Impact of Covid on Vitiligo

The Covid era posed a challenge for vitiligo treatment. Vitiligo worsened during this time period for various reasons, such as treatment irregularity or interruption, increased stress due to the sudden change in the routine, and more importantly, the fear of Covid (a life-threatening disease vs a life altering condition situation) made us reduce the immunosuppression/immunomodulators. Covid infection itself exacerbated the vitiligo mainly due to its impact on the immune system. In 2021, when Covid vaccination began, in early stages itself we observed that vitiligo became worse in patients who had stable or completely recovered vitiligo, and some patients developed vitiligo for the first time after such vaccination. We also noticed that most of the patients required 2-3 times higher dosage of immunosuppression/immunomodulation to control their vitiligo. Another significant negative impact that occurred during this period was that patients sought more convenient ways (when being more compliant was essential) to deal with their vitiligo, which made their vitiligo deteriorate and harder to manage. Fortunately, recently we are able to lower the immunosuppression/immunomodulation in almost all patients to pre Covid dosages to control their vitiligo.