Before we get to understand about the loss of colour from the skin in vitiligo, let us first see how the skin gets its normal colour. A pigment called melanin imparts the skin (as well as hair) the native colour. This pigment is produced in cells called 'melanocytes'. When the melanocytes die or are unable to function, it results in loss of melanin causing colour-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
- Alopecia areata
- Pernicious anemia
Possible things that can trigger vitiligo in an individual who is genetically prone include:
- Skin trauma
- Sun burn
- Diabetes mellitus
- 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
- generalised: 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
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 generalised 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.