Melanocyte transfer, NCMS and split-thickness grafts for stable, non-active vitiligo unresponsive to medical therapy. By Dr. Reena Sharma, MD Dermatology.
For patients with stable vitiligo who have not responded to medical therapy, surgical melanocyte transfer offers a high-success-rate option for repigmentation. Critical caveat: only stable disease is a candidate. Operating on active vitiligo can worsen it.
Suitability criteria
Stable disease (no new patches, no expansion for ≥12 months)
Failed adequate trial of medical therapy (topicals + phototherapy)
Patches in cosmetically important areas (face, hands)
No keloidal tendency
Patient committed to careful aftercare
Procedures we offer
NCMS (Non-Cultured Melanocyte Suspension): Donor skin processed to extract melanocytes, applied to dermabraded recipient site. Same-day procedure under local anaesthesia. Best for medium-sized patches.
Split-thickness graft: Larger area coverage. Donor site usually thigh.
Punch grafting: Small disc grafts placed in pre-prepared recipient holes. Pixelated regrowth pattern.
Patients with stable vitiligo (no new patches, no expansion of existing patches for at least 12 months) who have not responded adequately to medical therapy. Active or unstable disease is NOT a candidate — surgery on unstable vitiligo can trigger Koebner phenomenon (worsening).
What surgical methods are available?
Non-cultured melanocyte suspension (NCMS) — most common, harvests melanocytes from a small donor site. Split-thickness skin graft. Punch grafting. Suction blister grafting. Choice depends on patch size, location, and patient factors.
How successful is vitiligo surgery?
For stable disease: 60 to 90 percent repigmentation in suitable cases. Face responds best. Lips, fingertips, and bony joints harder. We assess on case-by-case basis.
Is the surgery painful?
Performed under local anaesthesia. Some discomfort during recovery (5 to 7 days), donor site heals over 2 weeks. Patients return to normal activity quickly.
How long until repigmentation?
Initial pigment appearance: 4 to 6 weeks. Significant repigmentation: 3 to 6 months. Final result: up to 12 months.
Can vitiligo come back?
In stable patients, recurrence is uncommon. If new patches develop elsewhere, that indicates underlying disease became active again — we treat medically.
