Lluís Puig
Director of the Dermatology Department of the Hospital de la Santa Creu i Sant Pau and professor at the Autonomous University of Barcelona
The clinical trial is of excellent quality; efficacy is demonstrated, but five patients must be treated for six months to achieve a repigmentation response of 75% or more in one patient. If treatment is continued for one year, every second patient responds. Relapse after a period of time cannot be ruled out (not analyzed in this trial), but has been observed in experimental models.
The adverse effects described are those to be expected - the acneiform reaction stands out in 6% of patients. The plasma concentrations detected - by absorption through the skin in the treated areas - are relatively low, but not negligible.
The main problem would be the price of the treatment; the sale price of the cream in the United States is 50 dollars per gram (like gold, approximately). Half a gram (see figure) can treat an area equivalent to the surface area of two hands.
A patient with vitiligo on the face would have to apply 0.5 g twice a day for 6 months, equivalent to 180 g; to improve 75% or more in one patient, five patients would have to be treated. That would be 5 x 9,000 €.