The goal of depigmentation is to unify skin color in patients with vitiligo virtually all over the body and those who have failed PUVA, who cannot use PUVA, or who reject the PUVA option. Since application of Benoquin may be associated with distant depigmentation, Benoquin cannot be used to selectively to bleach certain areas of normal pigmentation, because there is a real likelihood that new and distant white macules will develop over the months of use. Bleaching with Benoquin normally requires twice-daily possible side effects. Uncommonly, contact dermatitis is observed. Periodically following sun exposure, an occasional patient will observe focal repigmentation, which will require a month or so of local use of Benoquin to reverse.
Most patients are quite satisfied with uniformity and the finality of the results.
The only side effect of beta-carotene is the uncommon risk of diarrhea. Patients who undergo bleaching are at risk for sunburn. They should avoid midday sun exposure and should use a high-SPF sunscreen. To date no long-term untoward effects have been reported from the use of monobenzylether of hydroquinone for skin bleaching. Many physicians, and even some dermatologists, fail to recognize the profound social and psychological impact vitiligo may have on its victims.