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Medical dermatology

Vitiligo

Loss of skin pigment in patches — our dermatologists offer the latest treatments including Opzelura (ruxolitinib), phototherapy, and repigmentation therapy.

Types of Vitiligo

  • Nonsegmental (generalized): most common; symmetric patches that can spread over time
  • Segmental: unilateral, follows a dermatomal pattern, often stable; responds less to medical therapy but well to surgical grafting

Active vs. Stable Vitiligo

Active vitiligo spreads; stable vitiligo has not changed in 1–2 years. Stability is important for surgical candidacy.

Treatment Options

Medical

  • Ruxolitinib cream (Opzelura) — JAK1/JAK2 inhibitor; FDA-approved 2022; first-line for facial and body vitiligo in patients ≥ 12 years
  • Narrowband UVB phototherapy — highly effective; requires consistent sessions
  • Topical corticosteroids / calcineurin inhibitors — adjunct therapy for limited areas

Surgical

  • Suction blister grafting and punch grafting — for stable segmental or focal vitiligo
  • Melanocyte-keratinocyte transplantation — advanced option at select centers

Camouflage

  • Self-tanning products (DHA-based), medical cosmetic cover-up for quality-of-life support

Emotional & Psychological Impact

Vitiligo significantly impacts quality of life, especially in patients with darker skin tones. Holistic care including dermatology and mental health support is recommended.

Frequently asked questions

Is Opzelura (ruxolitinib) cream covered by insurance for vitiligo?
Coverage varies by plan. Opzelura received FDA approval for vitiligo in 2022 and many commercial insurers cover it with prior authorization. Our staff can assist with insurance appeals and patient assistance programs.
Can vitiligo spread to cover the whole body?
In some patients, vitiligo progresses to involve large body surface areas (universal vitiligo). However, progression is unpredictable — some patients stabilize with minimal spread, especially with treatment.

Most insurance plans cover medical dermatology procedures. Contact us to verify your benefits.

This page is educational. Specific treatment decisions are made during your visit with Dr. Puyana.

Before & After

Real patient results from Miami Skin Center.

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