A comparative study of topical travoprost 0.004% ophthalmic solution alone and in combination with 308 nm excimer light and fractional carbon dioxide laser in the treatment of resistant vitiligo patches

Background The treatment of vitiligo remains challenging. Prostaglandin F2 alpha analogs have emerged as a promising treatment option for vitiligo. Bimatoprost and latanoprost have shown efficacy in previous studies. However, the research on travoprost remains limited. Objectives This research aimed to compare the safety and efficacy of topical travoprost 0.004% ophthalmic solution alone and in combination with either 308 nm excimer light, fractional CO 2 laser, or both in treating vitiligo patches in patients with generalized nonsegmental vitiligo refractory to phototherapy. Patients and methods Twenty-six patients complaining of generalized nonsegmental vitiligo refractory to phototherapy completed the study. Four vitiligo patches were randomly chosen in each patient and assigned to one of the following treatment groups: (1) topical travoprost 0.004% ophthalmic solution alone, (2) topical travoprost combined with 308 nm excimer light, (3) topical travoprost combined with fractional CO 2 laser, or (4) a combination of the three treatment modalities. The changes in the surface area, Vitiligo Area Scoring Index (VASI score), dermoscopic features, and immunohistochemical analysis using Melan A were assessed. Results The excimer light and travoprost group showed the highest mean percentage of reduction in surface area and VASI score, followed by the triple combination group. Combining fractional CO 2 laser and travoprost was associated with an increase in the mean surface area and the mean VASI score of vitiligo lesions. Conclusion Combining excimer light with topical travoprost presents a promising and safe therapeutic option for vitiligo lesions that are unresponsive to conventional phototherapy.