What do the creams tend to cause?
Most of it is local. It shows up where the cream goes, and reads best against your skin a week earlier. Evidence Evidence Evidence Evidence Evidence Evidence Evidence Evidence
How to use this step
- Sources cited, not yet graded
Side effects are what readers ask about most. The steroid cream labels I read record change where the cream goes. Skin thinning, stretch-mark-like lines, small visible blood vessels and acne-like bumps. In the HI-Light trial, skin thinning was reported in about 2.5% of participants. The British guideline names potent topical steroids as a first choice, with a calcineurin cream as an option for the face. Protopic (tacrolimus) ointment records burning and itching where the ointment goes. Its own studies put burning at roughly 46% to 58% and itching at roughly 41% to 46%. Most reports start early and ease with use. Elidel (pimecrolimus) cream records burning where the cream goes. Both labels carry a boxed warning, the strongest US safety alert. Opzelura (ruxolitinib) cream reports application-site acne in 6% and itching in 5% in its vitiligo trials. Its label carries boxed warnings too. The calcipotriene label reports skin irritation as its most frequent reaction.
Check before moving on
- Depends on you
The tacrolimus, pimecrolimus and calcipotriene rates come from studies of other conditions. Early on, expected irritation and a reaction worth a call look much alike. Your dermatologist tells them apart, and a dated note helps.
Questions about reactions and reaching your office
Which of these effects should I expect where I apply this, and which are not normal?
Saving keeps this on your device and needs JavaScript, which is off in this browser.How would I spot early skin thinning on the patches I treat most?
Saving keeps this on your device and needs JavaScript, which is off in this browser.
What does light therapy leave behind?
Usually something close to mild sunburn in the hours after a session. I put the detail on Phototherapy reactions and when to call. Evidence Evidence Evidence Evidence
How to use this step
- Sources cited, not yet graded
The British narrowband UVB guideline covers the clinic safety framework, sunburn-type reaction limits and eye protection. A UK unit leaflet asks patients not to sunbathe or use a sunbed during a course, and to avoid burning. It records that many treatments can bring the wrinkling and discolouration of photoageing. It records that a review becomes usual practice past a stated number of treatments. AAD records that tanning raises the contrast between your natural colour and the light patches. It records that a bad sunburn can worsen vitiligo. The pooled vitiligo review covers narrowband UVB and PUVA, and it did not pool excimer light.
Check before moving on
- Depends on you
I found no number for a reaction in these sources. Redness reads differently on deeper skin tones, so what you feel counts too. A reaction that keeps building after you leave belongs in a message to the team.
Questions about reactions and reaching your office
How much redness after a session is expected for my skin tone?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Who do I contact if a burn or a blister appears between visits?
Saving keeps this on your device and needs JavaScript, which is off in this browser.
What do the oral JAK medicines ask of you?
Screening first, then watching. Infection signs and lab results carry more weight here than anywhere else: Evidence Evidence Evidence Evidence
- Litfulo (ritlecitinib): boxed warnings, infection and tuberculosis screening, blood-count monitoring.
- Rinvoq (upadacitinib): the same five boxed warnings, and European limits for infection, liver and pregnancy.
How to use this step
- Sources cited, not yet graded
The current US Litfulo (ritlecitinib) label I read is written for severe alopecia areata, not vitiligo. It carries boxed warnings for serious infections, mortality, malignancy, major cardiovascular events and thrombosis. It describes infection and tuberculosis screening, blood-count checks, vaccines and drug interactions. The current US Rinvoq (upadacitinib) label carries the same five boxed warnings, and also has no US vitiligo indication. The European Commission authorized Rinvoq for nonsegmental vitiligo in July 2026, in adults and adolescents age 12 and older. The European safety overview says Rinvoq must not be used with tuberculosis or another serious infection. It names severe liver problems and pregnancy as well.
Check before moving on
- Depends on you
These are class warnings, not your own risk. That context partly comes from a study of a different JAK inhibitor in older adults. A European authorization is not a US approval, and neither label sets one plan.
Questions about reactions and reaching your office
Which blood tests does this need, and what would an off result change?
Saving keeps this on your device and needs JavaScript, which is off in this browser.What infection signs would you want to hear about the same day?
Saving keeps this on your device and needs JavaScript, which is off in this browser.
What about surgery and depigmenting cream?
Both change skin on purpose, so both carry wound and colour risks the earlier options do not. Evidence Evidence Evidence Evidence
How to use this step
- Sources cited, not yet graded
The RECELL instructions name scarring, redness, itching and infection. They name the Koebner phenomenon and worsening vitiligo. The Koebner phenomenon is the name for patches that appear where skin was injured. The procedure adds a donor wound, laser surface preparation, anesthesia, dressings and wound aftercare. The FDA approval covers stable patches in a defined adult group, done by a trained professional. It does not guarantee colour match or durability. A surgical review records that results and harms vary by method and study. The old Benoquin (monobenzone) label lists irritation, burning, eczema and allergy. It warns that the colour change can be permanent, uneven, or far from where the cream was placed. It states that the skin stays sun-sensitive for life, and that sunscreen must be used in the sun.
Check before moving on
- Depends on you
I found no rate in these sources, and none predicts your result. The surgical review is largely nonrandomized, with disclosed industry ties. The monobenzone label is archived, and the brand is no longer sold.
Questions about reactions and reaching your office
What are my scarring, infection and colour-match risks for the area we discussed?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Which changes after the procedure should make me call you rather than wait?
Saving keeps this on your device and needs JavaScript, which is off in this browser.
Which of these can wait, and which cannot?
Three speeds. Sorting what you see into one of them is the whole job here: Evidence Evidence Evidence Evidence Evidence Evidence Evidence Evidence
- Keeps until the next visit: local burning or itching that is easing, a sunburn-like reaction that fades, a question about whether something counts.
- Call the office today: an infection sign on Litfulo (ritlecitinib) or Rinvoq (upadacitinib). A cream reaction that keeps building instead of easing.
- Call the office today: a wound, spreading redness or new pain after RECELL. Colour loss away from where a depigmenting cream went.
- Urgent assessment: severe pain, blistering, swelling across a large area, new eye symptoms, feeling very unwell, or whenever your own plan says so.
How to use this step
- Sources cited, not yet graded
The Opzelura (ruxolitinib) label points patients to its Medication Guide and care team. I found no single reaction there that should prompt a call. The Litfulo (ritlecitinib) and Rinvoq (upadacitinib) labels place serious infection in a boxed warning, and both describe screening and blood-count review. The British narrowband UVB guideline covers sunburn-type reaction limits. The unit leaflet asks patients to report a new medicine or cream. The RECELL instructions leave infection and wound aftercare with the treating team. The Benoquin (monobenzone) label warns that pigment loss can appear away from where the cream was placed. The Protopic (tacrolimus) label records that local burning and itching usually ease as treatment goes on.
Check before moving on
- Depends on you
I found no hour and no cut-off in these sources, so use the grouping to sort what you see. Your own written plan may move something up a level, and your plan wins. If it frightens you, or it is getting worse quickly, emergency care is the right call and nobody will mind.
Questions about reactions and reaching your office
Which symptoms on my treatment mean I call you the same day?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Who do I reach after hours, and what should I have ready to tell them?
Saving keeps this on your device and needs JavaScript, which is off in this browser.
Three speeds for a reaction
You notice something new on a vitiligo treatment. How fast should you act?
- Keeps until the next visit
- If local burning or itching is easing, a sunburn-like reaction is fading, or you are unsure whether something counts.The Protopic (tacrolimus) label records that local burning and itching usually ease with time.
- Call the office today
- If an infection sign appears on Litfulo (ritlecitinib) or Rinvoq (upadacitinib), or a cream reaction keeps building instead of easing.A RECELL wound, spreading redness or new pain belongs in the same call, and so does colour loss away from a depigmenting cream.
- Urgent assessment
- If there is severe pain, blistering, swelling across a large area, new eye symptoms, feeling very unwell, or whenever your own plan says so.If it frightens you, or it is getting worse quickly, emergency care is the right call and nobody will mind.
From the guidance I cite here.
One more answer: how to record a reaction so the call is short
How should you record a reaction?
Date it, name the patch, say what it felt like, and keep it. A short dated note beats a confident memory at the visit. Evidence Evidence
How to use this step
- Sources cited, not yet graded
The British guideline covers the history and assessment areas a review works from, and medical photography. The task force checklist names where the patches are. It records what the vitiligo has done in the past six months. It names stable vitiligo and active vitiligo as two states that change the care plan. Its shared-decision steps ask what you want from care. I put the camera method on Tracking change and photos, and the stay-or-switch conversation on reviewing your plan.
Check before moving on
- Depends on you
Both sources are written for clinicians, not as a home record. Bring the gaps as well as the entries, because a missed week is information. One point carries across every treatment. Stopping a systemic medicine on your own is a change to your plan. Make the call first, and let your dermatologist choose the next step.
Questions about reactions and reaching your office
What details do you want written down when a reaction happens?
Saving keeps this on your device and needs JavaScript, which is off in this browser.If a side effect is too much to live with, what are my options besides stopping?
Saving keeps this on your device and needs JavaScript, which is off in this browser.
Evidence behind this page
Sources
Each evidence badge opens the source and its limits. The full list stays available here.
- American Academy of DermatologyPatient education · Patient education, tier 5Independence not established
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports patient-facing context that skin which has lost its color can burn readily and that shade, clothing and labeled sunscreen use are broad protection options. It also supports that for some people a skin injury triggers new spots or patches, and it names cuts, scrapes and burns. The wound a tattoo makes can lead to the Koebner phenomenon, with new spots appearing about 10 to 14 days later. It supports that a tattoo added for pigment may not blend with natural skin color, that its color can eventually bleed, and that the vitiligo underneath can spread over time. It supports the page telling readers to avoid tanning, indoors and outdoors, because tanning increases the contrast between natural skin color and the light spots and patches. That is what it says makes vitiligo more noticeable. It supports that tanning beds, sun lamps and other indoor tanning devices are not safe alternatives to the sun. Like the sun, they can burn skin that has lost pigment and worsen vitiligo. It supports that a bad sunburn can worsen vitiligo, and that on a lighter skin tone untanned skin often makes the spots and patches less noticeable. It supports that self-tanners and skin dyes tend to last 3 to 5 days, against one day for makeup. It names dihydroxyacetone as the ingredient to look for, and says natural-looking results take practice. It supports that vitiligo increases the risk of some other diseases such as thyroid disease, and that a dermatologist can monitor for them.
What it does not support
The page acknowledges support from Incyte Dermatology, so it does not independently establish treatment efficacy. It does not establish a personalized sun plan, a product ranking or a treatment-day instruction. It gives no frequency for injury-related patches and no way to tell in advance who they happen to. It gives no measure of how much tanning changes contrast, no threshold for a bad sunburn, and no way to tell whether one person’s vitiligo will worsen. It compares no tanning device with prescribed narrowband UVB and establishes nothing about medical phototherapy. It names no product or brand for camouflage, self-tanner or skin dye.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- European Medicines AgencyRegulatory · Regulatory / guideline, tier 1Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports the EMA safety overview, including EU restrictions concerning tuberculosis or another serious infection, severe liver problems, pregnancy, and additional caution when no suitable alternative exists for older adults or people with cardiovascular or cancer risk. It does not calculate personal risk, establish reimbursement, or supply a vitiligo regimen.
What it does not support
The product-information document linked from this page was dated before the July 24, 2026 vitiligo authorization decision and must not be treated as the source of the new vitiligo indication.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- 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 current US labeling but not independent efficacy evidence.
What this source supports
Supports the current US indications and boxed safety information.
What it does not support
Vitiligo is not among the current US indications. The label does not settle a pending application, establish approval elsewhere or create a vitiligo treatment plan.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
Litfulo (ritlecitinib): current US prescribing information and Medication Guide (opens in a new tab)
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 current US labeling but not independent efficacy evidence.
What this source supports
Supports Litfulo identity, its current US severe-alopecia indication, boxed warnings, contraindication and other label safety boundaries. Vitiligo is not among the current US indications. Also supports the recommended dosage for the approved indication: 50 mg orally once daily, with or without food, with no loading dose or titration.
What it does not support
The alopecia label does not establish a vitiligo indication, vitiligo-specific event rates, individual suitability, coverage, a vitiligo regimen or approval in another jurisdiction.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- 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
Supports the approved indication and product-specific local and systemic corticosteroid warnings for this ointment.
What it does not support
It is one current US product label, not a vitiligo indication, a class-wide substitute for every corticosteroid label or independent evidence of vitiligo benefit. Its Dosage and Administration section supports discontinuing once control is achieved and reassessing the diagnosis if no improvement is seen within 2 weeks; its Patient Counseling section notes pediatric safety and effectiveness beyond 3 weeks of use is not known. It is one currently marketed product listed under its generic chemical name, not a brand-name label.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
Protopic (tacrolimus) ointment: US prescribing information and Medication Guide (opens in a new tab)
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.
- 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
Supports the US atopic-dermatitis indication, boxed warning, application-site effects, long-term-use precaution and instructions to avoid ultraviolet treatment and minimize natural or artificial sunlight. This label itself is a generic pimecrolimus cream filing (packager Oceanside Pharmaceuticals, a division of Bausch Health US, LLC), not the original brand Elidel label, so it also supports that a generic pimecrolimus cream is currently marketed. Its Dosage and Administration section supports applying a thin layer twice daily and re-examining the patient if signs and symptoms persist beyond six weeks; its boxed warning separately supports that continuous long-term use should be avoided. Its adult 1-year active-comparator adverse-reaction table (328 pimecrolimus-treated subjects) supports application-site burning in about 25.9%, headache in about 25.4%, nasopharyngitis in about 7.6%, and influenza in about 9.8% of that adult trial population.
What it does not support
It does not approve pimecrolimus 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, and its adult adverse-reaction percentages, are stated for its approved atopic-dermatitis indication and trial population, not as a vitiligo-specific schedule or vitiligo-trial safety rate.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- 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 vitiligo evidence.
What this source supports
Supports the psoriasis indication, 0.005% cream strength, current tube presentations, local irritation and dermatitis reports, the instruction not to use the cream on the face, contraindications for hypercalcemia or vitamin D toxicity, and calcium-related and ultraviolet precautions. Its Dosage and Administration section supports applying a thin layer twice daily, and that the label’s own safety and efficacy data cover an 8-week psoriasis treatment period. It supports that the label advises patients to avoid excessive natural or artificial sunlight and separately tells physicians they may wish to limit or avoid phototherapy in patients using this product. Its clinical-trial adverse-reaction data support skin irritation in about 10%-15% of patients (the most frequent reaction) and rash, itching, dermatitis, or worsening of psoriasis in about 1%-10%; post-approval reports separately support contact dermatitis, including allergic contact dermatitis.
What it does not support
It does not approve calcipotriene for vitiligo, establish vitiligo benefit, support a self-directed combination, or state a vitiligo-specific frequency, duration, or adverse-reaction rate. Its 8-week duration and adverse-reaction percentages are from psoriasis clinical trials, not a vitiligo population.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- DailyMed, U.S. National Library of MedicineRegulatory · Regulatory / guideline, tier 1Independence not established
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports the defined US nonsegmental-vitiligo indication, limitations of use, boxed warnings, skin-cancer and ultraviolet precautions, and clinical-study labeling.
What it does not support
It also supports the labeled dosing instruction: "Apply a thin layer of OPZELURA topically twice daily to affected areas of up to 10% body surface area." It further supports the labeled re-evaluation point: "If the patient does not find the repigmentation meaningful by 24 weeks, the patient should be re-evaluated by the healthcare provider." It also supports the vitiligo-trial adverse-reaction rates at 1% incidence or greater: application-site acne 6%, application-site itching 5%, a common-cold-type illness (nasopharyngitis) 4%, headache 4%, urinary tract infection 2%, application-site redness (erythema) 2%, and fever (pyrexia) 1%. It does not guarantee benefit, establish suitability beyond the labeled population, authorize adding phototherapy, or state which reaction should prompt a call to the prescriber beyond directing patients to the Medication Guide and their healthcare provider.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- U.S. Food and Drug AdministrationRegulatory · Regulatory / guideline, tier 1Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports FDA authorization of this device for repigmentation of stable depigmented vitiligo lesions in a defined adult population and trained professional setting.
What it does not support
It does not approve every grafting procedure, define stability for a reader or guarantee color match, durability or satisfaction.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- British Journal of Dermatology (Thomas KS, et al.)Randomized trial · Clinical research, tier 2Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports a group-level benefit for the exact supervised topical-corticosteroid and home handheld-light combination studied in active limited vitiligo, alongside minority success, reactions and limited maintenance after treatment ended.
What it does not support
It does not create a general home plan, support other product-device combinations or predict an individual result. The topical-corticosteroid-alone arm used mometasone furoate 0.1% ointment, applied once daily on alternating weeks for up to 9 months. It supports 17% (20/119) reaching participant-reported treatment success at 9 months, and 3% (4/115) reaching the trial’s stricter blinded-assessed ≥75% repigmentation at 9 months. Skin thinning was reported in 2.5% (13/517) of participants across all trial groups, including one on placebo ointment. Over 40% of participants across all groups reported loss of treatment response by 21 months. It supports that participant-reported treatment success at 9 months was lower for patches on the hands and feet than on other body regions, without publishing an exact per-region percentage in its main results tables. The trial randomized 517 adults and children, aged over 5, with nonsegmental vitiligo covering about 10% or less of body surface area and at least one patch active in the prior 12 months, across 16 UK hospitals.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- 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.
- 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.
- JAMA Dermatology (Ju HJ, et al.)Systematic review · Clinical research, tier 2Independence not established
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports that multiple surgical techniques have been studied for selected stable vitiligo and that reported response and adverse effects vary by method and study.
What it does not support
Much of the evidence is nonrandomized and an author reported industry relationships; the review does not determine stability, eligibility, color match, durability or individual outcome.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- U.S. Food and Drug AdministrationRegulatory · 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 product company authored the prescribing information hosted by FDA. It is authoritative for the historical label but not independent clinical evidence.
What this source supports
Supports the historical US indication for final depigmentation in extensive disseminated idiopathic vitiligo, the purpose and mechanism limits, permanence and distant-depigmentation warnings, listed reactions, contraindication boundary, and long-term unknowns. Re-read in full on 2026-08-21 for what it states about sun, which is in three places. Under Precautions, General, it states that following therapy with the cream the skin will be sensitive for the rest of the patient’s life, and that the person must use sunscreens during exposure to the sun. Under Clinical Pharmacology it states that exposure to sunlight reduces the depigmenting effect of the drug. The same section states that the histology of the skin after depigmentation with topical monobenzone is the same as that seen in vitiligo, the epidermis being normal except for the absence of identifiable melanocytes. Under Dosage and Administration it states that prolonged exposure to sunlight should be avoided during treatment, or that a sunscreen should be used. Under Carcinogenesis, mutagenesis, impairment of fertility it states that no long term studies have been performed to evaluate carcinogenic potential.
What it does not support
The archived label does not establish current commercial availability, approval of a compounded preparation, predictable uniform results, suitability, a personal plan, or current status outside the US. Its sun statements are the label instructing a patient under a prescriber; SteadySkin reports them as the label’s wording and issues none of them as advice. It sets no sun protection factor, no interval and no exposure limit, and it measures nothing about how depigmented skin behaves in sunlight beyond the sensitivity statement itself. Because it performed no long term carcinogenicity study, it establishes nothing about skin cancer risk after depigmentation in either direction. The document carries a printed revision of August 2000 and an FDA banner stating it may not be the latest approved label, so it is used only for what it plainly states and never as current guidance.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- U.S. Food and Drug AdministrationRegulatory · Regulatory / guideline, tier 1Relevant relationship disclosed
- Published
- SteadySkin last checked
What this source can and cannot tell you
Why the independence label says this: FDA hosts the approved instructions supplied by the device manufacturer. They control product use but are not independent comparative evidence.
What this source supports
Supports the trained-professional setting, donor-skin processing, ablative-laser surface preparation, contraindications, warnings, aftercare responsibilities, and body-site and population limitations in the approved US instructions.
What it does not support
The instructions do not select a patient, center, lesion, laser, aftercare plan, or predict response, color match, recovery, or coverage.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- Journal of the European Academy of Dermatology and VenereologyGuideline · 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 journal is the publisher. This label refers to extensive author relationships disclosed for the recommendation, not to the journal itself.
What this source supports
It supports current expert-consensus terminology, clinical assessment, disease-activity evaluation, treatment-goal discussion, and shared decision-making. Its modified assessment check list names where the patches are as a disease feature, and gives genital involvement as its own example. It records white hairs as an item of its own, apart from what the vitiligo has done in the past six months. Its classification table keeps mucosal vitiligo as a subtype, both across more than one site and at one site alone. It supports planning care around what is there to work with, and its example is hair that still has its color. It names stable vitiligo and active vitiligo as two different states that change the care plan. Its shared-decision steps ask what the patient wants from care. At the time it was written, one cream form of a newer drug type had just been approved. Pill forms of that same drug type were still being studied.
What it does not support
It is not independent comparative proof. It cannot diagnose a reader from a description or photograph. It gives no figure for genital involvement, and it does not name lichen sclerosus. It does not set out the Vitiligo European Task Force grading scale. It puts no figure on white hairs and predicts nothing for one person.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- 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.
- 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.
- British Association of DermatologistsPatient education · Patient education, tier 5Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
It supports a plain-language explanation that NB-UVB uses a small part of the UVB spectrum, is used for conditions including psoriasis, eczema, and vitiligo, and is distinct from sunlight or a sunbed. It also supports what a unit asks of its own patients during a course. It asks them not to sunbathe or use a sunbed for the whole of it, and to reduce sun exposure so that skin does not burn. It asks them to report a medicine, a cream, or newly exposed skin such as a haircut. It asks them to arrive without perfume, deodorant, aftershave or other cosmetics, because some of those raise light sensitivity and can leave patchy discolouration for months. It carries the unit’s own account of repeated courses. It states that the full risk of narrowband UVB is not known, and that roughly one in ten people in the UK develop skin cancer. It states that a review becomes usual practice past a stated number of treatments, and that many treatments can bring the wrinkling and discolouration of photoageing.
What it does not support
It is patient education, not primary evidence for an efficacy claim. Its printed next review date was June 2025 and it has not been updated since June 2022. It is therefore used only for what it plainly states, and never as current guidance. It is written for a UK hospital unit whose nurses examine skin at every visit, so it sets no rule for a device used at home. Its numbers stay in this record rather than in the copy. Those are the sun protection factor and star rating it names, the hours it names, the treatment count that triggers a review, and the multiple by which it estimates lifetime risk. That multiple is stated there as an assumption that narrowband UVB behaves like sunlight, not as a measurement.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.