Combination of fractional carbon dioxide laser with narrow band ultraviolet B to induce repigmentation in stable vitiligo: A comparative study

Background Despite the numerous treatment modalities available for vitiligo, responses to treatment are still unsatisfactory. For this reason, new treatment modalities and approaches are needed. Objective To evaluate the efficacy and safety of fractional carbon dioxide (CO2) laser therapy followed by narrow band ultraviolet-B (NB-UVB) phototherapy on stable resistant vitiligo. Subjects and methods Thirty-two patients with stable bilateral vitiligo were enrolled. For each patient, one side of the body was treated with NB-UVB in addition to two sessions of fractional CO2 laser performed at 2-months interval (laser side), while the other side was treated with NB-UVB alone (control side). NB-UVB was administrated twice weekly for 4 months. Outcomes were evaluated objectively based on standard digital photographs, patient satisfaction, and adverse effects. Results There was statistically significant improvement in the repigmentation in laser side compared to control side. Noticeable adverse events, such as infection, scarring, and Koebner phenomenon were not found in any patient. Conclusions Fractional CO2 laser therapy combined with NB-UVB phototherapy could be used effectively and safely as an alternative modality for the treatment of vitiligo. It shortens the duration of NB-UVB therapy and is expected to increase patient compliance