New vitiligo treatment could be offered on the NHS

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Wednesday 8th March 2023

A controversial new treatment for vitiligo could be offered on the NHS. Ruxolitinib, a skin cream, could be available on the NHS if UK regulatory bodies approve it. 

Vitiligo is a skin condition, which causes patches of the skin to become whiter. It affects all ethnicities but is most noticeable in people with darker skin due to the contrast between lighter and darker skin. It is thought that vitiligo is an autoimmune condition. This means that the body’s immune system, its defence mechanism, attacks healthy cells. In this case, it affects the cells (melanocytes) that produce the skin’s protective pigment, melanin. The lighter skin patches are more vulnerable to sun damage.

Ruxolitinib, which will be sold under the brand name Opzelura, has been hailed by some as a miracle treatment but it is controversial. It can restore the natural colour of the skin and eliminate lightened patches but it also causes side effects, including increased susceptibility to infections and illness due to its impact on the immune system.

During drug trials, some people reported additional side effects, including skin redness and acne but the cream did achieve impressive results. Around 50% of people who used the treatment twice a day reported a noticeable improvement while over 15% experienced total skin repigmentation within 3 months. The results were best among people who have nonsegmental vitiligo, which is the most common form of the condition. This type causes patches of whiter skin to form on both sides of the body. 

The treatment has already been approved for use in the US where a single tube costs $2,000 (approximately £1,650). European regulators are currently reviewing the drug and are expected to approve it in the coming weeks for patients over the age of 12. Vitiligo is not infectious and it cannot spread to others but it can have a significant impact on mental well-being and confidence. Some people who have vitiligo are more prone to low self-esteem and depression and they may feel anxious when meeting new people or attending events or social occasions.

Dr Viktoria Eleftheriadou, from the British Association of Dermatologists, explained that vitiligo can also cause some individuals to feel like they have lost a sense of their identity, particularly in terms of their race and ethnicity. Offering people the option to have treatment would be beneficial, she added. 

Vitiligo has become a talking point in recent years due to the rise to fame of supermodel, Winnie Harlow. As a child, she said that she actively tried to hide her skin and felt incredibly isolated and lonely but in her adult life, she has learned to embrace her looks and realised that her skin makes her unique. She has featured in a string of high-profile modelling campaigns working for designers and brands including Nike, Puma, Desigual, Tommy Hilfiger, Fendi, Marc Jacobs and Diesel. She now believes that her skin has become a superpower, which sets her apart. 

Although Winnie Harlow’s success has played a positive role in raising awareness of vitiligo and helping some people to feel more confident, not everyone can embrace the condition, according to the founder of Vitiligo Support UK, Emma Rush. Emma said that for many people, vitiligo is hugely debilitating and it holds them back. It’s possible to use makeup to try to hide patches of white skin but many people feel like they can’t walk around and feel confident without trying to hide their skin. Emma added that a physical alteration in the skin doesn’t just affect the way you look or how you feel in terms of confidence. It also leads to people making assumptions about your background and heritage and it can cause some individuals to feel like they have lost a part of their identity. Emma believes that having access to an effective treatment would make a huge difference to those who struggle with the effects of the condition.

There are treatment options available for vitiligo, including phototherapy, topical corticosteroids and drugs, such as tacrolimus but the results vary and in many cases, they are limited. Some solutions work better for some people than others and some treatments, including steroids, cause significant side effects. The UK regulator, the MRHA, will decide whether or not to approve the drug before it is considered by NICE (National Institute for Health and Care Excellence). NICE is responsible for determining whether or not the drug should be made available on the NHS.