A prospective observational study on the efficacy of narrowband UVB phototherapy combined with oral antioxidants in the management of vitiligo.

Background:Vitiligo is a chronic depigmenting disorder, often requiring prolonged therapy due to slow and variable repigmentation. Narrowband ultraviolet B (NB-UVB) is an established treatment approach, and interest has grown in combining it with oral antioxidant supplementation to enhance melanocyte recovery and reduce oxidative stress. Aim: To evaluate the efficacy and tolerability of NB-UVB phototherapy combined with oral antioxidants in patients with vitiligo. Methods: This prospective observational study included 50 clinically diagnosed vitiligo patients. All participants received NB-UVB phototherapy three times weekly, along with a daily oral antioxidant regimen, for 24 weeks. Demographic and clinical parameters were recorded. Repigmentation was assessed using the Vitiligo Area Scoring Index (VASI) at baseline, 12 weeks, and 24 weeks. Treatment response was categorized as excellent (>75%), moderate (50–75%), mild (25–49%), or minimal (<25%). Adverse events were documented throughout the study period. Results: The mean age of participants was 28.6 ± 9.4 years, with females comprising 56% of the cohort. Non-segmental vitiligo accounted for 74% of cases. The mean baseline VASI score was 6.8 ± 2.1, which reduced progressively to 4.3 ± 1.9 at 12 weeks and 2.7 ± 1.6 at 24 weeks. Excellent repigmentation was achieved in 28% of patients, moderate in 36%, and mild in 24%, while 12% showed minimal improvement. Facial and truncal lesions responded better compared to acral sites. Treatment was well tolerated, with only mild transient erythema and pruritus reported. Conclusion: NB-UVB combined with oral antioxidants resulted in meaningful repigmentation with good safety and patient acceptance. Recommendations: This combination may be considered as a preferred therapeutic strategy in the routine management of non-segmental vitiligo, especially when aiming for gradual yet sustained repigmentation.