outcomes separately, and reviews report variation by body site.

What is uncertain

  • Depends on you

A zero in those studies is not proof that hands and feet never repigment. It means nobody in them reached that bar, and 11.0% did see some color return. Study categories may group areas differently, and entry criteria may not match you.

Questions about the areas you want to treat

  1. Can we set separate goals instead of one all-or-nothing result?

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What about eyelids, genitals, or other sensitive areas?

A patch on a private area is not something you need to hide from your dermatologist. Sensitive or difficult-to-shield areas need an exact clinician and device conversation. Do not infer protection, exposure, or medicine safety from another body area. Evidence Evidence

What is known

  • Sources cited, not yet graded

I have a patch over my eyelids, so the eye end of this is not abstract for me. Phototherapy guidance treats eye protection and treatment around the eyes as specific safety questions. Product labels also contain site- and medicine-specific precautions. You can ask for privacy, a chaperone, and a plain explanation during the exam.

What is uncertain

  • Depends on you

Whether an area should be treated, exposed, covered, or excluded belongs in the clinical and device plan.

Questions about the areas you want to treat

  1. Should this area be treated, and what exact protection applies?

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  2. Does my topical medicine change the plan for this area?

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One person’s experience - not medical advice

Why I never mix a paste and a light box the same day

An Ayurvedic paste I once used on an eyelid patch works the same way as PUVA - a photosensitizer plus sunlight. That patch repigmented, but that does not predict what it would do for anyone else.

I never apply a plant-based paste like that and then use a phototherapy lamp the same day without telling my clinician. Some plant ingredients act like a light-sensitizing medicine.

How should I photograph more than one area?

Create a repeatable view for each priority area instead of forcing several areas into one image. Keep angle, distance, framing, background, and lighting as consistent as practical, and label setup differences honestly. Evidence Evidence

What is known

  • Sources cited, not yet graded

The guideline I read backs medical photography for follow-up, while validated clinical measures require trained use and defined methods. A consistent personal record can prepare a conversation without becoming a score.

What is uncertain

  • Depends on you

Phone cameras process images differently, and ordinary photographs cannot establish activity, response, or cause.

Questions about the areas you want to treat

  1. Which areas should I document for our next review?

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Evidence and update context

This optional layer shows the evidence boundary I reviewed as of 2026-09-19.

What this evidence supports
I use a home narrowband UVB panel myself, which is why I read this review closely. At the lower bar of at least a quarter of the pigment back, the first three areas sit close together: 82.0%, 81.7% and 79.0%. Hands and feet reach 11.0%. So the areas separate mainly on how complete the result gets, not on whether anything happens at all.
What it does not establish
Each area rests on 5 or 6 studies and roughly 150 people, so the ranges are wide. Face and neck runs from 24.2% to 64.2%. A pooled area average cannot predict one patch, and body area alone cannot select a treatment or device. Which areas get treated, and how, is set by your prescriber and the instructions for your exact device.
Evidence Evidence Evidence Evidence Evidence Evidence
Pending clinical review

This statement has a dated source and is waiting for a clinician's sign-off.

Pending clinical review

This statement has a dated source and is waiting for a clinician's sign-off.

Pending clinical review

This statement has a dated source and is waiting for a clinician's sign-off.

Applicability check

Who was studied?

These fields show what the cited evidence reports about the people and body sites behind outcome or safety claims. “Not reported” means the reviewed source omitted the field; “Pending exact source review” means SteadySkin has not made that determination yet.

One evidence record, 2 statements

Because one whole-body percentage hides the differences that matter to you. I read a 2017 review that pooled narrowband UVB results by area after at least 6 months. At least three quarters of the pigment came back for: Face and neck: 44.2% of 153 people in 5 studies. Trunk: 26.1% of 134 people in 5 studies. Arms and legs, hands and feet excluded: 17.3% of 162 people in 5 studies. Hands and feet: none of 172 people in 6 studies.

No, and the pooled numbers show how far apart they are. Nobody in the hands-and-feet group reached the near-complete bar, against 44.2% for face and neck. A treatment can still be worth it for one priority area while another area carries a different expectation.

Age range
Three of the pooled studies enrolled children only, 8 enrolled adults only, and 24 enrolled all ages. Reported mean ages ran from about 10 to about 49 years, and individual ages from 3 to 77.
Condition subtype
Generalized or nonsegmental vitiligo. Segmental vitiligo was not the subject of this pooled review.
Severity or extent
Extent requirements differed by study. Some required at least 2% of body surface, others 5%, 10%, 15%, 20% or more. Many studies did not state an extent.
Sample size
1428 people across 35 prospective studies. 1201 people in 29 studies received narrowband UVB, and 227 people in 9 studies received PUVA.
Geography and care setting
The pooled studies came from Brazil, Bulgaria, Canada, Egypt, England, Greece, India, Iran, Iraq, Italy, Korea, Nepal, Norway, the Netherlands, Tunisia, Turkey and the United Arab Emirates. All were prospective studies, so treatment was given in a study setting.
Skin tone or phototype
Fitzpatrick skin types were listed study by study and spanned types I to VI, most often types II to V. Several studies did not record skin type.
Race
Not reported
Ethnicity
Not reported
Body sites
For narrowband UVB, face and neck, trunk, extremities, and hands and feet were pooled separately after at least 6 months. PUVA was not pooled by body site, because too few of the studies reported it.

What that means for this page: These are pooled averages for groups of people in studies published up to January 2016. They describe what happened to those groups. They are not a prediction for you or for one patch, and the review sets no device, schedule or dose. Because the pooling combined single treatment arms, these percentages are not a measured difference against no treatment.

A patch on a private area is not something you need to hide from your dermatologist. Sensitive or difficult-to-shield areas need an exact clinician and device conversation. Do not infer protection, exposure, or medicine safety from another body area.

Age range
Not reported
Condition subtype
Not reported
Severity or extent
Not reported
Sample size
Not reported
Geography and care setting
One source is the UK narrowband UVB guideline for clinic and home services. The other is the current US Protopic (tacrolimus) prescribing label. Neither reports a study population.
Skin tone or phototype
Not reported
Race
Not reported
Ethnicity
Not reported
Body sites
Eyelids and periocular skin, and the genital area. The guideline treats eye protection and periocular treatment as its own safety question. The tacrolimus label carries its own site-specific precautions.

What that means for this page: Neither source is a study of sensitive-area outcomes. The guideline treats eye protection and periocular treatment as its own safety question. The label carries site-specific precautions for its product. Neither tells a reader whether their sensitive area should be treated. Whether to treat, expose, or exclude one area stays a clinical and device-specific decision.

Evidence behind this page

Sources

Each evidence badge opens the source and its limits. The full list stays available here.

  1. JAMA Dermatology (Ezzedine K, et al.)Observational study · Supporting research, tier 3Independence not established
    Published
    SteadySkin last checked
    What this source can and cannot tell you

    What this source supports

    Supports defined research use and psychometric evaluation of facial and total VASI measures and the need to interpret score change in the studied context.

    What it does not support

    The analysis used sponsor trial data and included AbbVie authors; it does not establish one personally meaningful outcome, validate untrained home scoring or provide a treatment-change rule.

    Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.

  2. DailyMed, U.S. National Library of MedicineRegulatory · Regulatory / guideline, tier 1Relevant relationship disclosed
    Published
    SteadySkin last checked
    What this source can and cannot tell you

    Why the independence label says this: The National Library of Medicine hosts DailyMed. The product company submits the label to FDA, so it is authoritative for product labeling but not independent efficacy evidence.

    What this source supports

    It establishes the US atopic-dermatitis indication, boxed warning, local effects, long-term-use precaution, and ultraviolet instructions for this product. Its mechanism-of-action section supports that tacrolimus binds FKBP-12 to block calcineurin phosphatase, preventing the T-cell activation that its boxed warning and local-effect data describe. Its local-adverse-reaction data supports burning in roughly 46-58% and itching in roughly 41-46% of studied patients, most often in the first few days and easing as treatment continues. Its Dosage and Administration section supports applying a thin layer twice daily and re-examining the patient if signs and symptoms do not improve within six weeks.

    What it does not support

    It does not approve tacrolimus for vitiligo or psoriasis, establish efficacy for either, or resolve off-label guideline discussion of supervised combinations. Its dosing and six-week re-examination window are stated for its approved atopic-dermatitis indication, not as a vitiligo-specific schedule.

    Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.

  3. JAMA Dermatology (Lee JH, et al.)Systematic review · Clinical research, tier 2Independent source
    Published
    SteadySkin last checked
    What this source can and cannot tell you

    What this source supports

    Supports pooled group-level repigmentation outcomes for topical calcineurin inhibitors alone and with phototherapy, including variation by body area.

    What it does not support

    Considerable study heterogeneity limits product-specific and individual inference, and the review does not override current product labels or prove one medicine superior. Supports the exact pooled figures: 55.0% (560 patients, 21 studies) reached at least a mild (>=25%) response, 38.5% (619 patients, 23 studies) reached a moderate (>=50%) response, and 18.1% (520 patients, 19 studies) reached a marked (>=75%) response using a calcineurin inhibitor alone, versus 47.5% marked response when combined with phototherapy. Supports a median treatment duration of 3 months (range 2-7 months) across the pooled studies.

    Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.

  4. JAMA Dermatology (Bae JM, et al.)Systematic review · Clinical research, tier 2Independent source
    Published
    SteadySkin last checked
    What this source can and cannot tell you

    What this source supports

    Supports the separate pooled repigmentation rates and participant counts the review reports for narrowband UVB and PUVA at 3, 6 and 12 months, and the narrowband UVB rates pooled by body region after at least 6 months. Each pooled figure rests on the subset of studies that reported that measure at that time, not on the full review. It also supports plainly labelled arithmetic complements of those reported rates.

    What it does not support

    The pooled arms are single-group, so they describe what happened to those groups, not what the light caused. The review planned an intention-to-treat count and kept people who stopped early where it could; otherwise it used the group described at the final assessment, so no pooled figure is guaranteed to cover every enrolled participant. It does not report how many people worsened during treatment, does not predict an individual course, and sets no device, schedule or dose.

    Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.

  5. British Journal of Dermatology (Eleftheriadou V, et al.)Guideline · Regulatory / guideline, tier 1Independent source
    Published
    SteadySkin last checked
    What this source can and cannot tell you

    What this source supports

    Supports the clinical history and assessment domains, evaluation of associated autoimmune conditions, its recommendation for thyroid function and antithyroid antibody screening, current classification context, treatment-option map, psychosocial assessment, medical photography and the limits of pediatric evidence. Its classification table defines mucosal vitiligo as the oral or genital mucosae. One mucosal site alone is filed as undetermined or unclassified. Its differential diagnosis table lists genital or extragenital lichen sclerosus among the conditions that can be mistaken for vitiligo. That table also lists eczema, psoriasis, lichen planus, pityriasis alba and piebaldism. It calls autoimmunity a contributor to the pathogenesis of vitiligo. It reports an earlier review finding a possible negative impact on intimacy and sexual functioning. It tells clinicians to discuss the psychosocial impact of living with the condition. R28 offers a skin camouflage visit to people who want one. R10 to R14 name potent or very potent topical steroids as the first choice, with a topical calcineurin-inhibitor cream as an option for the face. These are different creams with different proof behind them. R20 names narrowband UVB as the first light option. It says the skin often does better on the face and trunk than on hands and feet. It says there is not enough proof to use any one current pill alone for vitiligo that is not changing. R25 and Table 2 keep cell grafting for vitiligo that is not changing and did not respond to other care. They also say a doctor cannot always tell if the vitiligo has truly stopped changing.

    What it does not support

    It was designed for UK care and reviewed literature through May 2019; it does not establish a universal testing plan, prescribe an individual plan, or establish current US labeling or coverage. Its differential diagnosis table is a list, not a method a reader can apply to their own skin. It does not say how to tell any two of those conditions apart. It gives no figure for how often vitiligo affects genital skin.

    Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.

  6. British Journal of Dermatology (Goulden V, et al.)Guideline · Regulatory / guideline, tier 1Independent source
    Published
    SteadySkin last checked
    What this source can and cannot tell you

    What this source supports

    It supports that traditional NB-UVB fluorescent lamps emit a narrow UVB band peaking around 311 nanometres. It backs wearing UV-protective goggles and keeping UV scatter off people nearby. It records the consent form naming goggles and the same clothing at each session. It also covers clinical uses, how it compares with other light treatments, safety limits including sunburn-type reactions, and the added safeguards home phototherapy needs.

    What it does not support

    It does not provide a personal treatment plan, approve a particular home setup, or replace the instructions for your own device. SteadySkin never reproduces its treatment schedules.

    Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.

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Evidence source

Evidence details

Review what this source supports, what it cannot establish, and any relevant relationships.