NB-UVB: light that heals?

By Ana Espino | Published on september 19, 2025 | 3 min read

#Vitiligo #Immunity #Phototherapy #NB-UVB  


Vitiligo — a chronic autoimmune disease — is characterized by progressive depigmentation of the skin, caused by the destruction of melanocytes. Although not life-threatening, this condition has a profound psychological and social impact, especially in younger patients. Despite the wide range of existing treatments — topical corticosteroids, calcineurin inhibitors, phototherapy — no protocol guarantees stable and complete repigmentation, particularly in extensive or resistant forms.  

In this context, new combination strategies are being explored to optimize clinical outcomes. Tofacitinib, a JAK inhibitor, has recently emerged as a promising targeted therapy, acting on the inflammatory pathway involved in melanocyte destruction. When combined with NB-UVB phototherapy, it may promote faster and more complete repigmentation. The objective of this study was to evaluate the efficacy and safety of the NB-UVB + tofacitinib combination, compared with phototherapy alone, in patients with vitiligo.    

Three or five sessions: what really works?  

Five randomized controlled trials published between 2005 and 2015, including a total of 461 adult patients with vitiligo, were selected and analyzed. The included studies compared NB-UVB phototherapy with conventional treatments or no intervention, focusing on changes in the PASI score (Psoriasis Area and Severity Index).  

Due to heterogeneity in study protocols, a narrative synthesis was performed. Results indicated that NB-UVB significantly reduced PASI scores, regardless of session frequency (3 or 5 per week) or dosing method (fixed dose or adjusted to minimal erythema dose). A frequency of three weekly sessions appeared sufficient to achieve meaningful clinical improvement. The addition of selenium provided no additional benefit. No single protocol clearly outperformed the others, highlighting the flexibility of NB-UVB in clinical practice.    

Less rigid, more effective?  

Vitiligo is a common, chronic inflammatory dermatosis, both painful and stigmatizing, requiring treatments that are effective yet well tolerated in the long term. One of the main challenges remains the standardization of NB-UVB phototherapy protocols, given the considerable variability in practices and clinical responses. This review aimed to assess the clinical efficacy and tolerability of NB-UVB monotherapy in adult patients with psoriasis. The results confirmed that this approach is effective, well tolerated, and adaptable: different frequencies and dosages can still yield significant symptom improvement, making it a flexible therapeutic option.  

However, the study has limitations and highlights the need for further research. Future investigations should include larger randomized trials, long-term follow-up, quality-of-life assessments, and more rigorous comparative analyses across protocols. Identifying predictive factors of response will be key to tailoring treatment to individual patients. In parallel, evaluating therapeutic combinations — including systemic or topical approaches — could help prolong clinical benefits and optimize long-term outcomes.   

Read next: Tofacitinib in vitiligo

About the author – Ana Espino
As a scientific writer, Ana is passionate about bridging the gap between research and real-world impact. With expertise in immunology, virology, oncology, and clinical studies, she makes complex science clear and accessible. Her mission: to accelerate knowledge sharing and empower evidence-based decisions through impactful communication.