A comparative study of the mini-punch grafting and hair follicle transplantation in the treatment of refractory and stable vitiligo

Background: Some vitiligo lesions are resistant to all medical treatments. Objective: We sought to compare the efficacy of hair follicle transplantation and mini-punch grafting for the treatment of refractory vitiligo lesions. Methods: A total of 25 patients with stable and resistant vitiligo participated in the study. In each patient, a resistant vitiligo patch was divided into 2 equal parts. One part was treated with hair follicle transplantation and the other part with mini-punch grafting. Postsurgically, the recipient areas were exposed to narrowband ultraviolet B twice a week for 6 months. The diameter of the repigmentation around each graft was measured monthly. Results: At the end of the sixth month, 68% of follicle grafts, and 72% of mini-punch grafts, had repigmentation. The mean diameter of repigmentation around follicle grafts was 5 +/- 1.7 mm and around punch grafts was 5.3 +/- 1.6 mm. There was no significant difference between the 2 groups statistically (P = .18). Limitations: Small sample size and short time of follow-up are limitations. Conclusions: Because the results of the 2 methods are not statistically different and mini-punch grafting is much easier to do than follicular transplantation, we recommend mini-punch grafting to treat drug-resistant vitiligo.