Investigating the mystery of vitiligo
I don’t remember exactly when my addiction to detective stories began. It might have been back in the 1970s, when I first started watching the disarming and dishevelled homicide detective Lt. Columbo relentlessly hunting down his prime suspects with “just one more question” until they were finally forced into revealing themselves as the killer. Or it might date all the way back to endless childhood hours engrossed in the latest thrilling adventures of Enid Blyton’s Famous Five or Secret Seven. Nowadays I am a sucker for a good episode of Miss Marple, Poirot or, my guiltiest pleasure of all, Midsomer Murders. And I always have a ready supply of whodunnits on my Kindle as well as on my book shelf.
My preoccupation with murder mysteries may sound a little morbid but, in my defence, it is not the blood and guts that draw me to the genre. It is the intriguing plots and the challenge of piecing together a seemingly impenetrable puzzle. Of course, the pleasure in most crime dramas comes from looking for clues and motives, spotting red herrings and attempting to solve the mystery ourselves. The enjoyment in an episode of Columbo, on the other hand, comes from watching someone else put the pieces together, whilst we – the audience – already know who the killer was and how they did it.
The puzzle of vitiligo
I find the mystery of vitiligo every bit as challenging and absorbing as those fictional tales but I have not always felt this way. When I was still in the midst of my own drama – wondering why on earth my skin kept developing new white spots, dreading when and where the next one would appear and hoping and praying for a cure - or anything at all that would help even a little – I was too deeply affected by it all to want to spend too much time dwelling on it. It was easier to cover it up and try not to think too deeply about it. But once my re-pigmentation was in full swing it was as if I was watching another episode of Columbo, knowing how the story would end. The solution to the mystery was in plain sight and so I could relax and enjoy watching the rest of the story play out. Suddenly I didn’t mind focussing my attention on what was happening to me because it was no longer depressing. In fact, it was thrilling to see the colour returning to my skin and I became fascinated by the process. This was when I began to read everything I could find on the subject of #vitiligo in an attempt to understand as much as possible about what causes it, ways of treating it and ways of coping with it.
What I have learned (and am still very much in the process of learning) is that, unlike the fictional detectives who solve every crime, catch every villain and tie up every loose end, a vitiligo detective’s results are not as clear cut. It seems there are always differing medical opinions, conflicting theories, inconclusive research results and – most disturbing of all - deliberately misleading and bogus claims to sort through before you can come to any definite conclusions on the subject. But I suppose this just goes to show that vitiligo is not a work of fiction. It is real life and affects different people in different ways. It is an ongoing investigation that, in all probability, will eventually culminate in a complex set of solutions, reflecting the fact that it is a complex condition.
The most effective treatment
Obviously - since there is no official cure for vitiligo yet - this is a mystery that is still under investigation by researchers and sufferers alike. It is a detective story that looks set to run for quite some time. But everything I have learned, and experienced, so far convinces me that nutritional deficiencies play a central role, maybe the central role, in the development of vitiligo and that correcting those deficiencies is currently the most effective way to reverse it and keep it at bay. Saying this may not be quite the same thing as solving the mystery and closing the case but it has certainly made a world of difference to me - and to many others who have adopted the same, or a similar, approach to their treatment.
Just why a significant minority of the world's population seemingly randomly lose patches of their skin colour is evidently a complicated puzzle that is still in the process of being solved (though I am confident it will be eventually). Until it is, I shall continue to be a vitiligo detective and hunt down every fascinating clue I can find. I shall, like the good lieutenant, keep on asking “just one more question” and keep passing on any potentially useful answers I come across in this blog. However, much as I enjoy researching and writing it, I look forward to the day when the only mysteries I try to unravel are fictional ones because vitiligo will have become a straightforward condition to cure and this blog will have lost its relevance.
Vitiligo on TV makeover show
Earlier this month I watched Katie Piper’s Face to Face, a #TV documentary on Britain’s Channel 4 presented by a former model, in which she invited women with a variety of face-altering skin conditions to have a makeover. What made this programme so different from all the other makeover shows I have ever seen was that Katie herself has severe facial scars which she sustained several years ago when she was the victim of an acid attack. And, unbeknown to her guests, each of the make-up artists on the show shared the same facial condition as the person they were making up. The whole show was absorbing but I was, of course, particularly interested in the #vitiligo-makeover.
The big reveal
The most dramatic twist of all was "reverse big reveal” at the end of each makeover when, to the surprise of the person sitting in the make-up chair, the artist wiped off their own cosmetics to reveal that they too had the same condition. The effect of this was both moving and uplifting because it was so unexpected and, in a strange way, so intimate. This was definitely not your average makeover show (although there were some useful tips for anyone interested in cosmetics and camouflage) and it was certainly not about glamorous professionals helping to transform poor, needy victims by teaching them to hide their scars. It did show that make-up is a potentially empowering, but completely personal, choice for anyone whose face is different from the accepted norm. But, much more importantly, it showed the power of shared experience and mutual compassion between the invited guests and their make-up artists (some of whom were self-taught, rather than professionals). Seeing their reactions, I was reminded of the tremendous power of mutual support. Because, no matter how kind and well-intentioned a person may be, it takes someone who has been through a face-altering experience to truly understand how this makes a person feel.
One shared experience: two different ways of coping
The show also highlighted the different ways in which individuals cope with their skin condition. Rochelle, the guest with vitiligo, had come to terms so completely with her two-tone skin that she actually found the cosmetic transformation into airbrushed perfection rather unnerving, whereas Nancy, the artist who performed the makeover, relies on cosmetic camouflage to give her the confidence she needs each day to feel comfortable in her own skin. I found myself in awe of Rochelle's attitude but I completely related to Nancy's because my reaction to having vitiligo had always been to hide it at all costs and every time I removed my make-up and looked in the mirror it use to make me miserable. For me, the most powerful part of their interaction was seeing both of them instantly empathise with the other, whilst accepting that they each had completely different, yet equally valid, ways of coping on a daily basis.
Exposure and coverage
It is good to see vitiligo being shown and discussed in such an open and constructive way on mainstream TV. I am guessing that this will have been the first time that many viewers have ever seen or heard of vitiligo. I have always enjoyed a good play on words, so it strikes me as strangely fitting that a condition that presents each individual with a choice between exposure or (cosmetic) coverage should be in such need of both media exposure and media coverage! There is still a shockingly poor level of awareness and understanding of it, compared to other skin conditions. This widespread ignorance is one of the reasons so many people choose to cover their patches up (which, of course, helps to perpetuate that ignorance). After all, even if you are not particularly self-conscious, who wants to keep having to explain to people what the white spots are? Isn’t it just simpler to hide them and pretend they aren’t there? That’s how I used to feel before I re-gained my lost pigment and, I have to admit that it is probably how I would still feel today. It was my coping strategy then and I don’t suppose I would be much different now. But I do think that the more exposure vitiligo has in the media, the easier it will become for each person to decide for themselves, with no pressure from others, whether they want to cover up or not.
It seems to me that Katie Piper herself has developed a wonderfully positive and balanced attitude towards the role of make-up for those with skin imperfections. At the start of the show, she admits that, like anyone else, she worries about her appearance but, on the subject of make-up, she says she has come to see it as a friend she can call upon when she needs it but never be dependent on.
Having watched the show, I was prompted to find out more about its inspirational host and what impressed me the most when I read Katie's story was the fact that she has clearly emerged from her own utterly horrifying ordeal a stronger and more successful person with a heartfelt desire to use her painful experiences to help others overcome their physical, and emotional scars too.
If you did not see the show it is available to view on this link:
Just like many other medical conditions, #vitiligo shows no favouritism. It affects all ethnicities, old and young, rich and poor, male and female alike. It takes no account of whether or not you are a famous or a good person, whether or not you deserve to have additional problems in your life. And it certainly doesn't care whether or not you feel sorry for yourself – which, if we are honest, we all do from time to time. It’s just one of those things that happens to some people and, depending on your personality and attitude to life, it can either be (multiple choice coming up...you choose the description that best fits you):
Whatever category above you fall into, I am guessing there isn’t a single one of us that hasn’t ever, at least once, asked the question “why me?” So I would like to suggest 3 answers that I hope will help.
The first answer to this question should really be, “why not me?” The question is, after all, a pointless one. In fact, it is entirely the wrong question. It assumes that fate chose to afflict the wrong victim. It suggests that I would prefer someone else to have been cursed with unwanted, unexplained white patches all over their skin. Or, even more nonsensically, it suggests that I might have preferred to have cancer or been paralysed in a traffic accident. It implies that suffering is fine – as long as it happens to someone else! Well, suffering is not fine, no matter who is doing the suffering. But, sadly, it is a fact of life. Most of the time, when we ask ourselves (or fate, or God) “why me?”, we know deep down that we are just feeling sorry for ourselves (which is OK, by the way – at least, it is human). The main trouble with the question, though, is that we are powerless to answer it. And every time we ask it seems to reinforce that powerlessness.
So, my second answer to the question "why me?" is that we should ditch that question for now and ask a different one - one that we have the power to answer. I have come to realise that the most empowering question a person with vitiligo (or any other affliction or adversity, come to that) can ask is "what can I do about it?" And the answer to that question is - "a lot!".
The sad thing is that comparatively few vitiligo sufferers are aware of just how much they can do to reverse their #de-pigmentation and revolutionise their health and happiness. And it's no wonder when you consider how little accurate information is available, not to mention the misinformation that often comes at us, intentionally, from unscrupulous con-merchants and, unwittingly, from well-intentioned but ill-informed doctors.
For nearly 5 decades I believed what I had been told. I believed that vitiligo was a life sentence, that it was a waste of time trying to treat it and that it would only ever get worse. It's no wonder that this prospect caused me to feel sorry for myself from time to time. I am sure I would have continued to believe these things if I had not, more or less accidentally, becomeliving proof that they were all utterly incorrect. If you have read my story of vitiligo re-pigmentation you will know that a somewhat half-hearted experiment with nutritional supplementation and sun exposure seven years ago unexpectedly and wonderfully reversed vitually all of the 80% pigment loss I had suffered by that point in my life. It is too early to say categorically that this recovery is permanent of course because only seven years have passed since then. But I take the fact that I have had no relapse and have only continued improving since then as a good sign :)
In the previous section of this blog I recommended ditching the original question because it was not one we have the power to answer and because it generally encourages self pity. However, there are times when the question “why me?” can be a valid one to ask and actually does have a meaningful answer.
Once I knew, from personal experience, that vitiligo was not the hopeless condition I once thought it was, I finally felt able to return to that initial question but to ask it in a completely different way - a way that led me to an empowering and uplifting third answer. And that answer to "why me?" is: “so that I can empathise with others who are going through what I went through”. Whether you think about it logically - or emotionally - there can really only ever be one helpful answer to the question “why do apparently random bad things happen to certain people”. And that is so they can overcome them and also help other people do the same.
This third answer was the primary motivation for starting my vitiligo blog soon after my re-pigmentation and is the reason I now spend so much of my time learning about what made it happen, reading up on research and corresponding with vitiligo friends. It’s not that I set out with any master plan to provide vitiligo support to others or to become any kind of information source on the subject. It has just naturally developed out of my extreme excitement and gratitude at having recovered to such an amazing extent. And, it has to be said, that this was fuelled by frustration (at times, to the point of anger) that so few genuinely helpful and accurate facts are available to people living with vitiligo to help them ask the right questions and to find the answers that do exist but that are still not common knowledge.
as effective therapy for vitiligo
There was a time when any #vitiligo patient who dared mention the word “vitamin” in the presence of their doctor would have earned themselves a patronising smirk and a dismissive assertion that “no evidence exists to show #nutritional-supplementation has any effect on the condition whatsoever”. Sadly, that time is not yet firmly in the past. But I fervently hope, and believe, that an excellent new publication called “The Use of Vitamin Therapy for the Treatment of Vitiligo” will help to consign this kind of reaction to history.
The woeful ignorance of most mainstream doctors on the subject of nutritional therapy for vitiligo was clearly a key motivation for the book's author, Audrey VanStockum @Recouleur. As she explains in her preface, she suffered with vitiligo and psoriasis for years, was misdiagnosed for both conditions and visited a total of 23 clinicians over a 14 year period in her search for answers to her skin problems. She realised that her negative experience highlighted “a paucity of information and specialized training” and it puzzled her that so few healthcare providers seemed to have any knowledge of effective vitiligo treatments, even though published research on the subject - dating as far back as 1945 - was openly available. Her frustration at this state of affairs led her to start doing her own research into the subject of nutritional therapy, trying various vitamin and mineral supplements herself and observing her responses. Her wide reading on the subject and experiments in self-treatment resulted in some re-pigmentation and, ultimately to the creation of her own dietary supplement called Recouleur.
Audrey's expertise in the area of nutritional therapy is a wonderful example of how frustration can sometimes be the mother of invention. The idea that we need to take responsibility for our own vitiligo treatment is a familiar one for many of us because we too have repeatedly met the same brick walls when trying to find constructive help from the medical community. Like Audrey, some of us will have wondered why our doctors have apparently never come across any of the research that we ourselves may have seen whilst trawling the internet for solutions and why it is that they are so resistant to the suggestion that nutritional therapy should be prescribed for vitiligo. In fact, I have sometimes advised vitiligo friends to avoid the subject of food and supplementation completely when visiting their doctor because I could predict the likely reaction and did not want anyone to rain on their parade. My view was that the proof of the pudding was in the re-pigmentation that people were achieving through supplementation and that trying to persuade the medical profession to recognise these successes was futile. But that was because it was not a straightforward matter to have the relevant research at one's fingertips during the typical doctor-patient consultation. Well, that was before Audrey's new publication, which – in addition to its main aim of informing vitiligo sufferers themselves - could also easily be used as a way of presenting their doctors with the nutritional facts, all in one well researched and clearly written 40-page booklet.
One of the strengths of “The Use of Vitamin Therapy for the treatment of Vitiligo” is, in my opinion, the fact that it strikes the perfect balance between scientific detail and simple explanation so that it makes suitable reading for anyone, regardless of whether they have a scientific background or not – and regardless of their prior understanding of vitiligo. The author assumes nil knowledge of the subject, explaining what vitiligo is and the processes thought to be involved in its development. She then reviews key vitamins and minerals used by the body to produce skin pigment and describes the role played by each one, as well as the adverse effects of deficiencies. And, crucially, she backs up all of the information with relevant research studies. As I read through the book, I found references that I had not come across before, as well as some that I had seen but had since lost sight of in the vastness of the internet. So, it was extremely useful to have such a comprehensive overview of the subject and its associated literature all in one place and set out in such a clear and concise way.
I also found myself saying (aloud) “YES!!!” when I read the chapter on what Audrey has termed “The Three-Prong Approach” to vitiligo treatment because her view on this makes total sense and resonates with my own thoughts exactly. This approach states that that the most effective vitiligo therapies involve one component from each of the following categories:
In this way, the condition is being addressed from the inside out as well as the outside in and is benefiting from UV exposure (nature's way of stimulating pigment) as well as active, therapeutic ingredients (to treat the condition).
In my experience, most doctors only ever try to treat vitiligo “from the outside in” (i.e. they might use one, or both, of categories 2 and 3). Many do not even advocate any treatment at all because they claim that improvements are minimal and, at best, temporary. However, I am convinced that this is because they omit category number 1. They neglect to include nutritional therapy in their treatments. It stands to reason that external therapies may help treat skin symptoms but only internal ones can hope to address the root cause and prevent symptoms from recurring over the longer term.
The medical profession has been slow to pick up on the findings of research done as long ago as the 1930s and 1940s that clearly pointed to digestive deficiencies as being at the root of vitiligo. Audrey VanStockum draws on the findings of this research, further supported by anecdotal evidence of vitiligo sufferers whose pigmentation improved with improvements to their diet.
There is no question in my mind that correct nutritional #therapy can reverse vitiligo. Audrey and countless others (including myself) are living proof of the fact. But our modern health systems are heavily biased toward pharmaceutical and surgical solutions, no doubt because these are the areas of research that tend to receive the most funding. Concepts of healthy eating and nutritional supplementation as a means of restoring health receive very little serious attention and therefore do not produce the amounts of clinical research data demanded nowadays by the medical establishment. This is frustrating but perhaps it is understandable. Sophisticated drugs, stem-cell therapies and ground-breaking surgical procedures are needed for all kinds of life-threatening conditions that afflict the human race and they are super-expensive to develop. So this is where the funding tends to go. (And, if we want to be cynical about it, these are the treatments that can be patented and become lucrative for thedrug companies and professionals who administer them. Whereas foods and nutritional supplements already exist and are widely available.) What is lacking is not simply new clinical data to support nutritional therapies but an awareness and acknowledgement on the part of doctors that this approach is sometimes the most effective way of treating certain conditions, and that one of those conditions is vitiligo. And, to be fair, there is another requirement, if things are going to change: and that is individual patient responsibility not to be over-reliant for their own state of health on the men and women in white coats. We need to take charge of our own recovery.
In the final paragraphs of the book, Audrey puts all of this in a nutshell: she says, “First, patients need to be their own health advocates and seek solutions for treatable conditions instead of accepting any answers physicians provide, such as “Nothing can be done,” which is said all too frequently to vitiligo patients. Second, physicians need to be open to complementary therapies for treating highly challenging diseases that do not always respond to conventional treatments. Third, more robust studies are needed to analyze the role of vitamins in treating vitiligo; and fourth, dermatological residencies should include a tract on the role of nutrition.”
Obviously, there is far too much detailed information in this excellent publication for me to do more than scrape the surface in this blog. So, I would recommend it as essential reading for anyone, from any background (scientific or not) who wants to understand the relationship between nutrition and vitiligo and how nutritional therapy can help to treat this complex and frustrating condition.
Congratulations, Audrey - and thank you for sharing your knowledge!
for vitiligo and for general health
Having lived with widespread #vitiligo for almost 50 years, I am eternally grateful for my re-pigmentation and will never take my recovery for granted. Since this life-changing event came about as a result of taking nutritional supplements, I have to suppress a snort of derision every time I hear a doctor or a newscaster announce the latest opinion from the medical community, claiming that supplements are not necessary as long as you eat a “well-balanced diet”.
For a start, no one nowadays eats a well-balanced diet, unless they live in a remote area of the world with exceptionally good soil and unpolluted waters and produce their own organic vegetables, fish and meat. And, more to the point, not everyone enjoys that mythical state of “normal health” to which such a well-balanced diet would be sufficient. Some of us have chronic conditions which involve serious nutritional imbalances that have developed over many years. And it takes more than a plate containing a portion of each food group every day – important though that is – to rectify these imbalances.
It's official: supplementation is recommended
So, this week's research findings, confirming further benefits of vitamin D supplementation, should have come as no surprise. But surprised I was, so jaded am I by the constant refusal of most western health systems to acknowledge the importance of nutritional supplementation as a serious alternative to drugs. It is well-known that #vitamin-D deficiency can lead to bone diseases like rickets and osteoporosis but the new research, conducted at Queen Mary University of London and published this week in the British Medical Journal, confirms that vitamin D supplementation is not only helpful for bone health – as we all knew - but is also a safe and effective way to boost the immune system, helping to prevent upper respiratory infections like colds flu and even pneumonia. Since very little vitamin D is naturally available in our food (relatively small amounts can be found in oily fish, egg yolks, cheese and some types of mushrooms), the researchers conclude that supplementation is advisable and that the benefits of this are even on a par with the flu vaccination.
This information is likely to be of obvious interest to everyone, but since vitamin D plays a role in the process of skin pigmentation and most vitiligo sufferers have subnormal levels of it, it is yet another reason why those of us with a history of vitiligo should ensure we have sufficient intake of this nutrient. Moreover, the suitability of vitamin D supplementation as a real alternative to the flu jab is of additional relevance, since experts tell us that vaccines can actually be counterproductive for people with autoimmune conditions.
It is not known whether vitamin D deficiency is a cause of vitiligo or whether it is a consequence, especially in light of the fact that vitiligo sufferers are typically less likely to boost their levels naturally through the normal channels of sun exposure (since most avoid the sun) and may not absorb much, if any, through their diet (since many have poor digestive absorption). Either way, supplementation seems to be the only way of ensuring an adequate uptake.
So, whilst I am now free to enjoy healthy doses of sun-bathing whenever I go on holiday (or when the weather gods look kindly on us here in the UK), I still take additional vitamin D, in the form of a spray which is easily absorbed into the blood stream and I also get some with my regular top-up courses of Boost, the key supplement I used to re-pigment.
You may need to take action before you re-pigment!
Combating a stubborn and complex condition like #vitiligo is not easy. It is not simply a matter of asking your family doctor for a prescription. Not even your dermatologist can wave a magic wand and make the white patches on your skin disappear. Conventional medicine still offers woefully little in the way of comfort or real, lasting value to vitiligo patients. If you are determined to beat this particular skin disorder you have to be willing to reject the well-worn myths perpetuated by the medical profession (i.e. that the impact is purely cosmetic and that not much can be done, apart from using Protopic and, maybe, a course of UV therapy). Whatever the scientific, financial or political reasons may be for this widespread ignorance and indifference, the fact is that most doctors are not ready, willing or even interested in helping you to beat this condition. So, if you want to improve it, you have to be prepared to do some research of your own and take responsibility for devising your own therapy. And that takes guts. Fortunately, guts are exactly what I am going to discuss in this blog post… because it is my long-held belief that guts are not only the solution to your problem but they are also where you will find its source!
It takes guts to restore intestinal balance
It is ironic that a “skin disease” that is often seen as having purely visual impact should actually originate in areas of our body that cannot be seen at all when we look in the mirror. But all the evidence I can find in my vitiligo research, and my own experience, tell me that this is, in fact, the case. I am convinced, as are many researchers and vitiligo sufferers alike, that the causes of this condition lie deep in the bowels of… well, deep in our gut!
I have gradually come to realise that our digestive system is, in many ways, as complex and influential as our brain. Having thought, for years, that the #digestive system was a fairly simple piece of plumbing, I am now aware that it is, in fact, a highly sophisticated ecosystem (a “second brain” even) which must be kept in balance in order to maintain good health.
When this system works as it should, the entire body functions as nature intended: it receives the nutrition it requires for all of its physiological processes whilst harmful toxins, waste and pathogens are either eliminated or neutralised. But, as in any ecosystem, a disturbance to the natural balance can produce unwanted effects that may appear gradually at first, but then gain momentum as a process of cause and effect creates an ever-worsening vicious cycle. The longer the cycle is allowed to continue, the more of the body's processes are impacted and the more symptoms and syndromes emerge. As the body's largest organ and an important means of elimination of toxins from the body, the skin is often an early indicator of internal problems. It is my belief that the patchy pigment loss that characterises vitiligo is a symptom of such problems and that the clusters of other chronic symptoms and related illnesses that are so often associated with vitiligo are also a consequence of the same gut-based imbalances.
So, what are the events that form this vicious cycle? And which event is the ultimate root cause of it? Well, it probably doesn't matter too much which came first – the important thing is to identify the key issues and deal with as many of them as possible in a bid to interrupt the negative spiral and restore healthy balance. But, if I had to start somewhere, I would say the most likely prime mover in the disease process would be insufficient #stomach-acid.
Low stomach acid leads to chronic ill health
I have blogged before about the link between hypochlorhydria (low stomach acid) and vitiligo. Some people are born with too little stomach acid and are not able to produce enough to properly digest their food. The internal problems that this causes may or may not be apparent during early childhood. But the compound effect of inefficient digestion over the longer term inevitably results in symptoms at some point in time. Other people may have sufficient stomach acid when they are young but, since most people experience declining levels as they age, problems may occur later in life. The logic goes that low stomach acid results in incomplete digestion of food, resulting in nutritional deficiencies and “leaky gut” and that pigment loss is just one of many chronic conditions that eventually follow.
It seems that low stomach acid is a condition that, of itself, tends to become a vicious cycle. Evidently, it causes mineral deficiencies which, in turn, raise the acidity of the blood. Acidic blood further reduces mineral levels and lowers stomach acid even more. (And, God forbid that you should then take antacids for the indigestion symptoms that often accompany hypochlorhydria because this will make the cycle even more vicious by lowering what little stomach acid you still have.)
So, this is why, when low levels of stomach acid go unchecked, they can set in motion a downward spiral in the body's ability to absorb nutrition and eliminate waste. There are certainly a whole host of other negative repercussions from this, which (as a non-medic) I will lump together under the very broad term “inflammation”, which includes allergic and autoimmune responses.
The Candid truth about gut flora
Another factor in the vicious cycle of inflammation is undoubtedly Candida Albicans. Most of us have heard of it but we may not have considered its possible involvement in vitiligo. #Candida is a fungus (or yeast) that lives in the digestive tract where it aids normal digestion and nutrient absorption. But it is a part of our internal ecosystem that can easily grow out of control and severely upset its delicate balance. When this happens it is called candidiasis or COS (Candida Overgrowth Syndrome). A person with insufficient stomach acid is highly unlikely to be able to keep the growth of this fungus under control and this can result in damage to the intestinal lining, further contributing to the development of “Leaky Gut” (or intestinal permeability) and lending extra momentum to the whole vicious cycle of digestive impairment and its consequences.
As with low stomach acid, some people may be born with a Candida overgrowth but most of us develop it, to a greater or lesser extent, largely due to a diet that is too high in sugars and starch. Most people can bring it under control by improving their diet and taking a course of probiotics. But, if you have vitiligo, you are very likely to lack sufficient stomach acid to kill off excess fungal organisms and other pathogens and viruses living in your digestive tract. So the problem can be more extreme and more persistent and you may need to take probiotics on an ongoing basis.
Melanocytes are the first line of defence against Candida Albicans
Not only are we more susceptible than the average person to having the balance of our gut hi-jacked in this way, but there is some evidence to suggest that vitiligo sufferers also have fewer defences to fight it. Naturally, the longer the vicious cycle is allowed to continue, the weaker our defences are likely to be anyway. But research has found that melanocytes form the first line of defence against Candida Albicans, which poses the question (in my simple mind, anyway): does a lack of pigment lower our defences even further to this fungus?Vitiligo is known to affect the mucous membrane as well as our outer skin, so it seems logical to assume that vitiligo sufferers would have fewer functioning melanocytes in their gut than the norm.
Having just re-read this blog so far, I realise how alarmist it may sound. So I apologise if it has you clutching your stomach with one hand, whilst frantically googling “how to rid my body of killer fungi” with the other. My aim is not to overstate the case or to spread panic. If you are affected by the type of internal imbalance I have described, rest assured that it has taken time to develop (decades, in most cases) - and has not killed you yet! The good news is that it can be corrected, although it may take a little time and perseverance. But then, those are two of the requirements that you will find in every effective vitiligo treatment anyway.
The downward spiral of poor digestion and poor health that I have described may sound alarming, especially as a number of factors are involved and each of these, in itself, seems to be a vicious cycle within another vicious cycle. So how can we hope to halt the decline, never mind turn it around?
Keep calm and carry on healing yourself!
First of all, it is not necessary to have a perfect understanding of what is going on in order to correct it. After all, I didn't know any of this stuff seven years ago when I tried out a nutritional protocol on the off-chance it might work. I now understand a lot more about why it did work (and also why it improved my digestive symptoms too). But my ignorance at the time didn't prevent it from working. And, second of all, tackling the individual factors involved becomes much simpler when you look at them one at a time. So, let's do that now.
There are tests that can confirm whether or not you suffer from hypochlorhydria but simply checking out the symptoms online will probably give you a pretty good clue. If you are still not sure, then following the recommended HCl test will enable you to discover, by trial and error, whether or not you need to supplement with hydrochloric acid to help you digest your food. If you have a significant lack of stomach acid you will benefit from taking Betaine HCl and Pepsin with meals to boost your levels. Otherwise, just a diet that promotes stomach acid production may be sufficient.
The pH levels of the human body can be a really confusing subject, especially when it comes to deciding what we should eat to promote good health. One of the confusing aspects is that different parts of the body need different levels of acidity. As we know, the stomach requires a very high level of acidity in order to break down food, whereas the duodenum (which is where food goes immediately after leaving the stomach) needs an alkaline environment. The blood should be slightly alkaline too.
The other confusing thing is that foods are often wrongly described as “acid” or “alkalising” and this can be misleading. What our body needs is foods that help to promote healthy levels of stomach acid but also have an alkalising effect on the rest of our body. For example, citrus fruits and cider vinegar will help with acid production in the stomach but, once digested, they actually have an alkalising effect on the body, which seems quite counterintuitive.
So, how do we choose the right foods to satisfy all these different requirements? How do we know which foods are acid and which are alkaline? Luckily, most of the foods that we already know are good for us will help our digestive system to function properly: fresh vegetables and fruits, organic fish and meats will all do this. By eating along the lines of the so-called Cave-Man or “Paleo” diet consisting of exactly these foods (or at least limiting other foods like grains, dairy and all processed foods) it would be hard to go wrong, even if you don't understand all the science behind it. (However, a list of foods that are alkalising can be helpful for reference.)
Since becoming aware of all this information I have adopted a mainly Paleo diet myself and feel better for it (and losing some unwanted weight has been a bonus). But it is obvious to me now that my diet was sadly lacking until relatively recently, so this change in my eating habits cannot have been a factor in my recovery. I strongly suspect that taking daily doses of Five a Day greenfoods was the thing that compensated for deficiencies in my diet back then. I always think of this supplement as being the nutritional equivalent of eating a mountain of organic, leafy green vegetables every day, providing high levels of easily-digestible alkalising nutrition that I would not otherwise be able to eat in sufficient quantity without bursting!
Because low stomach acid and poor diet are two of the key factors in Candida overgrowth, following the same guidelines above for addressing acid imbalances will automatically help to combat it. In my own case, I eat a mainly alkalising, nutritious diet, take Betaine HCl with large meals when necessary and I take two doses of Five a Day daily. Every so often, I also take a course of pro-biotics if I suspect a yeast infection - or just as a precaution. (Probiotics for young children are also available.) But the healthy bacteria content of Five a Day (Lactobacillus Acidophilus and Lactobacillus Bifidus) seems to be sufficient for my needs the rest of the time.
The other factor that can lead to candidiasis is a lack of digestive enzymes. So, supplementing with these also helps to ensure better nutritional absorption.
I entitled this blog “Low stomach acid, Candida and vitiligo” so I shall finish off with this third component – my main reason for writing the blog. I decided to write about digestive issues, in the context of vitiligo, because there are a lot of vitiligo sufferers out there trying all kinds of different treatments to regain their skin colour. Many are not getting the results they want, quite possibly because they have untreated digestive issues that are sabotaging their efforts by preventing or reversing their recovery.
I have had “tummy troubles” all my life and, until the past few years, never made a mental connection between these and my vitiligo. But now that I analyse it, my recovery makes much more sense. At first, my re-pigmentation, using nutritional supplements, just seemed like a lucky fluke. But in fact, the supplements I used worked on both my gastric problems and on my skin's ability to make pigment. I believe that both components of the treatment were equally important. In fact, I doubt that the Boost tanning supplement that triggered by re-pigmentation would have had a chance to work as well as it did (or even at all) if I had not been helping my digestive system at the same time by also taking Five a Day green food.
It seems obvious to me that most of the western world is affected by poor digestion thanks to the average modern diet (although many people either have no symptoms yet, or simply ignore them and pop another antacid). But if you have vitiligo, there is statistically a much higher chance of your having a deficiency of stomach acid and of suffering from the vicious cycle that this sets in motion. Unbelievably – shockingly, in my opinion – very few doctors or dermatologists will ever mention such things. They continue to tell patients that vitiligo is incurable, or else they try to improve it with creams and drugs that only treat the outside, instead of recognising that the cause is internal.
So, my message to you, if you are looking for answers, is to take charge of your own recovery because you are the only person who can do this on a daily basis. Don't let digestive issues interfere with your efforts to re-pigment. Find out if you have low levels of stomach acid. If you do, then follow the recommendations above (or do some more research yourself). Find out if you have a Candida problem and take action to bring it under control. If you can do this, then I am convinced that whatever vitiligo treatment you choose to use will stand a hugely increased chance of working, and working long-term, just as mine has.
In closing, I'm sure you have sometimes heard courage referred to as “Intestinal fortitude”. Well, it does take some guts to manage your own recovery in the face of a lack of effective medical support. But if you can literally build up your intestinal fortitude (physiologically, as well as psychologically), your courage is much more likely to be rewarded with lots of healthy, new pigment!
May 2017 bring you healthy skin!
A belated happy new year (or a slightly early Chinese one) to all my Vitiligo Friends. I think it is fitting that the coming year is the year of the Rooster. This colourful bird is a perfect example of how marvelous nature's pigments can be and a reminder that we all deserve to enjoy our own unique colouring. I hope that 2017 will bring us all healthy skin (not feathers) and that Rooster-like self-confidence that comes with knowing we are all beautiful in our own way :)
The colours of nature are indeed a miracle. But, as with all miracles of nature, there is a truck load of science behind them. Now, science is not my forte and, whilst I was fortunate enough to receive a good education, I still managed to leave school without really knowing, for example, what an amino acid is.
This is a shame because it turns out that #amino-acids play all kinds of extremely crucial roles in how our body functions, including our ability (or inability) to create healthy pigment. If you are as clueless as I am on the subject of amino acids, what they are, what they do, and what relevance a deficiency or imbalance of them can potentially have then click here for a crash course.
Amino acids are no less than the essential chemical building blocks of life. They are the organic compounds that build proteins and, as such, are used in every cell in our body. These busy little compounds are what build our skin and bones, our muscles, ligaments, hair, teeth, organs… and any other part of the human body I may have left out, including our brain. Needless to say, they play a fundamental role in all our physical and mental functions.
Now that I actually understand something about amino acids and what they do, I am quite surprised that they receive so little popular attention outside of the scientific community. Most of us are pretty well versed in the role of vitamins and minerals and the importance of eating plenty of fruit and vegetables. But ask the average person if they think they have sufficient levels of amino acids, and they will probably give you a sideways look and a wide berth. (The exception to this might be body builders and professional athletes, since most of them have been supplementing with amino acids for years to help improve endurance during workouts and boost muscle recovery.)
The body-builder's interest, though, is generally limited to about 10 amino acids, including lysine, arginine, carnitine and the so-called branched chain amino acids (BCAAs) leucine, isoleucine, and valine. But there are actually 20 or so amino acids required by the human body for the healthy formation of protein, including its largest organ – the skin. And, like other nutrients, these are categorised into essential (those that cannot be manufactured by the body and therefore are required in the diet) and non-essential (these can be made by the body).
Again, just like other nutrients, a normal, healthy person who eats a well-balanced diet can expect to maintain a healthy level and balance of amino acids naturally. But just as vitiligo sufferers are typically deficient in certain vitamins and minerals – most likely due to poor digestion and inadequate nutritional absorption - a deficiency or inability to utilise amino acids vital to the pigmentation process would seem likely too.
Interestingly, one amino acid in particular is known to be able to help heal "leaky gut", thought by many to be one of the causes of poor nutritional absorption and chronic conditions, including vitiligo. This is #glutamine. So I now take a dose of this amino acid first thing every morning to help protect the lining of my gut and reduce inflammation and IBS symptoms.
There are supplements available that can ensure you are getting enough of all the amino acids. But, of all the amino acids, #Tyrosine is the most closely involved in the production of melanin. (Phenylalanine, as a precursor of tyrosine, is also important.) This explains why it is top of the list of ingredients in “Boost”, one of the two nutritional supplements that helped me to re-pigment my vitiligo. As with all nutrients, amino acids don't work in isolation but rather as part of a “team effort”. In the case of tyrosine, B vitamins are needed to enable the body to utilise tyrosine properly to produce melanin (which is, presumably, why they are included in the formulation of Boost, along with other ingredients like copper and zinc, also known to be involved in the tanning process.
Learning just a little about amino acids has helped me to understand more of the science behind the “miracle” of my re-pigmentation. In addition to the tyrosine content of Boost, I would imagine that the high levels of essential amino acids naturally present in Five a Day+V (the green-food supplement I used, along with Boost) will also have played a role, whereas I had always assumed the key benefits of this green food was its antioxidant and alkalising properties. No doubt the way all these nutrients work together is a lot more complex than anyone knows. Scientists are still learning more about amino acids and exactly how they affect our hormones and all our bodily processes. It is a fascinating subject and is another reminder of how amazing nature is.
So, with that thought in mind, I wish you, once again, the happiest and healthiest of new years and look forward to sharing more information with you on this blog – and to having more conversations with many of you - throughout 2017.
As someone who has a keen interest in language, I believe that terminology is important. How we talk about things influences how we think about them and how we think about them influences what we do about them. That's why I think that the terminology we use when we talk about vitiligo is important. If we aren't careful, it can lead to false assumptions about what vitiligo is and those assumptions can take us in unhelpful directions when it comes to what we choose to do about it.
This is why I persist in calling people with vitiligo “sufferers”, even though I realise I risk the disapproval of others who have decided to embrace their vitiligo by “celebrating their uniqueness”. Don't get me wrong: I respect that attitude totally. I appreciate the value of accepting those things beyond our power to change. I approve of positive mental attitude and I admire everyone who has a philosophical and constructive reaction to whatever hand life deals them. But the reason I never chose to “embrace” the loss of my skin pigment is because I never regarded it as being a normal or natural part of me. Unlike my rather short legs (which I choose to view – through rose-tinted glasses - merely as the result of having a longer than average body) I was not born with white patches on my skin. And unlike the loss of a limb or one of my senses, I never saw vitiligo as an accident or a disability with which I ought to have to come to terms. And, although there certainly were times when I doubted I would ever find an effective treatment in my lifetime, I never truly believed that vitiligo was, in fact, completely beyond my power to change. I see the condition as a sign of sub-optimal health rather than a badge of individuality.
I have always endeavoured to be a “glass half full” kind of person. Nonetheless, I definitely see vitiligo as losing pigment, not as gaining white patches. And my own view is that to seek to normalise it by using positive terminology can in fact be counterproductive because it can cause us to stop seeing it as something we can and should try to treat.
Is vitiligo a blessing or a curse?
Some people claim their vitiligo is a blessing because it makes them unique. I can appreciate what they mean. But, to my way of thinking, it is not the vitiligo that is the blessing in these cases. It is the admirable ability of the individual to find good in a bad situation that is the blessing. I myself feel that good things have come out of my having lived with vitiligo for so many years. It has made me so much more understanding of other people and their problems. It has, I hope, kept me humble. It has helped me to appreciate all the good things in my life and not take them for granted. And, above all, it has given me an empathy for other vitiligo sufferers and a desire to help them whenever possible. So I would say it has led to a number of valuable blessings, for which I am grateful. But I do not regard the condition itself as a blessing and I am more grateful than I can say to have made such a dramatic recovery from something that I always felt was much better described as a curse.
Is vitiligo a disease or a symptom?
Most doctors refer to vitiligo as a skin disease. But, again, I would disagree with this choice of terminology. In my opinion, it isn't a disease in the usual sense of the word. It certainly isn't a viral or bacterial infection. Sometimes it is referred to as a “skin disorder”. This is more accurate, since it is – let's face it - an abnormal condition that is acquired (we are not born with it). However, I think that a more meaningful label for vitiligo would simply be to call it a “symptom”. It is a visible sign that all is not well inside the body. Just as a cough or a rash are not diseases in themselves, neither - in my opinion - is the loss of pigment. All of these things are signals of some underlying issue - maybe a real disease, certainly a loss of full health. And to label it a disease (just like labelling it a blessing) can rob us of the incentive to rid ourselves of it. After all, a disease is something you "have". And, all too often it is something you keep. Once it is diagnosed, it is somehow official, written in stone and "embraced" in a medical context just as surely as it is embraced philosophically by those who call it a blessing.
If we are going to be really pedantic about terminology (oh, go on then, let's - I love a good bit of pedantry now and then!) I would have to say that the white patches that we refer to as vitiligo are the symptom, the process happening in the skin to cause the white patches is the disorder and whatever the underlying cause is is probably the real disease.
Is vitiligo your past or your future?
We never really know what is around the corner. It fascinates me to think that the day before I noticed my first new pigment starting to appear in my 50 year old vitiligo patches I had no clue that it was going to happen. Sure, I had been taking nutritional supplements for about 6 weeks at that point in the vague hope that they might help. But nothing else I tried ever had so I had no real expectations. One day vitiligo was my entire past (having started when I was an infant) and it would be, as far as I knew, my entire future. The next day the impossible had begun to happen and from that point on everything changed.
If, like I did for so long, you are assuming that your vitiligo will always be with you, you might want to reconsider how you talk about it and how you think about it. I'm not suggesting that you can "think it gone" by sheer willpower. If that were possible I'd have been cured decades ago. But I am suggesting that seeing it for what it is - a symptom of a deeper health issue - and thinking of it as your past, not a permanent feature of your future - you may feel empowered to take on this thing called "vitiligo" and be proactive about consigning it to your past.
Why cold weather may cause pigment loss
Just three weeks ago I was waxing lyrical about the golden beauty of the countryside in Autumn. But the weather reports this week have been warning of snow and my daily walks over the past few days have seen me swap a thin fleece for my warmest jacket, scarf, hat and gloves as the slide from one season into the next picks up pace.
I recognise that not all readers of this blog live in countries that have cold seasons, but I know that a lot do. And, whilst our Antipodean #vitiligo-friends are gearing up for their Summer and all the difficulties that this entails for people with skin that does not tan normally, we in the UK (and the rest of northern Europe and North America) are about to be plunged into a prolonged period of cold weather.
I used to look forward to Winter
I can remember how I used to feel at this time of year B.R. (Before Re-pigmentation!). As the first frosts started to bite I used to breathe a sigh of relief that, for the coming few months at least, I would no longer have to mess about with fake tans, a full face of make-up and impossible decisions about what clothes I could wear to keep cool and fashionable without exposing my white patches. Life was about to become less complicated and less stressful. And the greatest luxury of all was that I could almost completely forget about my vitiligo. I could behave and feel the same as everyone else around me. It was as if the Summer had left me exhausted from fretting and focusing on my skin all the time and now, finally, there would be some respite from my constant state of awareness of my condition. Nowadays, I am sad to see the end of Summer and find myself looking forward to taking a Winter break somewhere hot because regaining my normal colour has changed everything.
So, if you have vitiligo and live in the northern hemisphere, the good news is that you are about to be able to hide your skin under layers of fabric and the decreased levels of UV will probably also lessen the contrast between your normal skin and the vitiligo patches as the weeks go by. That's the good news...
Can cold weather cause vitiligo to spread?
But, on the other side of the coin, what I also remember experiencing (B.R.) was anxiety as I emerged from “hibernation” the following Spring, wondering whether new vitiligo lesions would have developed below the surface, waiting to appear as soon as I exposed any flesh to the elements and dreading the intrusion on my life once again of this condition that would continue to preoccupy my every moment. More often than not, I discovered at this stage that my vitiligo had indeed spread. It was not always apparent until I had had some sun exposure but it seemed that I started every Spring/Summer with less pigment than I had ended with the previous Autumn. So, does this mean that the winter is in some way harmful for vitiligo sufferers? And, if so, why?
I have blogged before on the question of how much sunshine is too much and concluded that UV exposure is an important component of every successful vitiligo treatment I have ever come across (including my own) but that excessive exposure, resulting in sunburn, often causes further pigment loss. So it is a question of moderation. Of course, it is simple enough to be sensible about how much sun exposure we choose to get during the Summer (well, perhaps that's debatable if you live in England) but many of us have little choice during the Winter - unless we have access to a UV device. We are simply stuck with the weather we are given. This made me wonder if there is a difference between the incidence or severity of vitiligo in different parts of the world based on the amount of UV they are exposed to.
Vitiligo is less severe in sunny climates
The evidence I was able to find suggests that there is no variation in the geographical distribution of vitiligo around the world but that vitiligo sufferers who live near the equator tend to have less widespread lesions than those who live further away from it.
Since the most obvious common denominator between countries near the equator is their consistenly sunny climate, this would seem to be in line with my belief that regular sun exposure is good for controlling the condition.
It is unfortunate for those of us who live in countries with distinct seasons that we are deprived of significant sunshine for several months at a time. For us, it is either feast or famine, when it comes to UV exposure. And, knowing that my recovery involved regular sun exposure during the Summer and phototherapy through the Winter, instinct tells me that long-term fluctuations in UV are probably counterproductive for anyone wanting to restore and keep lost pigment. I'm inclined to think that the cool, dull conditions that interrupt our exposure to the sun could actually be a major reason why many vitiligo sufferers living far away from the equator see their pigment loss spread each year by comparison to their equatorial counterparts.
It is not difficult to understand why sunshine (in sensible moderation) is good for vitiligo. Everyone knows that UV light stimulates the production of vitamin D (in which vitiligo sufferer's tend to be deficient) and that UV light is what triggers the tanning process. But the fact that a lack of UV – as experienced during Winter - does the opposite is perhaps not something we think much about, even if it is entirely logical.
In a sense, the long, dark Winter after the bright Summer months is similar to night-time after the day. The relative darkness reduces levels of the hormone serotonin in the brain, raises levels of melatonin and reduces our production of Melanocyte-Stimulating Hormones (MSH). These hormonal changes are usually kept in balance in the context of day and night. Serotonin is needed, amongst many other functions, to wake us up and melatonin helps send us to sleep. But a virtual night-time that lasts several months (i.e. Winter) may well upset the balance of hormones in the pituitary gland causing some people to suffer from Seasonal Affective Disorder, or SAD, some to lack vitamin D and some to lose pigment.
"Hibernation" can make us compLacent
Winter also presents another, unrelated, danger to the vitiligo sufferer and that is that we can be lulled into forgetting about our skin to the extent that we stop being careful about avoiding potential vitiligo triggers.
One of the first things that can go out the window is a healthy diet. It's easy to eat like a caveman and consume salads, fresh vegetables and unprocessed meats in the Summer but when it's snowing outside and dark by 4pm we find ourselves craving comfort foods and drinks, many of which are low in key nutrients (often ones that we already lack) and many of which contain ingredients that may aggravate the digestive system, causing vitiligo to spread.
It is also a time of year when we reach for heavier garments with necklines and cuffs that can increase friction to the skin and darker coloured fabrics containing stronger dyes, which typically contain a variety of chemicals that can potentially trigger de-pigmentation in susceptible individuals.
What I am saying is that, whilst the colder weather can be a wonderful opportunity for people with vitiligo to forget their troubles and simply get on with life (which is clearly a very positive thing to do), I believe that it is a mistake to take our eye off the ball altogether. I have come to the conclusion that it is just as important during this season to stick with any treatments and protocols that have proved beneficial during the rest of the year and, ideally, to find a way to include UV exposure if at all possible. So here's to either living somewhere that has winter sunshine, owning a UV lamp or – best of all – taking lots of sunny vacations!
But, above all else, we know that stressing over all of this can also be counterproductive. So, whatever else you do to keep your vitiligo in check, my advice is to...
... LOOK AFTER YOUR SKIN THIS WINTER!
It's what vitiligo is all about
It's a fair bet that most people would automatically associate the word “inflammation” with swollen joints, insect bites or infected wounds. But #inflammation can be completely invisible to the naked eye and it may or may not be accompanied by pain. It can occur in any organ and any cell in the body and it is involved in every type of illness and injury. In fact, you could say that inflammation = disease (in the real sense of the word, i.e. dis-ease) and an absence of inflammation = health.
As a non-scientist, I tend to think in descriptive terms about such things. A medical professional would be able to explain the inflammation process in a great deal of scientific detail, whereas I simply visualise it as an interruption or breakdown in an organism's natural balance. I'd be the first to confess that my description is vague and unscientific compared to a technically accurate one but it describes exactly the same reality and hopefully conveys it in a way that is easier for most of us to process.
There are many types of inflammation and they are not all necessarily cause for concern. For example, a sprained ankle, a flea bite or a bruise would all involve temporary, localised inflammation. A bad hangover or a bout of food poisoning would affect the whole person and, hopefully, not occur too often or last for very long. A case of flu can cause severe inflammation throughout the body that might last for several weeks. In all these instances, though, the inflammation is relatively short-lived because most people's internal systems (immune, digestive, circulatory, lymphatic etc.) are robust enough to do their job of righting the good ship “Healthy Human” whenever she hits stormy weather.
But a recurrent headache, ongoing joint pain, persistent indigestion, repeated allergy flare-ups or skin disorders are all examples of chronic inflammation that are highly unlikely to do anything other than continue to get worse unless action is taken to break what has become a vicious cycle of tissue damage. Left unchecked, such chronic inflammation typically leads to ever worsening general health as the constant degradation of the body's normal balance perpetuates a destructive chain reaction that produces more and more diverse symptoms, usually culminating in life-threatening illness. To make matters worse, the medication that is prescribed by most well-meaning but mystified doctors along the way, in their attempt to treat each new symptom as it arises, produces side-effects (as drugs invariably do). These side effects add to the burden of inflammation in the body so that, by the time the individual has descended into multiple mystery syndromes, full-blown autoimmune disease or any number of inter-related life-threatening conditions, finding and correcting whatever initially interrupted the balance of their good health would be like trying to find a hypodermic needle in a haystack full of other hypodermic needles under a pile of pills inside a locked barn in the middle of nowhere… without a map!
Modifying the immune response
It is well established that an inflammatory response is at the very heart of the development of #vitiligo and so some existing treatments, as well as current research into new treatments, focus on this aspect of the condition. They attempt either to neutralise the trigger for the inflammatory response - or else to interrupt, or prevent, the response in some other way – in the hope of stopping the de-pigmentation process in its tracks. For example, immune-suppressive and immunomodulator agents have been used (with varying results) to lessen the immune response to triggers but most of these have so far produced limited success with vitiligo and many unwanted side effects.
Tacrolimus (Protopic Ointment) and Pimecrolimus (Elidel Cream) are probably the best known, most effective and safest examples of this kind of treatment. They are proven to reduce inflammation but the side effects cited for both Protopic and Elidel are enough to make anyone think twice about using them. And the same can be said of corticosteroids like Triamcinolone, Hydrocortisone topical and Clobetasol Propionate.
Recent findings suggest that anti-inflammatory drugs developed for the treatment of rheumatoid arthrtis, like Tofacitinib (Xeljanz ) and Apremilast (Otezla) could potentially be of therapeutic benefit to vitiligo patients but the evidence so far is sparce and so much more research would be needed before coming to a definite conclusion on this.
Targeting free radical activity
Other treatments focus on the oxidative stress that is a feature of inflammation in vitiligo. These include pseudocatalase, which has been used in combination with Dead Sea climatotherapy or UVB exposure for the treatment of vitiligo. This treatment has enjoyed mainly positive reviews, a good safety record and very encouraging results but it is not without its detractors, with the authors of this paper even claiming it to be totally ineffective.
Another treatment I was alerted to recently involves the topical application Prostaglandin E2 (PGE2) as a treatment for vitiligo because of its stimulant and immunomodulatory effects on melanocytes but, whilst results were encouraging, it is still considered to be at the experimental stage. And yet another experimental treatment is Afamelanotide (Scenesse) which seeks to re-pigment vitiligo by preventing the inflammatory response to UV light.
Whilst the potential of these therapies for the future treatment of vitiligo is encouraging, their efficacy and safety have not yet been clearly established and, since we are talking in most cases about drugs with known side-effects (= more inflammation) and inconclusive results, my choice is still to reach for the contents of nature's own medicine chest when it comes to combating the inflammatory response involved in the de-pigmentation process.
Topical, dietary and supplemental antioxidants are known to reduce inflammation and restore acceptable levels of free radical activity in the body and they do this without fear of side effects. Applying naturally anti-inflammatory substances to the skin, like coconut oil or aloe vera is safe and can be effective as part of a wider nutritional and lifestyle protocol in treating vitiligo. Similarly, the use of custom-made vitiligo treatments like Vitix Gel and Vitix tablets, both containing natural antioxidant extracts that are proven to combat free radical damage without any known risk of adverse reactions seems to me to be a safer and more effective way of treating vitiligo, or indeed most chronic, inflammatory disease than taking unproven, experimental and potentially dangerous drugs and ending up buried in that drug-infested haystack inside a locked barn in the middle of nowhere… with no map.
Certainly, using nutrition as medicine to heal inflammation by restoring balance to my whole system, rather than working my way through the doctor's prescription pad with each symptom I developed, worked really well for me - virtually ridding me of all my white patches over a period of about 18 months. Not only was this result more dramatic than any I have found in any of the literature on pharmaceutical research to date but it was achieved without any adverse effects and, in fact, came with the added benefit of better general health too. No doubt this all-round improvement illustrates the point that, just as chronic inflammation can be a downward spiral, reducing inflammation by restoring balance throughout the body is an upward one.
A vitiligo blogger since 2011. My name is Caroline. I had vitiligo for nearly 50 years before finding an effective treatment. I created this blog to share my experiences with others affected by this skin condition.