Vitiligo Research Updates

January 19, 2015 Written by JP       [Font too small?]

Vitiligo is an autoimmune disease that affects up to two million adults and children in the United States alone. However, unlike many other autoimmune conditions, vitiligo is visibly apparent to those living with it and those around them. In most cases, the characteristic loss of skin pigmentation can’t be fully concealed with clothing or cosmetics. What’s more, conventional treatments used to manage vitiligo are often expensive, risky and not entirely successful in slowing its spread and/or repigmenting affected white patches. Thankfully, there is hope to found in the form of affordable, natural remedies with good safety profiles.

In recent years, numerous studies published in peer-reviewed medical journals have started to define specific deficiencies and imbalances associated with vitiligo. I think that addressing these known factors may very well improve the appearance of skin and/or change the course of this disease for the better. Technically speaking, these measures can help protect melanocytes (cells that produce melanin or pigment) from damage and possibly support the process of melanin production aka melanogenesis. These therapeutic effects are largely accomplished by using targeted nutritional supplementation. The addition of topical support, in the form of a homemade lotion, rounds out my current list of suggestions for those looking for an integrative approach to this form of autoimmunity.

According to the medical literature, many vitiligo patients exhibit higher than normal oxidative stress and lower than normal levels of copper, folic acid, Vitamins B12, D and zinc. For starters supplementing with an antioxidant-rich multivitamin/mineral which contains these nutrients can help address underlying deficiencies. I also recommend a B-complex or homocysteine-lowering formula that provides additional B12 and folic acid. Extra Vitamin D3 should likewise be seriously considered. A promising study from January 2013 reveals the reason why. In the 6 month trial, patients with psoriasis and vitiligo showed dramatic improvements in skin condition while taking 35,000 IUs of D3 daily. That was not a typo. They actually took 35,000 IUs each and every day! It should be noted that all the participants were instructed to drink at least 2.5 liters/day of water and avoid calcium supplements, dairy and calcium-fortified foods while following this “prolonged high-dose” protocol. 25% – 75% repigmentation was reported in 14 of the 16 vitiligo patients taking Vitamin D3. As an aside, those with psoriasis showed similar improvements in their symptoms. Perhaps more importantly, toxicity testing didn’t reveal any negative changes in calcium levels or kidney function.

Applying a cream or lotion containing Nigella sativa seed oil, also known as black cumin, is a good way to address loss of pigmentation from the outside in. An experiment published in May 2011 first documented the skin darkening effects of black cumin oil in a laboratory setting. The authors’ concluding remark stated, “This study opens new vistas for the use of N. sativa active ingredient, thymoquinone, as a novel melanogen for its clinical application in skin disorders such as hypopigmentation or vitiligo.” In June 2014, a human trial confirmed the previously mentioned hope. The 6 month study asked two groups of vitiligo patients to apply either black cumin oil or fish oil to depigmented lesions. Those using black cumin oil safely reduced the size of their vitiligo lesions. Since black cumin oil lotions aren’t easy to find, I suggest making your own by mixing a teaspoon of this rare oil into a gentle moisturizing lotion. I recommend making the mixture fresh each time and massaging well into all affected areas, preferably twice-daily.

Lastly, I looked into the topic of dietary causation or influence on the occurrence and progression of vitiligo. Unfortunately, I didn’t find a large volume of published data. However, there is some evidence of vitiligo improvement associated with the avoidance of gluten. From my perspective, adopting a gluten-free trial diet is certainly worth trying. Another avenue to consider is a diet and lifestyle that promotes greater insulin sensitivity. At least one study found a link between vitiligo and insulin resistance. Limiting high-glycemic and/or refined carbohydrates, getting regular exercise and enough sleep are three of the best ways to improve insulin sensitivity and overall health.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Comparison of Oxidant-Antioxidant Status in Patients w/ Vitiligo … (link)

Study 2 - Evaluation of an Oral Supplement Containing Phyllanthus Emblica (link)

Study 3 - Decreased Copper and Zinc in Sera of Chinese Vitiligo Patients … (link)

Study 4 - Hypothesis: Zinc Can Be Effective in Treatment of Vitiligo (link)

Study 5 – Improvement of Vitiligo After Oral Treatment w/ Vitamin B12 and (link)

Study 6 - The Role of Vit. D in Melanogenesis w/ an Emphasis on Vitiligo (link)

Study 7 - Influence of Narrowband UVB Phototherapy on Vitamin D and (link)

Study 8 – A Pilot Study Assessing the Effect of Prolonged Administration of (link)

Study 9 - Nigella Sativa Seed Extract & Its Bioactive Compound Thymoquinone (link)

Study 10 - Comparing Nigella Sativa Oil and Fish Oil in Treatment of Vitiligo (link)

Phototherapy Increases Vitamin D in Vitiligo Patients

Source: ISRN Dermatol. 2014 Mar 23; 2014: 493213 (link)

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6 Comments & Updates to “Vitiligo Research Updates”

  1. JP Says:

    Here are a few of the diet-related studies I mentioned in the closing paragraph:

    1) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482575/

    “There is a well-known association between CD (celiac disease) and other immune-mediated diseases [1]. A protective effect of a gluten-free diet was proposed more than a decade ago [16,28], but later studies have shown conflicting results [15,18].”

    2) http://onlinelibrary.wiley.com/doi/10.1111/j.1525-1470.2011.01388.x/abstract

    “There is a well-established association of vitiligo with autoimmune conditions, and circulating autoantibodies to melanocytes have been demonstrated in the serum of patients with vitiligo. We present a case of repigmentation of vitiligo lesions in a girl with celiac disease after initiating a gluten-free diet, which to our knowledge has not been reported.”

    3) http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1141&html=1

    “In conclusion, in this study we found that patients with vitiligo had higher IR than BMI- and waist circumference-matched controls. Increased insulin levels may be related to other mechanisms than obesity, such as cytokines or autoimmune reaction to melanocytes, in patients with vitiligo. Further experimental and clinical studies are needed to clarify this subject.”

    Be well!

    JP

  2. Gianfranco P. F. Says:

    Hi JP,

    Great research!

    It is a blessing to count on your skilled and knowledgable research and practical guidance to implement integrative solutions for Viltiligo!
    I will share this source with anyone I know affected by Vitiligo!

    Thank you!

    Paul

  3. JP Says:

    Many thanks, Paul! I appreciate your support!

    Be well!

    JP

  4. JP Says:

    Updated 04/16/16:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4784126/

    Ayu. 2015 Apr-Jun;36(2):163-8.

    Clinical efficacy of Apamarga Kshara Yoga in the management of Shvitra (vitiligo).

    INTRODUCTION: Vitiligo is a progressive, idiopathic, pigmentation disorder of the skin, characterized by hypopigmented patches. This condition is compared with Shvitra in Ayurveda. Many Ayurvedic drugs are beneficial in such cases and Apamarga Kshara Yoga is one among them.

    AIM: To evaluate the efficacy of Apamarga Kshara Yoga in Lepa and ointment forms in the management of Shvitra.

    MATERIALS AND METHODS: Total 50 patients of Shvitra were randomly grouped into two. Patients registered in Group A (n = 25) were treated with Apamarga Kshara Yoga Lepa and Group B (n = 25) with Apamarga Kshara Yoga ointment for 2 months. Rasayana Churna (3g) along with Honey and Ghee was given twice daily internally in the both groups.

    RESULTS: Significant improvement was found in the symptoms of Shvitra with treatment in both the groups. The difference in between the groups was statistically insignificant.

    CONCLUSION: Both forms of Apamraga Kshara Yoga are effective in cases of Shvitra and can be good alternatives for contemporary medicines.

    Be well!

    JP

  5. JP Says:

    Updated 11/19/16:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055927/

    Biomed Res Int. 2016;2016:8065765.

    Adult Onset Vitiligo: Multivariate Analysis Suggests the Need for a Thyroid Screening.

    Background. There are limited epidemiological studies evaluating the effect of age at onset on disease features in vitiligo. Objectives. To identify factors associated with adult onset vitiligo in comparison with childhood onset vitiligo. Patients and Methods. We retrospectively collected medical records of 191 patients. Such records included clinical examination, personal and familial medical history, laboratory evaluations, concomitant vitiligo treatment and drug assumption. Results. 123 patients with a disease onset after the age of 40 (adult onset vitiligo) were compared with 68 patients who developed vitiligo before the age of 12 (childhood onset vitiligo). Multivariate analysis revealed that personal history of thyroid diseases (P = 0.04; OR 0.4), stress at onset (P = 0.002; OR = 0.34), personal history of autoimmune thyroid disease (ATD) (P = 0.003; OR = 0.23), and thyroid nodules (P = 0.001; OR 0.90) were independently associated with adult onset vitiligo, whereas family history of dermatological diseases (P = 0.003; OR = 2.87) and Koebner phenomenon (P < 0.001; OR = 4.73) with childhood onset vitiligo. Moreover, in the adult onset group, concomitant thyroid disease preceded vitiligo in a statistically significant number of patients (P = 0.014). Conclusions. Childhood onset and adult onset vitiligo have different clinical features. In particular, ATD and thyroid nodules were significantly associated with adult onset vitiligo, suggesting that a thyroid screening should be recommended in this group of patients.

    Be well!

    JP

  6. JP Says:

    Updated 06/12/17:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5420602/

    Postepy Dermatol Alergol. 2017 Apr;34(2):116-119.

    Evaluation of the serum zinc level in patients with vitiligo.

    INTRODUCTION: Vitiligo is an acquired, idiopathic disorder characterized by circumscribed depigmented macules and patches, which affects approximately 0.1-2% of the general population worldwide. Zinc is an essential trace element that is necessary for growth and development at all stages of life. Some studies have reported an association between serum zinc levels and vitiligo.

    AIM: To measure the serum zinc level in patients with vitiligo compared to healthy subjects.

    MATERIAL AND METHODS: One hundred patients with vitiligo and 100 healthy controls were referred to our clinic. The two groups were matched for age and sex. Atomic absorption spectrophotometry was used to measure serum zinc levels. The statistical analysis was performed using SPSS software.

    RESULTS: The mean serum level of zinc in vitiligo patients and controls was 80.11 ±17.10 μg/dl and 96.10 ±16.16 μg/dl, respectively. The serum zinc level in patients with vitiligo was significantly lower than in healthy controls (p = 0.0001).

    CONCLUSIONS: The results of our study revealed a significant association between vitiligo and serum zinc levels. A relative decrease in the serum zinc level in vitiligo patients can highlight the role of zinc in the pathogenesis of vitiligo, and large-scale studies need to be conducted to confirm these findings and assess the effect of oral zinc supplements in patients with low zinc levels.

    Be well!

    JP

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