TOPLINE

Among patients with vitiligo who achieved repigmentation, about half reported concerns about treatment durability, with fear of relapse accounting for nearly 90% of all concerns, according to a French cohort study. Active repigmentation was associated with lower experienced stigmatisation than no repigmentation, but mental load remained unchanged regardless of repigmentation status.

METHODOLOGY

• This cross-sectional analysis of the VITAL study examined the relationship between repigmentation, experienced stigmatisation, and mental load in patients with vitiligo.
• A total of 765 French patients (mean age, 50.5 years; 68.2% women) completed a digital self-administered questionnaire. Perceived disease severity was evenly distributed across mild (31.9%), moderate (36.2%), and severe (31.9%) categories.
• Outcome measures included the Patient Unique Stigmatization Holistic tool in Dermatology (PUSH-D) questionnaire (range, 0-64; higher scores indicated greater stigmatisation) and the Dermatological Mental Load Questionnaire (DMLQ; range, 8-32; higher scores indicated greater mental load).
• The researchers categorised patients into three groups: those with active repigmentation (n = 230; 30.1%), those with past but no longer active repigmentation (n = 183; 23.9%), and those with no repigmentation (n = 302; 39.5%).

TAKEAWAY

• Among 413 patients (54.0%) who reported achieving repigmentation at some point during their disease course, 89.1% described the experience as positive or very positive, and 62.7% reported improvements in self-confidence or social life.
• However, 46.0% of patients who experienced repigmentation were concerned regarding treatment durability, and fear of relapse accounted for 88.9% of all concerns.
• Patients with active repigmentation had a significantly lower stigmatisation score than those with no repigmentation (mean PUSH-D score, 14.7 vs 18.1; Bonferroni-adjusted P = .022), but those with past repigmentation showed no significant difference from those with no repigmentation (mean PUSH-D score, 17.0 vs 18.1; P = 1.00).
• No significant differences in mental load were observed across repigmentation status groups (global Kruskal-Wallis P = .194), with DMLQ scores remaining relatively stable regardless of treatment outcome.
• Perceived disease severity strongly influenced stigmatisation, with mean PUSH-D scores increasing from 9.6 in mild disease to 26.5 in severe disease; however, mean DMLQ scores rose more modestly from 17.4 to 20.6.

IN PRACTICE

"[R]epigmentation is highly valued by patients with vitiligo and is associated with reduced stigmatisation when actively maintained. However, mental load remains largely unchanged, and fear of relapse affects nearly one in two patients who achieve repigmentation," the authors wrote. "These findings suggest that treatment success in vitiligo should be defined not only by achieving repigmentation, but also by maintaining it and addressing the psychological burden associated with its potential loss," they added.

SOURCE

The study was led by Martine Carré, Association Française du Vitiligo, Paris, France. It was published online on September 08, 2026, in the British Journal of Dermatology.

LIMITATIONS

The study was limited by its cross-sectional design, which prevented the assessment of causality. Recruitment through a patient association may have introduced selection bias, and the reliance on self-reported disease severity may have affected accuracy.

DISCLOSURES

This study was supported by Incyte Biosciences France. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.