Segmental vitiligo (SV) is a chronic skin condition marked by localized loss of pigmentation, typically appearing on one side of the body. It is often associated with abnormal cutaneous microcirculation and disrupted sympathetic nervous system function. Despite ongoing research, therapeutic options for stable SV remain limited. In this context, low-energy laser therapy has emerged as a potentially effective strategy for restoring pigmentation and improving local blood flow.
The He-Ne Laser Intervention
In this clinical study, 40 patients with stable SV on the head and/or neck received treatment with a continuous-wave helium-neon (He-Ne) laser. The intervention was performed point-by-point using the OMNIPROBETM Laser Biostimulation System, delivering 3.0 J/cm² per treatment point, one to two times per week. No additional therapies were used during the study period. In a subgroup of six patients, laser Doppler fluxometry and iontophoresis with phenylephrine, clonidine, and propranolol were used to assess cutaneous microcirculation and sympathetic adrenergic responses.
Encouraging Outcomes
Initial repigmentation was observed after approximately 17 treatment sessions. Around 60% of patients achieved significant repigmentation (>50%), and three patients (7.5%) reached complete repigmentation after about 20 sessions. Repigmentation patterns included perilesional and perifollicular areas, with no noticeable hyperpigmentation, and newly pigmented skin matched the surrounding normal tone.
Importantly, the elevated blood flow seen in SV lesions prior to treatment normalized after laser therapy, aligning with the levels found in healthy skin. Furthermore, the impaired vasoconstrictive response to clonidine was restored post-treatment, indicating partial recovery of sympathetic nerve function in the affected skin.
Authors’ Conclusions
The authors interpret these findings as evidence that He-Ne laser therapy can effectively promote repigmentation in segmental vitiligo lesions. They suggest that the treatment supports microvascular repair and enhances local blood flow, creating an environment conducive to melanocyte repopulation. The proposed mechanisms include the stimulation of key growth factors—such as bFGF and NGF—by keratinocytes. While promising, the authors note that ongoing maintenance treatments may be necessary to sustain repigmentation, likely due to the incomplete restoration of sympathetic function. They advocate for future randomized controlled trials to validate the effectiveness and practical applicability of this therapeutic approach.
Reference: Wu CS, Hu SC, Lan CC, Chen GS, Chuo WH, Yu HS. Low-energy helium-neon laser therapy induces repigmentation and improves the abnormalities of cutaneous microcirculation in segmental-type vitiligo lesions. Kaohsiung J Med Sci. 2008 Apr;24(4):180-9. doi: 10.1016/S1607-551X(08)70115-3.