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Ginkgo For Vitiligo

Vitiligo may be a non-communicable and cosmetic skin condition but it can cause self-loathing and depression fueled by social rejection. Therefore, the best time to treat this condition is as early as possible. While prescription vitiligo therapies may work, they do come with some restrictions and unsightly side effects. However, herbs like ginkgo are effective, safe and generally well tolerated. But how does ginkgo work and what are the clinical evidences to back its use in vitiligo therapy? Read on to find out.
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What is Vitiligo?

Vitiligo is a skin condition defined by the appearance and spread of white patches on the skin. It affects about 1 out of every 100 people globally.

It occurs when the skin cells responsible for skin pigment are destroyed or lay dormant. These cells, known as melanocytes, are found in the epidermis where they produce melanin: the pigment responsible for skin color.

Vitiligo commonly affects the face, neck, shoulders and torso but it can also be found on the knees, elbows, feet, hands, and even the genitals.

A small spot which appears lighter than the surrounding skin usually signals the onset of vitiligo.

Such small spots can progressively extend to cover larger portions of the skin resulting in the appearance of irregular white patches of different shapes and sizes on the skin.

Although it can occur at any age, most cases of vitiligo are usually detected before the age of 20. It affects all races but it is more obvious on dark-skinned people.

Vitiligo cannot be described as life-threatening or dangerous because it is just a cosmetic problem. However, it can cause serious depression and thus limit a patient’s social life.

Causes of Vitiligo

The specific cause of vitiligo is not completely understood though it can be triggered by certain factors such as autoimmune disorders, oxidative stress and nerve damage.

Vitiligo is known to run in some families and some of the specific genes responsible for this familial link have been identified. Clinical data show that as much as 30% of vitiligo patients have at least a family member with the condition.

When the cause of vitiligo is autoimmune destruction of the melanocytes, the immune system produces specific antibodies directed at these cells. In such cases, the immune system mistakes melanocytes for foreign bodies and, therefore, mounts repeated attacks to destroying these skin cells. This autoimmune attack can severely reduce the production of melanin and causes the gradual loss of skin color.

The presence or absence of these antibodies in the sera of vitiligo patients is used to determine when a vitiligo case is caused by an autoimmune disorder. Furthermore, when vitiligo is caused by an autoimmune attack on the melanocytes, there is almost always another underlying autoimmune disease present.

Autoimmune disorders known to be associated with vitiligo include Hashimoto's thyroiditis, Graves' disease, diabetes, Addison's disease, alopecia areata and pernicious anemia.

Vitiligo can also be triggered by oxidative stress caused by free radicals and reactive oxygen species such as peroxides.

During normal cellular metabolism, free radicals and reactive oxygen species are released as byproducts of oxidation reactions. These free radicals are normally broken down by antioxidants which are naturally produced in the body before they can damage cells such melanocytes.

Exposure to some industrial and household chemicals is another major source of oxidative stress especially to the skin.

When vitiligo is caused by oxidative stress, patients usually have low levels of catalase (an important antioxidant enzyme) and high levels of reactive oxygen species in their skin. Without optimal antioxidant protection and increased oxidative stress, melanocytes die out quicker and the skin experiences gradual depigmentation.

A 2009 study published in the Indian Journal, Dermatology Venereology Leprology investigated the role of oxidative stress in vitiligo by measuring and comparing superoxide dismutase and catalase levels in vitiligo lesions and unaffected skin.

50 people were recruited for the study and they were divided into two groups: the vitiligo group and the control group.

The result of the study showed there was statistically significant increase in the levels of SOD in both normal skin and depigmented, vitiligo lesions in the vitiligo group compared to the control group. However, the CAT levels in the skins of the patients in the vitiligo group were considerably lower than the level of the enzyme in the control group.

There are various treatment options available for vitiligo and the goals of these treatment options are to stop the spread of vitiligo lesions and restore the skin color.

Both of these goals can be accomplished through ginkgo.

What is Ginkgo?

Ginkgo biloba is one of the oldest species of trees known. Also known as the maidenhair tree, ginkgo is native to Asia especially China where it has been extensively cultivated for centuries mainly for its culinary and medicinal benefits.

Ginkgo leaf extract possesses various medicinal properties which are useful in the treatments of glaucoma, dementia, multiple sclerosis, tinnitus, peripheral artery disease and vitiligo. It also improves memory and blood circulation.

The relevant properties of ginkgo to vitiligo are its antioxidant and immunomodulatory properties.

Ginkgo extract mainly contains two active groups of phytochemicals:

  • Terpene lactones
  • Ginkgo-flavone glycosides (flavonoids)

Other constituents of ginkgo extracts are dimeric flavones (bilobetin, ginkgetin, isoginkgetin, scieadopitysin), ginkgolic acid, proanthocyanidins ascorbic acid, and carotenoids.

Ginkgo extract is available as supplement in form of capsules, tablets, tinctures, fluid extracts, and dried leaves for teas. They can also be applied topically and found in various over-the-counter creams.

The flavonoids, terpene lactones and proanthocyanidins in ginkgo are mainly responsible for the immunomodulatory and antioxidant properties of the herb.

The terpene lactones found in ginkgo are called ginkgolides and bilobalides. The ginkgolides are of different types (ginkgolides A, B, C, J, and M) and they vary in degree of potency. Ginkgolide B is the most active of them.

The flavonoids in ginkgo are known as ginkgo-flavone glycosides and the important ones are quercetin, kaempferol, and isorhamnetin.

Ginkgo extracts are commonly derived from its dried leaves and these extracts are standardized to contain about 24% flavone glycosides and 6% terpene lactones.

How Ginkgo Works

Besides hereditary vitiligo genes, oxidative stress and autoimmune destruction are the other major causative factors of vitiligo. Ginkgo extract has been repeatedly proven to be highly effective against the latter two causes.

The flavone glycosides and proanthocyanidins are very active against a wide variety of free radicals and reactive oxygen species including peroxides which are commonly found in the skin and known to destroy melanocytes.

They scavenge and break down these free radicals and also increase the activities of antioxidant enzymes in the skin. They also protect against lipid peroxidation, which is the most common type of free radical reaction in the body.

Ginkgo increases the activity of superoxide dismutase within skin when it is applied topically. This boosts the skin’s natural defenses against reactive oxygen species. Therefore, through this action, melanocytes are spared from further destruction and the spread of vitiligo is effectively controlled.

Ginkgo can influence the immune reaction to melanocytes through its immunomodulatory property.

Some of the active phytochemicals in the herb specifically target T-lymphocytes and, therefore, modify the response of the immune system. This modification spares melanocytes from destruction by antibodies.

Ginkgo also increases blood flow to the skin and, therefore, by extension it improves the supply of oxygen and nutrients to melanocytes. This increases the rate of recovery of weakened melanocytes and it can contribute to the repigmentation of the skin.

Clinical Studies on Ginkgo

A 2003 study published in the journal, Clinical and Experimental Dermatology, examined the effectiveness of oral Ginkgo biloba extract in treating limited, slowly spreading vitiligo in a double-blind placebo trial.

52 patients with limited and slowly spreading vitiligo were recruited for the study. Only 47 patients were eventually evaluated with 5 patients dropping out for reasons not related to the study.

The patients were divided into 2 groups. The first group was given 40 mg Ginkgo biloba extract three times daily and the control group received the same dosage of placebo.

The result of the study showed that the ginkgo can stop the depigmentation of the skin. The difference between the ginkgo group and the placebo group was statistically significant. Furthermore, 10 patients in ginkgo group showed complete to significant repigmentation compared to only two volunteers in the placebo group.

There was no adverse reaction recorded in the study showing that the ginkgo extract was safe and well tolerated by the patients.

Another study published in the journal, Complementary and Alternative Medicine Journal also examined the effectiveness of ginkgo extract in the treatment of vitiligo patients.

This study was an open label pilot trial with 12 vitiligo patients recruited. These patients were given 60 mg of standardized ginkgo extract two times daily for 12 weeks.

Vitiligo Area Scoring Index (VASI) and Vitiligo European Task Force (VETF) score which evaluate the area and intensity of depigmentation caused by vitiligo skin lesions were used to determine the effectiveness of the ginkgo extract.

The result of the study showed that progression of depigmentation stopped in all the patients.

The same journal published another study with the same aim but involving more patients. In this study, 47 patients were given 120 mg of standardized ginkgo extracts for 6 weeks.

The same methods of evaluation were employed to determine effectiveness of the ginkgo extract.

The result of this study showed that significant improvement was observed in 80% of the patients while repigmentation was observed in 40% of the patients.

Side Effects of Ginkgo and Contraindications

Although some studies have shown that ginkgo is well tolerated, side effects such as intestinal problems, headache, and allergic skin reactions have been reported in some users. However, these are mild side effects that can be resolved with time or dosage adjustments.

There are concerns that gingko can cause seizures and thus may worsen seizures in users with history of epilepsy.

It is also important to note that ginkgo is a blood thinner that reduces the activity of blood platelets. Therefore, using ginkgo with blood thinners such as aspirin, ibuprofen or anticoagulants like coumadin may increase the risks of internal bleeding.

Ginkgo should not be taken along with a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). This may increase the risk of serotonin syndrome which is a potentially fatal condition.

Sources


http://www.raysahelian.com/ginkgo.html

http://www.activenaturalsinstitute.com/library_ginkgo_biloba

http://www.edwardsdrugs.com/PDF/moregeneralhealth/NC16%20-%20Issue%2016%20-%20Ginkgo.pdf

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