Natural treatments for vitiligo

DEFINITION: Treatment of the skin disease in which pigment-making cells are destroyed.

PRINCIPAL PROPOSED NATURAL TREATMENTS: Khellin, L-phenylalanine

OTHER PROPOSED NATURAL TREATMENTS: Folate, Ginkgo biloba, para-aminobenzoic acid, Picrorhiza kurroa, ultraviolet light, black cumin, vitamin D, vitamin B12

Introduction

Vitiligo is a skin disease in which pigment-making cells, called melanocytes, are destroyed, leaving white irregular patches of skin where pigment used to be. The patches usually appear on the hands, feet, arms, face, and lips but can also occur on the skin around the mouth, nose, eyes, and genitals. Hair growing from areas affected by vitiligo may also turn white. Although vitiligo is not painful, it can cause emotional distress.

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Science has not identified the cause of vitiligo, but some researchers theorize that an autoimmune process plays a role. In an autoimmune disease, the immune system starts attacking innocent tissues. In vitiligo, antibodies may develop against melanocytes, ultimately destroying some. Vitiligo seems more common in people with other autoimmune diseases; however, most people with vitiligo have no other autoimmune disease.

Most conventional vitiligo treatments combine ultraviolet light (UVA) exposure with oral or topical drugs that selectively sensitize the skin to UVA; such drugs are called psoralens because they are most commonly used to treat psoriasis. The results of this treatment are generally good. Another option is topical corticosteroids, which may be best for localized vitiligo. In severe cases, surgical procedures, including skin grafting and melanocyte transplantation, may be considered, although these approaches are still experimental.

Principal Proposed Natural Treatments

Most natural therapies for vitiligo also employ exposure to UVA or natural sunlight in conjunction with an oral or topical treatment.

Khellin. Khellin, an extract of the fruit of the Mediterranean plant khella (Ammi visnaga), is closely related to the standard psoralen drug methoxsalen. Both are used with UVA to repigment vitiligo patches. A double-blind, placebo-controlled study of sixty people indicated that the combination of oral khellin and natural sun exposure caused repigmentation in 76.6 percent of the treatment group; in comparison, no improvement was seen in the control group receiving sunlight plus placebo. A subsequent placebo-controlled study of thirty-six people found that a topical khellin gel plus UVA caused repigmentation in 86.1 percent of the treated cases, as opposed to 66.6 percent in the placebo group. A typical oral dosage of khellin is 100 milligrams (mg) daily. Khellin has no reported side effects when used topically. Oral doses, however, have caused various side effects ranging from nausea and vomiting to liver inflammation.

L-phenylalanine. A few preliminary studies suggest that oral L-phenylalanine, a natural amino acid, might also be helpful for vitiligo. It, too, is combined with either sunlight or controlled ultraviolet light.

Of four studies, only one was double-blind. It found positive results; however, because only twenty-four people were enrolled, further research will be necessary to confirm its conclusions. The other studies were open, uncontrolled trials, so they proved little.

Other Proposed Natural Treatments for Vitiligo

A double-blind study of fifty-two people found that using Ginkgo biloba extract (40 mg three times daily) helped slow the spread of vitiligo in people with limited, slowly spreading symptoms. There is some evidence that people with vitiligo have lower-than-average levels of both vitamin B12 and folate. In addition, there is a particularly high incidence of vitiligo among persons with pernicious anemia, a condition in which vitamin B12 is poorly absorbed. However, this information does not prove that taking extra vitamin B12 and folate will help. Furthermore, a much larger study of one hundred people found no significant association between vitiligo and low levels of either vitamin. One uncontrolled study suggests that vitamin B12 and folate supplements might improve pigmentation in vitiligo, but the results prove little because of the study’s poor design. Also, one poorly designed single-blind study suggests that the herb Picrorhiza kurroa might increase the effectiveness of the standard drug methoxsalen.

Para-aminobenzoic acid (PABA) is best known as an active ingredient in sunscreen. Based on a 1942 study, oral PABA has been suggested as a vitiligo treatment. The study, however, lacked a control group, so the results are not meaningful. Another study suggests that high oral doses of PABA can cause vitiligo.

Vitiligo is sometimes associated with pernicious anemia, which is often linked to low stomach gastric acid levels, a condition called achlorhydria. For this reason, some physicians specializing in natural medicine recommend supplemental hydrochloric acid (often in the form of betaine hydrochloride) to augment low gastric acid, but there is no evidence that it helps.

Several other natural treatments for vitiligo have been proposed, though most are anecdotal and need scientific verification. Making a salve out of lemon and sweet basil extract or turmeric and mustard oil may ease symptoms. Papaya and red clay have also been suggested as possible natural topical medications. Some also believe that diets rich in phytochemicals, beta-carotene, and antioxidants may be beneficial. Individuals with vertigo should also consider increasing their copper, iron, zinc, and vitamin C intake. Black cumin, an oil traditionally used for skin conditions, has shown promise in some studies promoting repigmentation. Obtaining vitamin D through moderate sun exposure and reducing stress may also help with repigmentation. Aloe vera, ginger, and clay masks are also suggested. These proposed natural treatments are more effective when combined with traditional therapies such as phototherapy and corticosteroids.

Bibliography

Camacho, F., and J. Mazuecos. "Treatment of Vitiligo with Oral and Topical Phenylalanine." Archives of Dermatology, vol. 135, 1999, pp. 216-217.

Gianfaldoni, Serena, et al. "Herbal Compounds for the Treatment of Vitiligo: A Review." Open Access Macedonian Journal of Medical Sciences, vol. 6, no. 1, pp.03-207, 21 Jan. 2018, doi:10.3889/oamjms.2018.048.

Hazra, Kashmera. "Vitiligo Diseases: 10 Best Home Remedies." Kayakalp Global, 30 June 2023, www.kayakalpglobal.com/health/10-best-home-remedies-for-vitiligo-diseases. Accessed 15 Sept. 2024.

Kim, S. M., Y. K. Kim, and S-K Hann. "Serum Levels of Folic Acid and Vitamin B12 in Korean Patients with Vitiligo." Yonsei Medical Journal, vol. 40, 1999, pp. 195-198.

Njoo, M. D., et al. "Nonsurgical Repigmentation Therapies in Vitiligo." Archives of Dermatology, vol. 134, 1998, pp. 1532-1540.

Parsad, D., R. Pandhi, and A. Juneja. "Effectiveness of Oral Ginkgo biloba in Treating Limited, Slowly Spreading Vitiligo." Clinical and Experimental Dermatology, vol. 28, 2003, pp. 285-287.

"Vitiligo: Types, Symptoms, Causes, Treatment & Recovery." Cleveland Clinic, my.clevelandclinic.org/health/diseases/12419-vitiligo. Accessed 15 Sept. 2024.