Studies show that phosphodiesterase 4 inhibitor creams reduce vitiligo. Vitiligo, like gray hair, is a melanocyte pigmentation disorder. A drug that repigmentates vitiligo is expected to also work on white hair.
Repigmentation in a patient with vitiligo on crisaborole 2% ointment
Vitiligo is a common condition of autoimmune etiology resulting in skin depigmentation, which often causes psychological distress and reduced quality of life. Treatment options for vitiligo are limited. Phosphodiesterase type 4 (PDE4) is an intracellular enzyme, which is overactive in multiple inflammatory conditions, including vitiligo (Zaky et al, unpublished material). The oral PDE4 inhibitor apremilast is approved for psoriasis, psoriatic arthritis, and Behcet disease.1 In a recent case series, apremilast demonstrated some improvement in controlling the progression of vitiligo.2 Crisaborole is a topical PDE4 inhibitor approved for atopic dermatitis in patients aged 3 months or older. We present a patient with vitiligo treated with crisaborole 2% ointment, who demonstrated skin repigmentation and control of depigmentation progression.
