Vitiligo Treatment - Overview
Vitiligo is a common condition in which the skin loses the pigment that determines its color. Also commonly known as Leucoderma (leuco = white and derma = skin), this condition is characterized by irregular pale or milky white patches on the skin.
Vitiligo is one of those conditions that have more of a social significance than medical. Although it affects people of all races, the symptoms are often more prominently seen in people with a darker complexion. This condition has been the cause of stress for millions of affected people worldwide as well as their near and dear ones.
At Dr. Batra's, our experience of successfully treating more than 45,000 cases of skin enables us to ensure you of a safe and scientific solution for an effective Vitiligo treatment. So, go ahead and experience a lasting solution that comes to you without side effects.
What is Vitiligo?
Before we get to understand about the loss of color from the skin in Vitiligo, let us first see how the skin gets its normal color. A pigment called melanin imparts the skin (as well as hair) the native color. This pigment is produced in cells called 'melanocytes'. When the melanocytes die or are unable to function, it results in loss of melanin causing color-less, white patches on the skin.
Vitiligo is a chronic disorder and tends to run a variable and often unpredictable course. It affects up to 2% of the population globally and the incidence is almost double this (3 to 4%) in India and Mexico. People of different races, religions, ethnic groups, socio-economic groups and with different dietary habits are affected by this condition.
Vitiligo affects males and females equally and it is commonly seen in children as well. The incidence is higher in children whose both parents are affected by Vitiligo. By and large, people who develop it are between 10 to 30 years of age and most of those who develop this, do so before 40 years of age.
The goal of most treatment options available today is largely to stop or slow down the progression of pigment loss and to attempt the re-pigmentation in affected areas.
The underlying mechanism which causes Vitiligo is loss of melanin. This occurs due to destruction of existing melanocytes and defective formation of new melanocytes. However, the precise reason for white spot on skin that is loss of melanin and what causes the destruction of these pigment-forming cells is not completely understood.
A combination of auto-immune, genetic and environmental factors has been seen as Vitiligo causes, in most cases. Recent studies have demonstrated that Vitiligo may also be caused by stress which affects the immune system, leading the body to react and mistakenly destroy the melanocytes by releasing antibodies against them.
Heredity has been strongly proposed as one of the Vitiligo cause, since many cases with Vitiligo do report incidence of this condition (or other auto-immune disorders) in their family. Research has also shown the NALP1 gene to be the trigger in predisposing people to Vitiligo.
Additionally, Vitiligo is said to be associated with (and affecting people with) certain auto-immune and inflammatory diseases such as:
- Hypothyroidism - Under -functioning of thyroid gland
- Hyperthyroidism - Over -functioning of thyroid gland
- Diabetes mellitus
- Addison's disease
- Alopecia areata
- Pernicious anemia
Possible things that can trigger Vitiligo in an individual who is genetically prone include:
- Skin trauma
- Sun burn
- Emotional stress
- Skin rash
- Exposure to de-pigmenting chemicals - the disease can later spread beyond areas of contact via immune-mediated mechanism. Phenolic/catecholic derivatives are the prime chemicals causing this.
All said and done, the exact reason why Vitiligo affects some people and not others, and that too with such unpredictability, still remains unexplored!
As one of the key Vitiligo symptom, a sudden onset is seen in most cases where the patient notices a single, few or many milky white patches of irregular shapes and sizes on the skin. Small areas of de-pigmentation gradually start spreading to involve larger areas of the body. The patches appear more prominent in dark-skinned people and can be quite disfiguring at times.
As far as the progress and reasons for white spot on skin are concerned, it is highly unpredictable. Some cases experience an extremely fast advancement with quick involvement of large areas of the body whereas in some cases there may be few small patches that don't change much with time. The active phase of development of new patches can be followed by a phase where there are no new patches.
The affected areas retain the normal sensitivity to touch and pain; however sun-sensitivity is seen to be increased in many cases. Other Vitiligo symptom may be that the hair over the affected parts, such as skin, scalp, beard, eyebrows, eyelashes, etc. may also lose colour.
Over a period of time, some of the Vitiligo patches may re-pigment by themselves.
The patches of Vitiligo can affect any part of the body though sun-exposed regions, body folds (e.g. groins, armpits), areas around body orifices or sites of previous injury are commonly affected. Following are some of the common patterns of body affection seen in Vitiligo patients:
- Focal: The patches are limited to particular areas of the body
- Segmental: The distribution of the patches is usually asymmetrical affecting one side of body
- Symmetrical: Bilaterally symmetrical patches over the body
- Generalized: Widespread patches spread all over the body
- Over Bony Prominences: The skin near the joints is affected by the patches
- Lip-tip Vitiligo: Vitiligo that is limited to the lips, tips of the fingers and toes, fingertips
- Genital Vitiligo: The private parts of the body are affected
The look of Vitiligo is typical enough to diagnose it on the first look. In addition, your medical and family history will enable your physician to make sure of his diagnosis. However, certain tests may be conducted to confirm the condition as well as to ascertain the cause if possible:
- Biopsy of the affected area can confirm the diagnosis of Vitiligo
- Blood tests may be done:
- To check the thyroid functions
- To look for the presence of anti-nuclear antibodies (that would point towards auto-immune cause)
- To rule out pernicious anemia
- Examination of the spots under Wood's lamp can be used to diagnose and evaluate Vitiligo especially when the changes are not appreciated with the naked eye.
At Dr. Batra's, we scientifically evaluate each case of Vitiligo with Wood's lamp and effectively use it for the following:
- To accurately diagnose Vitiligo
- To rule out fungal infections
- To measure extent of the disease
- To detect early changes that are not visible to naked eyes
- To monitor response to treatment
Vitiligo can be socially devastating for afflicted individuals and it has a significant psychological impact on patients. It can cause feelings of being shunned by the society or being singled out due to the disfigurement that is often seen in this condition. In certain countries like India, these patients often face discrimination especially at the time of marriage. Sometimes Vitiligo can even be a ground for divorce if the patient develops it after marriage.
Vitiligo patients often feel awkwardness in public places and for some it is even hard to move around without developing feelings of embarrassment. Long term sufferers are more prone to fall prey to depression, anxiety and feelings of low self esteem. Many are constantly on the watch as to how the opposite person will react to their looks. Thus, it has significant negative effects on the self-image of a person, his quality of life and self esteem.
For some people, Vitiligo might even be a limitation in pursuing the career of their choice or marrying the person they like. Such people must be encouraged to come out of their shells and to lead a healthy life that does not give too much significance to looks. They must be explained the significance of pursuing whatever they want in life with full confidence because suffering from Vitiligo does not change the kind of personality they have. Regular counseling may be required for those few who do not improve in spite of all these steps.
Recent studies conducted in University of Toronto and published in the BioMed Central journal of Dermatology have clearly demonstrated evidence of benefits of orally taken Ginkgo biloba in the treatment of Vitiligo. This is a known homeopathic drug and besides some others drugs, it has been successfully used in the treatment of Vitiligo.
In another clinical study conducted by the AKP Homoeopathic Clinical Center, 259 Vitiligo patients had improved out of 629 patients included in the study and 42 Leucoderma patients had benefited out of 97 patients. Thus research has also demonstrated the effectivity of Homeopathy in a difficult condition such as Vitiligo.
At Dr. Batra's, we have the expertise of treating more than 45,000 skin cases successfully over last 35 years and we can ensure you of a safe and scientific solution for your Vitiligo. The treatment is primarily aimed at stopping or slowing down the further destruction of melanocytes and stimulating the re-pigmentation in the existing patches. Our team of expert homeopaths, dermatologists and nutritionists work in unison to ensure the best for every case we treat.
The scope of homeopathic treatment extends beyond the physical symptoms and the approach is more holistic in nature. It also addresses the underlying stress and depression that is often seen in many cases. Thus, the treatment at Dr. Batra's goes a step further and works towards re-integrating the patient into normal life.
Prognosis with Homeopathic treatment depends on certain criteria such as the location, duration, extent of spread and the disease activity. It also depends on the general health of the patients and the presence of other systemic illnesses such as thyroid disorders, auto-immune diseases, etc. Vitiligo over bony prominences, around lips, on tips of fingers and toes and generalized extensive Vitiligo show slow improvement. Even after starting the treatment, patient may notice occurrence of some new spots; however, this is because it takes some time to control the disease activity and balance the immune system.
The medicines prescribed at Dr. Batra's are known to be safe without any adverse effects and the patients are not advised any particular dietary restriction which is otherwise a common case with most of the alternative treatments available in the market.
Additionally, at Dr Batra's , we follow certain international medical protocols set by our dermatologists to monitor the improvement of the Vitiligo patients:
- Appearance of the Trichome sign (pale pink color development in the patches)
- Re-pigmentation around the follicles
- Concavity of the borders of the affected patch
Apart from all this, our qualified and experienced nutritionists formulate a personalized diet chart to give the Vitiligo patients valuable dietary help. Thus treatment at Dr. Batra's is truly holistic in every sense of the word and is different from the superficial nature of conventional treatments for Vitiligo.
Brief overview of Conventional treatment options for Vitiligo:
The conventional methods aim at treating Vitiligo by altering its appearance without addressing the underlying cause. The treatment varies from the patches being hidden by cosmetic camouflage solutions to application of cortico-steroidal creams to phototherapy. Camouflage solutions also include tattooingof the affected patch. However, it is often difficult to match the exact color and the patches also tend to spread in spite of the tattooing.
Phototherapy is another option available but this carries a risk of causing sun burn as well as skin cancer. Lastly, surgical procedures are also opted for by many patients and include grafting of the skin on the affected patches but again these cannot be performed in extensive and generalized Vitiligo and carry the risk of scarring apart from its cost value.
Self Care Tips
Based on our expertise and experience of treating thousands of cases over the last 35 years, we at Dr. Batra's have seen patients being helped with certain changes in their diet and lifestyle. These have been clinically verified by us repeatedly and have a scientific backing as well. Here are some points that Vitiligo patients can put to good use:
- Exposing the affected areas to early morning sunlight just after sunrise is known to stimulate pigment forming cells. However, patients must avoid strong sunlight especially between 10 am to 4 pm. If necessary to move out during such hours, patients must opt for a sunscreen with SPF (Sun Protection Factor) of more than 30.
- Regular use of sun screen also guards against sunburn and long term damage
- Use mild soap for bathing and avoid rubbing skin vigorously after a bath (friction can trigger new patches)
- Wear clothing that adequately covers the skin (e.g. full sleeved shirt) - this protects the skin from any kind of external trauma
- Avoid direct contact with deodorants, perfumes - spray on clothes rather than directly on skin
- Avoid mental stress - take effective steps to identify and tackle with stress, if it exists
- Diet rich in copper is suggested for Vitiligo patients since scientific studies have shown low serum copper levels in patients suffering from Vitiligo. Green leafy vegetables and sesame are good sources of copper.
- Supplementation with vitamin B12, folic acid and pantothenic acid has been seen to have beneficial effects in Vitiligo patients (it has been credited with the formation of new melanin). Patients should include adequate lentils, eggs and yogurt in their daily diet for the same.
Facts and Myths
Myth: Vitiligo is contagious.
Fact: It is not contagious and cannot be passed on through contact. Click here to read about what causes Vitiligo.
Myth: Vitiligo increases after consuming milk and other white foods.
Fact: It is an auto immune disease which has no direct relation to food.
Myth: Will my child also get it?
Fact: Researches claim that it does not get carried to the progeny, however strong hereditary tendencies cannot be denied.
Myth: Does the disease stop spreading as the treatment starts?
Fact: It can't be guaranteed as it takes time to build the immune system and by the time the immune system is built, few new spots might appear which recover as the treatment proceeds.
Myth: No new spots come after the stoppage of the treatment.
Fact: Generally speaking no new spots occur but there are certain cases of extreme stress or compromised immunity wherein the spots may recur, however these can be taken care of and controlled by the treatment.