Prostaglandin E2 (PGE2) Analogs

PGE2, by virtue of its growth-stimulatory effects, is capable of regulating the proliferation and maturation of melanocytes [65]. Kapoor et al. studied the efficacy and safety of topical PGE2 in the treatment of stable vitiligo (<5 % body surface area). Excellent response was seen in 55 % of patients. Side effects in the form of a transient burning sensation especially on the lips were reported in a few patients [66, 67].

Capsaicin and Curcumin

Treatment with these antioxidants inhibits caspase-induced apoptosis, increases the total antioxidant capacity of the body, decreases the generation of ROS and lipid peroxidation, and improves mitochondrial activity. Moreover, C. melo extracts have shown superoxide dismutase and catalase-like activities [68]. Thus, topical capsaicin and extracts of C. melo might protect against vitiligo progression [69]. However, well- designed randomized clinical trials are needed to support the use of these extracts for vitiligo because of conflicting reports regarding its effectiveness and efficacy [67, 70].