Whether or not it's why Michael Jackson went from black to white, each year millions of Americans lose the pigment in patches of their skin due to a condition called vitiligo. This condition has a variety of treatments–from steroids to ultraviolet light exposure–though none promise sure results. A group of French researchers tried a new type of therapy, a topical drug called tacrolimus combined with ultraviolet light, to see if it worked better than the rest.

What the researchers wanted to know: Does the topical drug cream tacrolimus combined with ultraviolet light therapy help patients with vitiligo?

What they did: The researchers treated 14 patients, with a total of 43 patches of unpigmented skin. The researchers treated some patches with ultraviolet light therapy and other patches with a combination of ultraviolet therapy and a cream containing tacrolimus, a drug usually used for organ transplant patients. Some patients received both types of treatments, which were done twice weekly for 24 weeks.

What they found: The combined therapy, using both the cream and light therapy, worked better than the light therapy alone. All the patches treated with the combined therapy showed some degree of darkening, compared with 85 percent of the light-therapy only patches. In addition, patches treated with the combination therapy usually got darker, and closer to the person's natural skin tone, than the patches treated by light therapy alone. There were few serious consequences of either treatment, though skin redness was common and some patients reported that the cream stung their skin a little bit.

What it means to you: Though this study was small, it provides good evidence that a combination of light therapy and tacrolimus topical cream could be beneficial for people with vitiligo. Ultraviolet light therapy is already thought to be the most effective treatment, and this combination could improve on that, without many negative effects.

Caveats: First, this study was done with only a small number of patients and over a shorter time period than most previous vitiligo studies. So, the results are far from absolute. Second, many of the patches of skin that the researchers tested happened to be in areas of the body that are more often resistant to ultraviolet light therapy. So, it's hard to tell how much better the combination therapy would work on areas that are sensitive to light therapy. In addition, some ultraviolet light therapies can increase the risk of cancer, especially if patients are not careful about how much sun they are exposed to after the therapy. The authors say more studies are needed to figure out whether the tacrolimus cream exacerbates the skin cancer risk or not.

Find out more: The National Institutes of Health has a website with basic questions and answers about vitiligo. The National Vitiligo Foundation's website has a great deal of information.

Read the article: Passeron, T. et al. "Topical Tacrolimus and the 308-nm Excimer Laser: A Synergistic Combination for the Treatment of Vitiligo." Archives of Dermatology. September 2004, Vol. 140, No. 9, pp. 1065–1069.

Abstract online: http://archderm.ama-assn.org