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What Vitiligo Is
Vitiligo is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin are destroyed.
As a result, white patches appear on the skin in different parts of the body. Similar patches also appear on both the mucous membranes, and the retina. The hair that grows on areas affected by vitiligo sometimes turns white.
Cause of Vitiligo
The cause of vitiligo is not known, but there are several theories of what causes it.
There is strong evidence that people with vitiligo inherit a group of three genes that make them susceptible to depigmentation. The most widely accepted view is that the depigmentation occurs because vitiligo is an autoimmune disease-a disease in which a person's immune system reacts against the body's own organs or tissues.
As such, people's bodies produce proteins called cytokines that alter their pigment-producing cells and cause these cells to die. Another theory is that melanocytes destroy themselves.
Finally, some people have reported that a single event such as sunburn or emotional distress triggered vitiligo; however, these events have not been scientifically proven as causes of vitiligo.
Who Vitiligo Affects
About 0.5 to 1 percent of the world's population, or as many as 65 million people, have vitiligo.
In the United States, 1 to 2 million people have the disorder. Half the people who have vitiligo develop it before age 20; most develop it before their 40th birthday. The disorder affects both sexes and all races equally; however, it is more noticeable in people with dark skin.
Vitiligo may also be hereditary. Children whose parents have the disorder are more likely to develop vitiligo. In fact, 30 percent of people with vitiligo have a family member with the disease. However, only 5 to 7 percent of children will get vitiligo even if a parent has it, and most people with vitiligo do not have a family history of the disorder.
Symptoms of Vitiligo
People who develop vitiligo usually notice white patches on their skin first. These patches are more commonly found on sun-exposed areas of the body, including the hands, feet, arms, face, and lips.
Other common areas for white patches to appear are the armpits and groin, and around the mouth, eyes, nostrils, navel, genitals, and rectal areas. Vitiligo generally appears in one of three patterns:
- focal pattern-the depigmentation is limited to one or only a few areas
- segmental pattern-depigmented patches develop on only one side of the body
- generalized pattern-the most common pattern. Depigmentation occurs symmetrically on both sides of the body.
In addition to white patches on the skin, people with vitiligo may have premature graying of the scalp hair, eyelashes, eyebrows, and beard. People with dark skin may notice a loss of color inside their mouths.
Treatment Options for Vitiligo
The main goal of treating vitiligo is to improve appearance.
Therapy for vitiligo takes a long time-it usually must be continued for 6 to 18 months. The choice of therapy depends on the number of white patches; their location, sizes, and how widespread they are; and what you prefer in terms of treatment.
Each patient responds differently to therapy, and a particular treatment may not work for everyone. Current treatment options for vitiligo include medical, surgical, and adjunctive therapies as well as vitamins and supplements.
A number of medical therapies, most of which are applied topically, can reduce the appearance of white patches with vitiligo. These are some of the most commonly used ones:
- Topical steroid therapy-steroid creams may be helpful in repigmenting white patches, particularly if they are applied in the initial stages of the disease. Corticosteroids are a group of drugs similar to hormones such as cortisone, which are produced by the adrenal glands.
- Psoralen photochemotherapy-also known as psoralen and ultraviolet
A therapy, or PUVA therapy, this is probably the most effective treatment
for vitiligo available in the United States.
The goal of PUVA therapy is to repigment the white patches. However, it is time-consuming, and care must be taken to avoid side effects, which can sometimes be severe. Psoralen is a drug that contains chemicals that react with ultraviolet light to cause darkening of the skin. The treatment involves taking psoralen by mouth or applying it to the skin.
This is followed by carefully timed exposure to sunlight or to ultraviolet A (UVA) light that comes from a special lamp. Typically, you will receive treatments in your doctor's office so you can be carefully watched for any side effects. You must minimize exposure to sunlight at other times. Both oral and topical psoralen photochemotherapy are described below.
- Depigmentation-this treatment involves fading the rest of the
skin on the body to match the areas that are already white. For people who
have vitiligo on more than 50 percent of their bodies, depigmentation may be
the best treatment option.
Patients apply the drug monobenzylether of hydroquinone twice a day to pigmented areas until they match the already-depigmented areas.
In addition to medical and surgical therapies, there are many things you can do on your own to protect your skin, minimize the appearance of white patches, and cope with the emotional aspects of vitiligo:
- Sunscreens-people who have vitiligo, particularly those with fair
skin, should minimize sun exposure and use a sunscreen that provides
protection from both the UVA and UVB forms of ultraviolet light.
Sunscreen helps protect the skin from sunburn and long-term damage. Sunscreen also minimizes tanning, which makes the contrast between normal and depigmented skin less noticeable.
- Cosmetics-some patients with vitiligo cover depigmented patches
with stains, makeup, or self-tanning lotions. These cosmetic products can be
particularly effective for people whose vitiligo is limited to exposed areas
of the body.
Self tanning lotions have an advantage over makeup in that the color will last for several days and will not come off with washing.
- Counseling and support groups-many people with vitiligo find it
helpful to get counseling from a mental health professional. People often
find they can talk to their counselor about issues that are difficult to
discuss with anyone else.
A mental health counselor can also offer support and help in coping with vitiligo. In addition, it may be helpful to attend a vitiligo support group.
Natural Supplement - Callumae
Callumae, Progressive Health's extremely active Vitiligo formula, has been specifically designed to support immunological functioning and the skin's natural pigmentation processes.
Whether used alone, or in combination with your current treatment regime, Callumae may work to slow the progression of Vitiligo and help restore normal skin pigmentation.
Research indicates that the ingredients found in Callumae can benefit all vitiligo sufferers, especially when combined with ultraviolet light therapies.
Clinical trials have shown that many important vitamins are lacking in a large number of vitiligo patients, including Folic Acid, vitamin B6, and vitamin B12 - nutrients responsible for pigmentation, energy metabolism, and nervous system function.
A few ingredients in Callumae are:
- Picrorhiza (Picrorhiza kurroa)- This medicinal plant has a long tradition of use for immune dysfunction in Ayurvedic medicine, which may be beneficial to patients with vitiligo.
- Ginkgo biloba- Oxidative stress appears to play a role in the pathogenesis of vitiligo, making antioxidant compounds useful in the treatment of this disorder.
- Vitamin B6- This essential vitamin plays a critical role in energy metabolism, nervous system function and immunity. Vitamin B6 is often given empirically for people with autoimmune disease.
- Vitamin B12 and Folic Acid- A clinical study of patients with actively spreading vitiligo was conducted where subjects took a combination of vitamin B12, folate and vitamin C along with UVB treatments. The results showed that 100% of subjects had a halt in depigmentation, and induction of repigmentation in 6-8 weeks.
- Khellin- An extract of Ammi visnaga, khellin is similar to
the conventional vitiligo drug methoxsalen. Khellin is as effective as
conventional PUVA therapy when combined with UVA (either artificial or
solar), and does not cause adverse effects like PUVA.
Khellin appears to stimulate growth and production of melanocytes (skin pigment producing cells).
- L-Phenylalanine- Clinical research shows that this amino
acid produces good results in both children and adults with vitiligo, when
combined with light therapy.
A combination of oral and topical L-phenylalanine, sunlight or UVA and 0.025% clobetasol proprionate at night is especially effective for treatment of evolutive vitiligo on the face or in children, and is without side effects.
For a complete list of ingredients