The depigmented skin areas in piebaldism are unresponsive to medical or light treatment. In 12 adult patients (eight women and four men), a method using dermabrasion and thin split-skin grafts was applied initially. Residual leucodermic areas were subsequently treated using a minigrafting method. Additional irradiation with ultraviolet A (10 J/cm2) was performed to enhance melanocyte migration. This combined surgical therapy led to 95–100% repigmentation of the leucodermic defects. A perfect colour match with the surrounding non-lesional skin was achieved in all cases. Complications were minor and easy to correct. Dermabrasion and split-skin grafting followed by minigrafting should be considered as the first choice of therapy in piebaldism.