Failure of Botulinum Toxin Treatment for Localized Vitiligo

Background: It was found that acetylcholine concentration increased with a significantly reduced expression of acetylcholinesterase in vitiliginous patches that return to normal upon repigmentation. Objective: To evaluate the efficacy and safety of botulinum toxin A in patients with localized vitiligo. Methods: Ten patients were recruited. Eight patients had two or more focal vitiliginous patches. Two had segmental vitiligo. For each patient with focal vitiligo, one or two vitiliginous patches were treated. For each patient with segmental vitiligo, half of the lesion was treated. The untreated parts were used as a control. Botulinum toxin was injected. The response was analyzed at the initial visit, and then two weeks, two months and six months after therapy. Results: Thirteen vitiliginous patches were treated. Reassessment showed no evidence of repigmentation. Comparing treated versus untreated sides, no differences were found. No adverse effects were reported. Conclusion: Botulinum toxin is not effective in the treatment of localized vitiligo.