Frequent applications of DHA are required to maintain desired effect as the normal epidermal turnover exfoliates the epidermis. The staining usually lasts up to 3–5 days. DHA binds only with the stratum corneum layer, and thus the intensity of the tan correlates with the compactness and thickness of the horny layer. Old, mottled hyperkeratotic, or rougher skin takes up an uneven finish. Lighter skin requires a lower concentration of DHA cream than subjects with dark skin. The advantage of DHA is its high substantivity and water resistance, avoiding discoloration of cloth on staining. Its innate sun protection properties however have little practical application due to its low SPF which decreases after application with each passing day. Obtaining a proper color match is difficult as blending with the surrounding skin is tricky [4, 5].

After the formulation becomes 6–9 months old, it starts to impart a greenish color to the skin; thus, product storage requires special care.

DHA is an economical, effective, and safe therapeutic option for patients with recalcitrant vitiligo. It is advantageous over camouflage cream involving the hands and feet as the cover creams are just waterproof and not rub proof [4, 5, 7].

DHA is applied every alternate night on perfectly dry skin. The lesions are cleaned with water and scales are gently removed with a towel, prior to application. Using a cotton bud, a finger, or a paintbrush, a thin layer of the cream is applied with circular movements to obtain a homogeneous result. Application on the mucosa and areas near the forehead hairline and eyebrows should be avoided. The areas which take to self-tanners quite well such as the face and neck should have sparing application. In case the hairs are short, the application of the product should be behind the ears. Nails and hair may take color, whereas mucous membranes do not. In order to avoid staining, the fingers should be cleaned immediately after application. Contact with textiles is avoided for the first 30 min, and no water contact is allowed over the next 2 h. Bathing, swimming, or any activity that will lead to sweating must be avoided for 1 h; no belts, brassieres, and shoes should be worn for 1 h, if the products have been used on the body. During periods with high UV exposure, sun protection is recommended with potent sunscreens of a high UVA and UVB protection factor [7, 8].