Favourable features: recent onset; younger age; facial, neck or trunk involvement; no white hairs within patches; currently stable; darker constitutional pigmentation.

Less favourable features: long duration; involvement of hands, feet or lips; white hairs within patches; active Koebner phenomenon; very extensive disease.。

Realistic expectations, honestly stated:

• Spontaneous repigmentation without treatment occurs in fewer than 10–20% of patients and is usually partial.

• No treatment works quickly. Three to six months is the minimum before any judgement can be made.
• Repigmentation typically appears first as small dots around hair openings within the patch, gradually merging.
• Returning pigment may initially be darker or lighter than surrounding areas; this usually evens out over months.
• The realistic goal for most patients is substantial improvement in visible areas, not complete clearance of every patch.
• Segmental vitiligo stops spreading on its own within 6–24 months and rarely recurs, but medical treatment seldom repigments it — surgery is the answer.
• Vitiligo remains a lifelong tendency. Maintenance treatment is what keeps results.

Reference:

1. Ezzedine K, et al. Revised classification/nomenclature of vitiligo. Pigment Cell Melanoma Res. 2012 — VGICC consensus, basis of the classification section.
2. Eleftheriadou V, et al. British Association of Dermatologists guidelines for the management of people with vitiligo. Br J Dermatol. 2022.
3. Seneschal J, Taïeb A, et al. European Dermatology Forum / EADV vitiligo guideline (most recent update).
4. Rosmarin D, et al. Two Phase 3, Randomized, Controlled Trials of Ruxolitinib Cream for Vitiligo. N Engl J Med. 2022 — TRuE-V1 and TRuE-V2.
5. Passeron T, Prajapati V, Sivamani R, et al. Efficacy and safety of upadacitinib in adolescents and adults for treatment of non-segmental vitiligo: results of two phase 3 studies (Viti-Up). Presented at the 2026 American Academy of Dermatology Annual Meeting, March 27–31, 2026, Denver, CO.
6. China Medical System Holdings. New Drug Application of ruxolitinib phosphate cream for vitiligo approved by the Pharmacy & Poisons Board of Hong Kong, 4 November 2024.
7. Cavalié M, et al. Maintenance therapy of adult vitiligo with 0.1% tacrolimus ointment: a randomized, double-blind, placebo-controlled study. J Invest Dermatol. 2015.
8. Bae JM, et al. Phototherapy for vitiligo: a systematic review and meta-analysis. JAMA Dermatol. 2017.
9. Middelkamp-Hup MA, et al. Treatment of vitiligo vulgaris with narrow-band UVB and oral Polypodium leucotomos extract: a randomized double-blind placebo-controlled study. J Eur Acad Dermatol Venereol. 2007.
10. Hong Kong Drug Office, Department of Health — search the local registration status of any medicine mentioned.