She cured herself, of course
My last blog was about the domino effect involved in the development of #vitiligo. In truth, all disease could be described as a process of cause and effect. But just how many dominoes are involved in the chain reaction leading to full-blown symptoms varies from one condition to the next. In the case of vitiligo there certainly appears to be a complex knock-on effect at play, involving genes, hormones, the digestive and immune systems, as well as environmental and life-style factors. Trying to determine which domino belongs where, or even if the same sequence of events occurs in all cases of vitiligo is no easy task – which, presumably explains the frustratingly slow rate of progress in vitiligo research.
Whilst researchers and specialists in this field are well aware of the complexities of vitiligo, most medical practitioners who deal with vitiligo patients are not. A frighteningly high proportion of these doctors dole out the same tired old phrases: “harmless skin condition”… “no cure”… “try this steroid cream or else just ignore it”… “stay out of the sun”, “blah, blah, blah”. If you are lucky, your dermatologist might recommend phototherapy. But, even then, temporarily helpful as this may or may not prove to be, the doctor's focus is still firmly fixed on the very last domino to fall: i.e. the white patches. Try to talk to your doctor about genes, hormones, digestion, nutrition or even autoimmunity and you are likely to be met with a glazed expression, if not a patronising one.
In spite of everything that has been discovered and published about the aetiology of vitiligo, in spite of all the clinical studies, scientific papers and ongoing research pointing to systemic involvement in the development of those white patches, very little of it has filtered down to the men and women who diagnose and treat them day in and day out.
As pointless as polishing a rusty car
Call me simple, but I think that trying to treat a vitiligo patch without first treating the human body that has produced it is about as pointless as polishing a rusty car. Of course, I am not telling you anything you didn't already know. I think we all accept that our mainstream health system in the western world is, for the most part, based on the principle of treating the symptom rather than the patient. All too often this means superficial diagnosis rather than in-depth investigation, prescribing drugs rather than promoting healing and reducing waiting lists instead of reducing disease. Such a system is not suited to ensuring the long-term vitality and well-being of individuals with complex, chronic conditions.
I am not saying that this is a deliberate policy. I am not a conspiracy theorist. I don't think that the medical profession is trying to keep us all sick so that they can keep making money from us. I am sure that the majority of doctors enter the profession because they want to heal people. (I'm not so sure about the drug companies though: they have a huge vested interest in keeping us sick and, of course, they are massively influential in how doctors treat their patients.) But the harsh reality is that the system has become a colossal industrial machine in which patients are sorted, tagged, processed, stamped and ejected the other end of the conveyor belt as efficiently as possible. This is not necessarily all bad. For someone with a broken leg this is a system that works pretty well. But for the person with a chronic condition which has no simple cure and crosses multiple medical disciplines (dermatology, genetics, endocrinology, gastroenterology, neurology, immunology, rheumatology, etc.) it is often an unmitigated disaster. This is why so many vitiligo patients end up feeling worse when they leave the doctor's office than they did when they first walked into it.
Layers of causality
My view of the health system is not so jaundiced that I would ever advise against consulting your doctor. On the contrary, it is usually the very first thing that I advise, if only to get an accurate diagnosis. But it is a question of having realistic expectations of what will happen after that. Because of the way our health system works, most doctors simply don't have the time or specialist skills to drill down through the layers of causality in non-life-threatening, chronic illnesses like vitiligo. This is why most patients who actually do find long-term effective treatments do so either by going to complementary medical practitioners for natural and holistic solutions, or by doing their own research and using the trial-and-error method of self-treatment at home, as I did myself.
The process of discovering what treatment will work puts me in mind of the old nursery rhyme “There was an old lady who swallowed a fly”. Getting to grips with the mystery that is vitiligo is like looking at the end result (i.e. the white patches - or the dead lady who swallowed a horse) and working your way back through the steps that led there. Was it the cow that caused the old lady to swallow the horse? Well, yes – but she wouldn't have swallowed the cow unless she had previously swallowed the dog, etc., etc.
Some experts believe that vitiligo is caused by melanocytes being either killed or “disabled” and they stop at that. Others offer the explanation that the loss of functioning melanocytes is a result of inflammation. But what causes the inflammation? We are often told that this inflammation is a consequence of various stresses: physical (i.e. injury or friction), emotional (mental trauma or pressure) and oxidative stress. As it turns out, inflammation and oxidative stress are also associated with both raised histamine levels and autoimmunity. But which came first? Does it really matter which came first, when it comes to finding an effective treatment? If - as I suspect - all of these phenomena form a vicious cycle, which came first is not entirely relevant. The most important thing is to break the cycle at some point, any point - preferably at every point.
Some say that faulty genes are at the bottom of all these adverse reactions but that vitiligo only occurs in cases where an environmental trigger is present. If genetics are at the root of the problem, you could liken that to the fly. It would have been better for the old lady never to have swallowed the fly in the first place. But it is what it is – it's too late to correct that now. This is not a point at which we can break the cycle without more scientific research and medical intervention. But at every subsequent stage in the chain of cause and effect there are ways we can intervene in order to stop the old lady from dying of horse-induced ingestion and 1% of the population from losing random chunks of their treasured skin colour.
As I said in my last blog. It makes sense to me to intervene at as many stages as it takes to get the job done. In other words, we may not be able to tackle the genetics involved, but there are multiple ways we can reduce stress, histamine and inflammation, increase antioxidant levels, avoid triggers and balance our immune system. After all, it wasn't the fly that killed the old lady. It was what came after.
The moral of the tale
Well, if you have made it all the way down to this point in my ramblings then I congratulate you! You are probably about ready to eat a horse yourself by now. So I will get to the point. My point is that, for most of us, our family doctor and our dermatologist will not be able to cure our vitiligo. They may or may not be able to improve it. But the chances are that any improvement will be temporary (as with phototherapy alone) or may come at the cost of side effects (as with steroid treatments).
The only person who will be willing and able to devote the time to sift through the layers of causality that have resulted in your pigment loss is your holistic practitioner (for which you will pay – but, if successful, it would be worth it) or YOURSELF.
I chose to do it myself. This old lady may have been unfortunate enough to swallow a fly but, thankfully, she didn't rely on a doctor's prescription for indigestion tablets to solve her horse problem. She was lucky enough to stumble on a simple home treatment that worked for her and this prompted her to take responsibility for her own health and well-being by continuing to learn as much as possible about her condition and find as many safe and effective ways as possible to support her own body in its efforts to heal itself. If you haven't already read her story you can do so here.
In the course of writing this post, I decided to go for a walk in the fresh air to clear my head. And, by a strange quirk of fate, guess what happened along the way?... I swallowed a fly!
My name is Caroline.