Effect of narrow band ultraviolet B phototherapy as monotherapy or combination therapy for vitiligo: a meta-analysis

Photodermatol Photoimmunol Photomed. 2017 Jan;33(1):22-31. doi: 10.1111/phpp.12277. Epub 2016 Nov 23.


Background: The treatment of vitiligo is still one of the most difficult dermatological challenges, although there are many therapeutic options. Narrow band ultraviolet B (NB-UVB) phototherapy is considered to be a very important modality for generalized vitiligo.

Objective: The aim of this study was to explore whether a combination of NB-UVB and topical agents would be superior to NB-UVB alone for treating vitiligo.

Methods: We searched the electronic databases such as PUBMED, EMBASE, Cochrane Library, and Web of Science. The primary outcome was the proportion of ≥50% repigmentation (a clinical significance), and secondary outcome was the proportion of ≥75% repigmentation (an excellent response).

Results: Seven randomized controlled trials (RCTs) involving 240 patients (413 lesions) were included in this meta-analysis. The study showed no significant difference between NB-UVB combination therapy (NB-UVB and topical calcineurin inhibitor or vitamin D analogs) and NB-UVB monotherapy in the outcomes of ≥50% repigmentation and ≥75% repigmentation. However, lesions located on the face and neck had better results in ≥50% repigmentation (RR = 1.40, 95% CI 1.08-1.81) and ≥75% repigmentation (RR = 1.88, 95% CI 1.10-3.20) with NB-UVB and topical calcineurin inhibitor combination therapy vs. NB-UVB monotherapy.

Conclusions: The meta-analysis suggested that adding neither topical calcineurin inhibitors nor topical vitamin-D3 analogs on NB-UVB can yield significantly superior outcomes than NB-UVB monotherapy for treatment of vitiligo. However, addition of topical calcineurin inhibitors to NB-UVB may increase treatment outcomes in vitiligo affecting face and neck.

Keywords: narrow band ultraviolet B; topical calcineurin inhibitors; vitamin-D3 analogs; vitiligo.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Administration, Cutaneous
  • Calcineurin Inhibitors / administration & dosage*
  • Calcitriol / administration & dosage
  • Calcitriol / analogs & derivatives
  • Chemoradiotherapy
  • Dermatologic Agents / administration & dosage
  • Dihydroxycholecalciferols / administration & dosage
  • Facial Dermatoses / drug therapy
  • Facial Dermatoses / radiotherapy
  • Humans
  • Neck
  • Randomized Controlled Trials as Topic
  • Skin Pigmentation / drug effects
  • Skin Pigmentation / radiation effects
  • Tacrolimus / administration & dosage
  • Tacrolimus / analogs & derivatives
  • Ultraviolet Therapy / methods*
  • Vitamin D / analogs & derivatives*
  • Vitiligo / drug therapy*
  • Vitiligo / radiotherapy*


  • Calcineurin Inhibitors
  • Dermatologic Agents
  • Dihydroxycholecalciferols
  • Vitamin D
  • calcipotriene
  • 1 alpha,24-dihydroxyvitamin D3
  • pimecrolimus
  • Calcitriol
  • Tacrolimus