The Vitiligo therapy is still a topical issue today. According to the Russian and European clinical guidelines, modern therapy for vitiligo includes UVB-311 nm phototherapy, topical glucocorticoids and topical calcineurin inhibitors. Standard treatment regimens require a long time of application and their effectiveness on the average does not exceed 40%, which leads to disappointment in the treatment not only for patients but also for dermatologists. In this regard an active search for therapies for vitiligo continues. Thus, one of the modern options for the treatment of this disease is microneedling. Microneedling is a relatively new, easy to perform, safe and minimally invasive therapeutic technique that enhances the regenerative process by creating numerous microtraumas occurring when shallow needles are punctured into the skin. This procedure causes a cascade of reactions similar to the wound healing process, stimulating the production of collagen, elastin and growth factors and increases the migration of melanocytes and keratinocytes leading to repigmentation of vitiligo lesions. Local damage to the skin with needles enhances penetration of active ingredients into deeper layers, so microneedling is often combined with the use of UV light, as well as with various biopharmaceuticals to increase efficiency. Although the procedure is relatively new it has demonstrated efficacy, good tolerability, limited undesirable effects and a short recovery time, making micro-needling a promising treatment for vitiligo. This article is a review in nature. The purpose of this review is to update the available information on the treatment of vitiligo as well as to explore a promising new method of therapy. A systematic literature review was conducted using PubMed, Cochrane Library, CyberLeninka, Clinicaltrial.govand the open-access Internet databases to examine the efficacy, principles of action, and tolerability of the new treatment. Key words used in the literature search in the aforementioned databases were vitiligo, vitiligo treatment, microneedling, and quality of life .The results of various clinical studies are presented. This review is addressed to practicing dermatovenerologists interested in vitiligo therapy.

Vitiligo is a disease that negatively influences patients quality of life, lowers their self-esteem, and causes significant psychological discomfort. According to numerous studies, patients with vitiligo are more likely to develop depressive and anxiety disorders, suicidal thoughts. Despite the prevalence and social significance of the disease, vitiligo therapy remains a topical issue today. So, at the moment in the world there are still no specially registered drugs and treatments for vitiligo. Therapy of the disease today is mainly represented by drugs from the group of corticosteroids and calcineurin inhibitors, both in the form of monotherapy and in the form of combination therapy with narrow band UVB phototherapy. However, the overall effectiveness of standard treatment regimens does not exceed 80%, and the relapse rate can be up to 75%, which does not meet the expectations of the patient and the dermatovenerologist. This article is of a review character. The aim of the article was to study new promising methods of treatment of the disease in the practice of Russian and foreign specialists, their availability and principles of action. A systematic literature review was performed using PubMed, Cochrane Library, Clinicaltrials.gov, Cyberleninka, and Internet databases to identify new drugs/methods in development, in clinical trials, and soon to be on the biopharmaceutical market. Keywords such as vitiligo, quality of life, and treatment were used in the literature search of the above-mentioned databases. The results of various clinical trials are given. The review identified the main contenders for the role of long-term therapy for vitiligo, which in the future will optimize patient management tactics and adherence to treatment. This review, addressed to practicing dermatovenerologists interested in vitiligo therapy, points to a process of active research and development of new therapies, in which more than 20 biopharmaceutical companies worldwide are currently involved. It should be expected that in the next few years the range of drugs used to treat the disease will completely change. Based on recent research on the pathogenesis of vitiligo, it can be concluded that from the entire list of promising drugs, local janus kinase inhibitors are probably the most promising new class of drugs for the treatment of this disease.