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Vitiligo treatment, private in London.

Consultant-led vitiligo care in London: topical tacrolimus and pimecrolimus, MHRA-approved ruxolitinib (Opzelura), narrowband UVB, excimer laser, oral JAK inhibitors and, where stable, surgical repigmentation.

A stethoscope on a clinical desk

What vitiligo is

An autoimmune loss of pigment, not a cosmetic quirk.

Vitiligo is autoimmune destruction of melanocytes, producing depigmented patches. It affects around one percent of people worldwide, at any age and any skin tone.

Non-segmental vitiligo

The most common pattern. Symmetrical patches, often on the face, hands and around body openings, that can spread over years.

Segmental vitiligo

A single unilateral patch, usually appearing in childhood or young adulthood, that stabilises within twelve months and does not typically spread further.

Focal and mucosal

Isolated patches that have not yet declared themselves, or patches confined to the lips and genitalia. Treatment choices differ by site.

Vitiligo is associated with other autoimmune disease, particularly autoimmune thyroid disease, alopecia areata, pernicious anaemia and type 1 diabetes. A proper first assessment screens for these.

Assessment

A proper first appointment, not a five-minute glance.

The first hour with a consultant dermatologist should map every patch, quantify severity and screen for the autoimmune conditions vitiligo travels with.

  • Full skin examination

    Head to toe in good light, with photography for a baseline you can compare against at follow-up.

  • Wood’s lamp examination

    Ultraviolet light picks up subclinical patches and confirms the diagnosis, particularly on paler skin.

  • VASI scoring

    The Vitiligo Area Scoring Index gives a repeatable number to track response to treatment over time.

  • Thyroid function bloods

    TSH, free T4 and thyroid antibodies, because autoimmune thyroid disease is the commonest coexisting problem.

  • Autoimmune screen

    ANA, full blood count, vitamin B12 and, where relevant, coeliac and diabetes screening.

  • Impact and expectations

    An honest conversation about what treatment can achieve, over what timescale, and what it will cost.

Indicative pricing

What private vitiligo treatment costs in London.

Indicative ranges across UK private providers.

In short

Consultant assessment £250–£450, topicals from £30/month, ruxolitinib from £1,800/month.

Option Indicative range
Consultant dermatology assessment £250–£450
Topical tacrolimus or pimecrolimus £30–£80/month
Ruxolitinib (Opzelura) cream, private £1,800–£2,600/month
Narrowband UVB course (30–50 sessions) £900–£1,800
Excimer laser 308 nm (per session) £150–£280
Oral JAK inhibitor, specialist-initiated £1,500–£2,400/month
Melanocyte–keratinocyte transplant (per treatment) £3,500–£6,500

Prices vary by clinic, by the consultant’s seniority and by whether treatments are combined.

Who it suits

When private vitiligo care is worth it.

The patients who benefit most, and the honest reasons treatment is sometimes not advised.

  • Non-segmental vitiligo, still active

    New or spreading patches, or existing patches with unstable edges. Early treatment protects more melanocytes.

  • Segmental vitiligo, stable

    A unilateral patch that has not changed for at least a year. This group often responds well to grafting.

  • Focal patches on the face

    Facial and neck patches respond fastest to topicals, ruxolitinib and narrowband UVB, in that order.

  • You have an autoimmune history

    Thyroid disease, alopecia areata or type 1 diabetes alongside vitiligo. Both sides need testing and treating.

  • Willing to attend phototherapy

    UVB works when the schedule is kept. Two to three visits weekly for months is a real commitment.

  • Camouflage alongside medical care

    You want a proper medical plan and something practical for the interim, not just concealer or bleaching.

  • A named consultant, not a rotating list

    The person who assesses you should be the person who treats you and reviews you afterwards.

  • Red flag: seeking depigmentation of remaining skin

    Total depigmentation with monobenzone is irreversible and specialist-only. This decision needs very careful specialist handling.

Options

Topicals, ruxolitinib, UVB, laser, oral, surgery.

Each treatment adds something the last one cannot. A good consultant layers them.

  • Topical first-line

    Tacrolimus 0.1% ointment twice daily for face and flexures, off-label but standard. Pimecrolimus 1% for gentler sites. A potent topical steroid, cycled to avoid atrophy, on the trunk and limbs.

  • Ruxolitinib (Opzelura)

    Topical JAK1/2 inhibitor, MHRA and CE-marked for non-segmental vitiligo from age 12. TRuE-V trials showed roughly half of patients reached F-VASI75 on the face by 24 weeks. Private only for now.

  • Narrowband UVB

    The workhorse. 311 nm narrowband UVB, two to three times weekly for six to twenty-four months. Whole-body cabinet or a home unit. Combines well with topicals and ruxolitinib.

  • Excimer laser 308 nm

    Targeted UVB for focal patches. Useful when only a few areas are involved or as a top-up to cabinet UVB on stubborn sites.

  • Oral JAK inhibitors

    Upadacitinib and ritlecitinib have emerging evidence in extensive, active vitiligo. Currently off-label and private, and needs consultant-led monitoring.

  • Surgical repigmentation

    Melanocyte–keratinocyte transplantation, minigrafting and blister grafting for stable segmental vitiligo or refractory stable patches that will not repigment medically.

  • Sun protection and camouflage

    Daily SPF 50+ protects both the patches and the contrast around them. Medical camouflage and self-tan help the day-to-day while the medical plan works.

  • When to escalate or refer

    Rapidly progressive vitiligo, extensive body-surface involvement or coexisting autoimmune disease can need combined dermatology and endocrinology care.

Realistic expectations

What repigmentation actually looks like.

Vitiligo does not turn around in weeks. Setting expectations properly is half of good care.

  • Six to twenty-four months

    Typical timeframe to see meaningful repigmentation with topicals, UVB or ruxolitinib. Give a full protocol before judging it a failure.

  • Face and trunk respond best

    Hands, feet and bony prominences respond least well. Some acral patches never repigment fully.

  • Sun protection matters

    SPF 50+ protects patches from burning and reduces contrast with the surrounding skin.

  • Maintenance prevents relapse

    Twice-weekly tacrolimus, or a maintenance UVB frequency, keeps repigmented skin repigmented.

Safety and monitoring

What to expect during and after treatment.

Consultant-led vitiligo care is generally low-risk. The things worth planning are candidacy, dose, and what happens if something is not right.

  • A named UK consultant, in a CQC-regulated setting

    The consultant who assessed you should be the consultant who prescribes and reviews. That alone removes most of the common safety problems.

  • Realistic outcomes, spelled out

    Repigmentation is slow. Six to twenty-four months is typical, some patches never fully repigment, and hands and feet respond least well. All of this should be said before you commit.

  • Topical calcineurin inhibitor safety

    Tacrolimus and pimecrolimus are well tolerated on the face and flexures. Transient burning is common, serious risks are rare. Cumulative use should be monitored.

  • Phototherapy safety

    Narrowband UVB has a strong long-term safety record when dosed by protocol. Cumulative dose is tracked and eyes and genitals are shielded on every session.

  • Ruxolitinib and oral JAK safety

    Topical ruxolitinib has a favourable local safety profile. Oral JAK inhibitors need blood pressure, lipids, bloods and shingles-risk review before and during treatment.

  • A same-day contact number

    Written aftercare plus a phone number that answers the same day. Early advice prevents a small phototherapy burn or reaction from becoming a bigger problem.

  • Included follow-up

    Follow-up at three, six and twelve months, with photography and VASI scoring, is booked before you leave, included in the pathway rather than billed separately.

  • Contraindications matter

    Pregnancy, photosensitising drugs, history of skin cancer, active infection and severe immunosuppression all change the plan. A good clinician asks, and listens.

  • Written record and second opinion

    You leave with the record, the photographs and the plan, enough for another consultant to pick up if you ever want a second opinion.

Reading your treatment record

Your treatment record in four parts. Read the last one first.

Whichever pathway you chose, the record the clinic sends you keeps to the same shape.

  1. 01 Assessment

    What was recommended and why

    The consultant’s written note, including Wood’s lamp findings, VASI score, autoimmune screen results and the plan agreed with you.

  2. 02 Treatment

    What was actually prescribed or done

    The named treatment, strength, frequency and, for phototherapy, the starting dose and increment protocol. Keep this for future care.

  3. 03 Findings

    What was measured

    Baseline and follow-up VASI scores and standardised photographs, in plain English alongside the technical terms.

  4. 04 Plan

    Follow-up, medication, warning signs

    When to come back, what to do if a patch reacts, when to pause phototherapy and when to phone the same day.

Recognised by major UK insurers

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Insurance cover for vitiligo varies by policy. Assessment and phototherapy may be covered, ruxolitinib and oral JAK inhibitors are usually self-pay.

Frequently asked

Common questions about vitiligo treatment.

Quick answers on cure, spread, insurance, ruxolitinib, sun protection and camouflage.

  • Is there a cure for vitiligo?

    No, there is no permanent cure. Treatment can repigment patches significantly, and in some patients almost completely, but ongoing maintenance is usually needed to prevent relapse. Segmental vitiligo, once stable, can sometimes be treated definitively with surgical grafting.

  • Will my vitiligo keep spreading?

    Non-segmental vitiligo can be stable for years then flare. Segmental vitiligo usually declares itself within twelve months and then stops. Early treatment while the disease is active protects more melanocytes and gives the best long-term result.

  • Is vitiligo treatment covered by private health insurance?

    Consultant assessment and phototherapy are sometimes covered when documented as medical rather than cosmetic. Topical ruxolitinib and oral JAK inhibitors are usually self-pay because they are off-label in the UK or newly approved.

  • How do I get ruxolitinib (Opzelura) cream in the UK?

    Topical ruxolitinib is MHRA-approved for non-segmental vitiligo from age 12 but is not yet routinely funded on the NHS. It is prescribed privately by consultant dermatologists, at around £1,800 to £2,600 per month. NICE assessment is in progress.

  • Do I still need sun protection on depigmented patches?

    Yes, and it matters more, not less. Patches have no melanin and burn quickly, and tanning the surrounding skin makes the contrast worse. Daily SPF 50+ and clothing cover both the patches and the skin around them.

  • What about camouflage while the medical treatment works?

    Medical camouflage and self-tan bridge the six to twenty-four months of medical care. The British Red Cross and specialist camouflage services teach application, and your clinician can refer you.

Ready to start

Match me to a consultant dermatologist for vitiligo.

One working day, one written recommendation, two or three consultant options with firm prices.

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