Depigmented skin in piebaldism is generally considered unresponsive to medical or light treatment. In 12 adults, dermabrasion and thin split-skin grafts were applied initially, with residual leukodermic patches subsequently treated using a minigrafting method.  Additional irradiation with ultraviolet A (10 J/cm2) was provided. This new combined approach led to 95-100% repigmentation of the leukoderma. An almost perfect color match with the surrounding nonlesional skin was noted in all cases; therefore, dermabrasion and split-skin grafting followed by minigrafting may be a good option for selected patients. Autologous punch grafting for repigmentation in piebaldism may be considered in selected individuals.  Another option is autologous cell suspension transplantation using a cell extraction device.