Exploring How Healthcare Professionals Diagnose and Manage Vitiligo: Global VALIANT Study Findings and Recommendations

Vitiligo is a chronic autoimmune disease characterized by progressive skin depigmentation. Many patients experience delayed diagnosis, which can prolong associated psychosocial burden. This study explored vitiligo diagnostic and management approaches among healthcare professionals (HCPs) who regularly treat patients with vitiligo. The cross-sectional, multinational Vitiligo and Life Impact Among International Communities (VALIANT) survey recruited HCPs practicing in dermatology, primary medicine, or internal medicine and assessed how they diagnose and treat vitiligo. Among 1203 HCPs who completed the survey, most were dermatologists (91.4% versus primary care physicians [PCPs], 8.6%). In total, 62.3% (749/1203) of HCPs self-reported being vitiligo specialists and rarely or never made referrals; most nonspecialist HCPs (82.2% [373/454]) also attempted treating patients before referring them to vitiligo specialists. Although most HCPs diagnosed vitiligo by examining lesions (74.1% [892/1203]), less than half used Wood’s lamp (42.3% [509/1203]) to support examination. HCPs most commonly prescribed topical therapies (91.4% [1099/1203]); light, laser, or phototherapy (65.7% [790/1203]); and oral medications (53.8% [647/1203]). Among HCPs who reported prescribing topical, light, and oral treatments at least sometimes, 14.4%, 9.6%, and 4.4%, respectively, waited > 6 months to determine treatment outcome, whereas 45.5%, 49.8%, and 69.9% waited ≤ 3 months. More than half of HCPs (60.8% [731/1203]) also reported advising patients to take a drug holiday from vitiligo treatment, most commonly due to lack of treatment response (32.5% [316/972]). Findings underscore the need for continued education of HCPs regarding vitiligo management, supplemented with rapid referral or consultation with vitiligo specialists for optimal care. The authors highlight that timely diagnosis and treatment are essential in vitiligo management; Wood’s lamp may be a useful tool to support vitiligo diagnosis and monitoring, although its value may vary by patient skin type. Furthermore, because repigmentation is a lengthy process, prolonged treatment for at least 6 months is essential to support optimal outcomes. Vitiligo is a condition that causes the skin to form white patches. People living with vitiligo often experience delays before getting an accurate diagnosis, which can worsen the impact on their mental health. The VALIANT study was a global survey of healthcare professionals who treat people with vitiligo. This analysis explored how healthcare professionals diagnose and treat their patients. Results presented here include responses from 1203 healthcare professionals. Most healthcare professionals completing the survey specialized in skin diseases, and many considered themselves vitiligo specialists. However, the survey responses highlighted several areas where patient care could be further improved. First, nearly all nonspecialist healthcare professionals attempted treating patients before referring them to a vitiligo specialist. Second, fewer than half of healthcare professionals used a Wood’s lamp to support examination. Wood’s lamp can help healthcare professionals assess pigment changes, disease activity, and early repigmentation, especially in people with fairer skin. Third, healthcare professionals were often too quick to stop or change treatments. Regaining skin pigmentation can often take more than 6 months; however, fewer than 2 in 10 healthcare professionals waited this long before deciding if a treatment was working, and more than half advised patients to take a break from treatment rather than treating continuously. Educating healthcare professionals on the importance of working with vitiligo specialists and the usefulness of Wood’s lamp in diagnosis and monitoring, as well as strategies for treating vitiligo and the need for long-term continuous treatment, will be important to support repigmentation for people with vitiligo.