Laser for vitiligo: the 308 nm excimer
The laser used for vitiligo is the 308 nm excimer. It is the same ultraviolet idea as phototherapy, delivered as a beam aimed only at the patch. That precision buys higher doses and faster results on small areas, makes it the wrong tool for widespread disease, and is priced per session by the area treated.
At a glance
- The laser
- 308 nm excimer: targeted ultraviolet B
- Suits
- A few small patches, especially facial
- Frequency
- 2 sessions a week; 24–48 in a course
- First signs
- Often by 8–12 sessions on the face
- Cost
- Per session, by area; quoted after examination
- Not for
- Widespread or unstable disease
Precision, and what precision buys.
Laser treatment for vitiligo means the excimer, a 308 nm ultraviolet B source delivered through a handpiece. Narrowband UVB treats the whole body, which means the dose is limited by what your normal skin can tolerate. The excimer treats only the patch, so the dose can be pushed considerably higher without burning the skin around it.
Two practical consequences follow. Results generally come faster. Facial patches often show the first pigment within eight to twelve sessions rather than three months. And the normal skin is not tanned, so the contrast problem that makes early phototherapy look discouraging largely disappears.
The trade is coverage. Treating a large surface patch by patch is slow and expensive, which is why excimer is chosen for a handful of stubborn areas and narrowband UVB for anything widespread. Many patients have both. Full-body light for the general disease, excimer for the two patches that won’t shift.
Who is treating you, and what his patients said.
Dr. (Lt Col) Khagendra Varada
- 45 years in dermatology and dermatosurgery
- 25 of them in the Indian Army Medical Corps
- MBBS, Osmania Medical College
- Dip. Practical Dermatology, Cardiff · Dip. Dermatology, AAAM
Reg. No. 10461, Hyderabad State Medical Council
Full background →“I have been going pillar to post to get my son cured of his white spot on his left side of lip and chin. It appeared 8 years back. I was told it’s special type of nerve vitiligo which has no cure. After reporting to him he told us that it is SEGMENTAL VITILIGO and unlikely and difficult to be cleared by medications alone. He suggested for surgical melanocyte transplant… I was amazed after around one month that he started rapidly getting pigmentation. I wholeheartedly suggest please do not waste time like I did.”
“Dark spots are seen in one month… Even before perticular treatment for vitiligo, great”
A beam, or a room.
Both use ultraviolet light to stimulate pigment cells. The difference is what else gets treated. A targeted handpiece doses one patch at a higher intensity; a cabinet doses everything at once.
- 1
- 2
- 3
- 4
- 1Skin beside it is spared
- 2One patch, one beam
- 3The whole body at once
- 4Normal skin too
Targeted light suits a few small patches and spares the normal skin between them. Once the disease is widespread, treating each patch separately stops being practical and the cabinet is the sensible tool.
- Skin beside it is spared
- One patch, one beam
- The whole body at once
- Normal skin too
Illustration, not a photograph.
Excimer or NB-UVB?
| Excimer laser | Narrowband UVB | |
|---|---|---|
| Area treated | Individual patches only | Whole body or large regions |
| Dose per session | Higher: normal skin spared | Limited by normal skin |
| First visible change | Often 8–12 sessions | Usually 2–3 months |
| Normal skin tanning | Minimal | Expected |
| Best for | Few, small, localised patches | Widespread disease |
| Cost per session | Higher | Lower |
| Cost per course | Depends on area treated | Predictable |
These are not competitors. On a patient with scattered disease plus two stubborn facial patches, using both is the correct answer.
What treatment involves
A test dose
The first session establishes how your skin responds. Everything after is titrated against that.
Twice a week
Sessions are short: the beam is applied patch by patch, often only seconds each. Most appointments take minutes.
Reviewed at 12 sessions
Facial patches showing perifollicular dots by then are on track. No change at all after 20 sessions is a reason to reconsider.
Stop or hand over
Once the patch has recoloured, treatment stops. Patches that do not respond are assessed for grafting instead.
Where excimer will not help.
Excimer is light, and light works by recruiting pigment cells from hair follicles. Where that reservoir is gone, more light, however precisely aimed, does not create it.
Patches with white hairs, lips, and fingertips remain poor responders with excimer just as they are with narrowband UVB. Being told that at the start saves twenty sessions of finding out.
What works on those sitesWhite hairs in the patch
The follicular reservoir is depleted. Surgery is the option that brings pigment cells from elsewhere.
Active disease
Spreading vitiligo is quietened first. Repigmenting one patch while three more appear is not progress.
Excimer laser questions
Which laser is used for vitiligo?
The 308 nm excimer, a targeted ultraviolet B source. Lasers that remove hair, pigment or tattoos work by destroying something; the excimer does the opposite, stimulating the pigment cells that survive in hair follicles. No laser removes vitiligo, and no laser cures it; this one repigments patches that still have a reservoir to draw on.
How much does laser treatment for vitiligo cost?
It is charged per session, and the session price depends on the area treated, so the figure is quoted after examination rather than published. What can be said in advance is the structure: two sessions a week, a course of 24 to 48, and a review at twelve sessions at which a non-responding patch is taken off the laser rather than billed for twenty more.
Is laser better than skin grafting for vitiligo?
They answer different patches. Laser works where the hairs inside the patch are still dark, because those follicles hold the pigment cells it recruits. Where the hairs are white, or on the lips and fingertips, grafting is the realistic option and the laser is not.
How many excimer sessions are needed?
Typically 24 to 48, at two sessions a week. Facial patches often need fewer; patches on the limbs need more, and some need to be reassessed for surgery instead.
Is excimer better than phototherapy?
Not better. Different. Excimer is faster and more precise for a few small patches. Narrowband UVB is the right choice for widespread disease. For many patients the correct plan uses both.
Does excimer laser hurt?
Very little. Most patients describe warmth. Mild pinkness for a day afterwards is the intended response; blistering means the dose was too high and is adjusted.
Can excimer treat lips or fingertips?
It can be aimed there, but response is poor because those sites have little or no follicular pigment reserve. Grafting is usually the more realistic option.
Is it safe for children?
Yes, and its precision is an advantage in children because total-body ultraviolet exposure is avoided. Cooperation with goggles is the practical limiting factor.
The clinical statements on this page follow the guidance and evidence below. They are independent sources. None of them is connected to this clinic, and none of them sells the treatments described here.
- Vitiligo: diagnosis and treatmentAmerican Academy of Dermatology
- PhototherapyDermNet (New Zealand Dermatological Society)
- VitiligoDermNet (New Zealand Dermatological Society)
- VitiligoNHS (United Kingdom)
Related on this site
The first appointment is a diagnosis.
Not a treatment plan sold on the spot. Message the clinic and bring your history.