A combination of medicines that exerts potent antioxidant activity is used to achieve better outcomes. Sometimes these are used alone or in a variety of other systemic medications. These are much safer options, but they are most effective as adjuncts.
As described earlier, autoimmunity plays a significant role in vitiligo. However, it is not the cause. Its effect and plays a vital role in cell destruction. One needs immunosuppression in actively growing vitiligo. The treatment is insignificant compared to different autoimmune disorders. Mainly oral steroids in pulsed dose (weekends) and methotrexate in very least amount (weekly once) either given mutually or alone. The dose term depends on the age, associated conditions, kind of vitiligo, the severity of vitiligo, and other patient-related reasons. It is not just in all cases. The decision was taken on a case-to-case basis. Proper explanation and guidance are given. Usually, the duration required is six months to 9 months. Conditions like autoimmune thyroiditis require a more extended period of treatment. Most patients have minimal, temporary, and reversible side effects if they follow precisely the directions given.
These medicines either work individually or with immunosuppression. They are much safer options. In extreme ages, we depend only on these. However, in severe cases, they need to be combined with immunosuppression. These are continued for a long time even after the patient recovers from vitiligo.
A multivitamin and multi-mineral pill is used in combination with other medicines. They work only as adjuncts. They play a significant role in the early maintenance period.