Low dose naltrexone would be a good medication to try as long as Sermin isn't taking Vicodin or any other opiate-based drugs for pain.
Vitiligo is fairly complex and is known to be triggered by both eviromental and genetic factors. These factors lead to the production of autoantibodies that destroy the melanocyte cells that produce melanin. Oxidative stress is considered a primary trigger and anti-inflammatory diets and antioxidant vitamins are also reported to help. Similar to other autoimmune diseases, anything that helps the immune system heal, like LDN, diet, and exercise, helps reduce symptoms and induce remission.
Areas of the skin subjected to repeated trauma are more susceptible to vitiligo. Patches of vitiligo often develop on these areas, including the fingers, inner wrists, bony prominences (knees, elbows, shoulder blades), and taking care with these areas can also help.
Phototherapy with narrow-band UV-B light is one of the most common therapies and for many people it helps induce repigmentation. Systemic and localized phototherapy are both used. The excimer laser and low beam laser are also good options.
Several studies show that phototherapy used in combination with tacrolimus cream works well in people who have less than 30 percent of their surface affected. Corticosteroids are another option but side effects from long-term therapy make them more of a last choice.
Depigmentation therapy using monobenzylether or hydroquinone are also used and there are also surgical alternatives. Surgery is usually reserved for segmented (unilateral) or localized stable vitiligo. Micropigmentation with tattos is also an option and appears to be gaining in popularity.
Overall, LDN would be a way of reducing disease progression, but other therapies might be needed to help with restoring skin pigment.
While there aren't any formal studies in LDN and vitiligo, there's quite a bit of anecdotal information available suggesting that LDN offers promise for vitiligo. Best, Elaine