Thursday, 14 May 2015

Vitiligo

Vitiligo

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.
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.
Vitiligo Causes
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
Psoriasis
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!
Vitiligo Symptoms
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
Diagnosis
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
Psychological Impact
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.
Homeopathic treatment
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.
We have the expertise of treating more than 45,000 skin
cases successfully over last 50 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 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 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, 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 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 50 years, we 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.