Q: I am 37 years old and have vitiligo spots on the back of my hands and on the scalp for the last 4-5 years. The vitiligo spots are still unstable - will Azoran help in stabilising the spots and can a steroid like Defcort 6 be taken along with Azoran? One doctor suggested Azoran; other disagreed and suggested Defcort 6, twice a week instead. I was also suggested to use Elidel but the other doctor said it might not help. I am confused. I have also heard of Melagain lotion. What is this and will this help in re-pigmentation?

A:Elidel is the brand name of a medicine called pimecrolimus. It is indicated in the treatment of eczema and not vitiligo. Defcort is a steroid called deflazacort. It is just like prednisolone with all its side effects if taken by mouth (e.g. high blood pressure, weight gain, fluid retention, diabetes etc). In vitiligo, oral steroids are not of much help. Instead steroid creams may have some use. Azoran (azathioprine) is an immunosuppressant and has been tried in some conditions such as pemphigus vulgaris but its role in vitiligo is unlikely to be beneficial. Unfortunately there is no effective therapy known as of date.