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Step 2: Medical Management For early or active vitiligo, medical therapies are used to control progression and promote repigmentation: Topical medications to reduce immune activity Oral therapies when required Antioxidant support to improve skin response Step 3: Light-Based Therapy Phototherapy helps stimulate melanocytes and enhance pigment spread: Narrowband UVB therapy Targeted light treatments for localized patches These therapies are often combined with medications for better outcomes

[2] [7] Risk stratification using FIB-4 in primary care, with second-line tests such as the Enhanced Liver Fibrosis (ELF) test or transient elastography when indicated, helps identify those who may need specialist referral

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They work by blocking cyclooxygenase (COX) enzymes, which reduces prostaglandin production and dampens pain signaling

Like MOTS-c, its mood relevance comes through mitochondrial support rather than direct neurotransmitter modulation