Vitiligo patients may desire laser hair removal, skin rejuvenation, vascular treatments and other laser or Intense Pulsed Light (IPL) assisted treatments. However, there is a risk of inducing new vitiligo patches (Koebner phenomenon). In absence of guidelines on the safe use of laser or IPL in vitiligo patients, dermatologists tend to be reluctant to administer these treatments. The aim of this survey study was to provide an estimation of the occurrence and related risk factors of laser/IPL-induced vitiligo. A cross-sectional survey study was performed among 15 vitiligo experts from 11 countries, with 14 questions about affected patients, involved laser/IPL treatments and the physicians’ approach. In a total of 10670 vitiligo patients, laser/IPL-induced vitiligo was reported in 30 patients (0,0027%). Of these, 12 (40%) patients had a medical history of vitiligo and seven (58%) of these patients had stable (>12 months) vitiligo before the treatment. Most frequently reported were hair removal procedures and localization of the face and legs. Side effects like blistering, crusting and erosions occurred in 56,7% of the cases. These vitiligo experts based their advice on the risk of the laser treatment on stability of the vitiligo (43%) and activity signs (50%), and 50% discuss the risks before starting a laser treatment. Relevant activity signs are the Koebner phenomenon (57,1%), confetti like lesions (57,1%) and hypochromic borders (50%). Laser-induced vitiligo is an uncommon phenomenon. Remarkably, a minority had a medical history of vitiligo of which 58% were stable. Consequently, most cases could not have been prevented by not treating vitiligo patients. However, a majority had laser/IPL-induced skin damage. Therefore caution is advised with aggressive settings and test-spots prior to the treatment are recommended. This study showed significant variation in the current recommendations and approach of vitiligo experts regarding laser/IPL-induced vitiligo.

Background
Vitiligo patients may desire laser hair removal, skin rejuvenation, vascular treatments and other laser or Intense Pulsed Light (IPL) assisted treatments. However, there is a risk of inducing new vitiligo patches (Koebner phenomenon). In absence of guidelines on the safe use of laser or IPL in vitiligo patients, dermatologists tend to be reluctant to administer these treatments. 

Objectives
The aim of this survey study was to provide an estimation of the occurrence and related risk factors of laser/IPL-induced vitiligo. 

Methods
A cross-sectional survey study was performed among 15 vitiligo experts from 11 countries, with 14 questions about affected patients, involved laser/IPL treatments and the physicians’ approach. 

Results
In a total of 10670 vitiligo patients, laser/IPL-induced vitiligo was reported in 30 patients (0,0027%). Of these, 12 (40%) patients had a medical history of vitiligo and seven (58%) of these patients had stable (>12 months) vitiligo before the treatment. Most frequently reported were hair removal procedures and localization of the face and legs. Side effects like blistering, crusting and erosions occurred in 56,7% of the cases. These vitiligo experts based their advice on the risk of the laser treatment on stability of the vitiligo (43%) and activity signs (50%), and 50% discuss the risks before starting a laser treatment. Relevant activity signs are the Koebner phenomenon (57,1%), confetti like lesions (57,1%) and hypochromic borders (50%).

Discussion
Laser-induced vitiligo is an uncommon phenomenon. Remarkably, a minority had a medical history of vitiligo of which 58% were stable. Consequently, most cases could not have been prevented by not treating vitiligo patients. However, a majority had laser/IPL-induced skin damage. Therefore caution is advised with aggressive settings and test-spots prior to the treatment are recommended. This study showed significant variation in the current recommendations and approach of vitiligo experts regarding laser/IPL-induced vitiligo.

ESDR543 - Expert opinion about laser and Intense Pulsed Light induced vitiligo: a cross-sectional survey study

The scientific meeting of the European Society for Dermatological Research (ESDR) is held yearly, usually in September. With an international attendance of more than 1000 skin scientists from around the globe, the four-day event includes short oral presentations from peer-reviewed abstracts, keynote lectures from international experts, sponsored symposia, satellite programs, educational events as well as an important focus on posters, networking and building collaborations amongst scientists. For more information about this year’s meeting visit our website.