Vitiligo is a common disorder of pigmentation.¹ Pathogenetically, vitiligo represents a complex reaction pattern involving multiple etiologic factors, some of them necessarily working in concert. On-going research is focussing on a better understanding of pathogenesis and thus searching for better treatment modalities. Treatment is classified into medical, light-based, surgical, camouflage, and depigmentation therapy².

Surgical treatment is generally considered when medical/light-based treatment has failed and includes tissue transfer (e.g., punch grafting, partial split-thickness grafting, and suction blister grafting) and cellular transfer, which is further divided into cultured and non-cultured techniques.^3-5  The basic principle of surgical treatment is to transfer the melanocytes from normal skin to-vitiliginous skin. Non-cultured epidermal cell suspension (NCES) is considered the standard and most effective surgical treatment for stable vitiligo and, it along with suction blister grafting (SBG), has a better outcome than other surgical methods.⁶

Autologous mini punch grafting is the easiest, effective, and less expensive method of vitiligo surgery. It is indicated in almost all sites especially in acral vitiligo involving palms, fingers, nipples, and lips.⁷

The technique of Mini punch grafting (MPG)  has undergone many modifications over the years to reduce the requirement for equipment and to save time. The time consumed in MPG using punches of less than 1.5 mm is more when compared with punch grafting with 2-3 mm punches, moreover the number of grafts required is also more with a decrease in punch sizes. With the advent of motorized power punches the procedure can be done with more ease in lesser time to harvest more mini grafts (<1.5 mm) in a single session.⁷

A newer technique of Motorized 0.8-mm micro punch grafting for refractory vitiligo from a retrospective study of 230 cases concluded that refractory vitiligo with short procedure times had an excellent outcome. This technique could be a rapid and convenient surgical option with acceptable adverse events and is promising for treating refractory vitiligo on an outpatient basis, particularly in patients who are unlikely to tolerate prolonged surgery.⁸

We also want to know the efficacy of the same by doing it in the exclusive lip vitiligo and to look at the adverse effects of the 0.8mm micro punch grafting.