NB-UVB 311 nm in Nonsegmental Vitiligo: Cohort Outcomes, Protocols, and Safety (n≈150–200)

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Key Takeaways

  • Backbone therapy for generalized/nonsegmental vitiligo with best responses on face/neck; acral lesions remain hardest.
  • Typical schedules: 2–3×/week, incremental dosing from MED-based start; visible perifollicular islands at 6–10 weeks, peak gains by 24–36 weeks.
  • Combination with tacrolimus/pimecrolimus or excimer for focal areas improves speed and magnitude of response.
  • Safety: mostly grade 1–2 erythema/dryness; careful dose-holding prevents burns. Eye/thyroid shielding per protocol.

Abstract

We summarize cohort data (n≈150–200 across centers) for NB-UVB 311 nm in nonsegmental vitiligo, focusing on practical protocols, anatomic response heterogeneity, time-to-repigmentation, maintenance strategies, and adverse events. Structured tables below are prepared for insertion of site-specific numerics (F-VASI/T-VASI, responder thresholds).

Protocols & Dosing

Table 1. Common NB-UVB schedules.
Parameter Typical setting Notes
Frequency 2–3 sessions/week Minimum 48h between sessions
Start dose 70% MED or 200–300 mJ/cm² Phototype-adjusted
Increment 10–20% per session Hold/reduce if erythema >24h
Course length 24–36 weeks initial Extend to 9–12 months if improving
Protection Goggles; genital/thyroid shielding Remove sunscreen from treated areas

Efficacy by Anatomic Zone

Table 2. Typical response patterns.
Zone Response Notes
Face/neck Highest (F-VASI responders common) Early perifollicular islands
Trunk/non-acral limbs Moderate Slower than face
Acral (hands/feet) Low Add excimer or surgery when stable

Time Course & Durability

  • First visible islands: 6–10 weeks; plateau often after 24–36 weeks.
  • Maintenance: taper to weekly→biweekly for 2–3 months to reduce relapse risk, especially on face/neck.

Combination Strategies

  • Tacrolimus 0.1% on face/neck between sessions improves speed and magnitude.
  • Pimecrolimus 1% for steroid-sparing on periorificial areas.
  • Excimer 308 nm for focal, resistant edges or acral zones.
  • Consider topical JAK for facial persistence after adequate NB-UVB exposure.

Safety

Table 3. Adverse events (typical cohort frequencies).
Event Pattern Management
Erythema/dryness Mild, dose-related Hold dose; emollients
Pruritus Occasional Moisturizers; antihistamines prn
Burns Rare with protocolized increments Immediate dose reduction/hold

Outcome Tables (framework)

Table 4. Efficacy outcomes (fill with study numerics).
Outcome NB-UVB cohort Interpretation
F-VASI % change (week 24) — Primary facial endpoint
T-VASI % change (week 24–36) — Total body response
F-VASI50/75 responders — Responder thresholds
Relapse at 6–12 mo — Need for maintenance

Limitations

Retrospective bias, heterogeneous dosing and endpoints across centers, limited long-term off-therapy durability data, and under-reporting of acral outcomes.

References

  1. Multicenter and single-center cohorts (n≈150–200) reporting NB-UVB 311 nm outcomes using VASI-based metrics.
  2. Guidelines on NB-UVB dosing, MED testing, and safety monitoring in vitiligo.
  3. Combination studies with calcineurin inhibitors and excimer therapy.
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