How eating your greens helps prevent skin from turning white
It amuses me every time the media picks up on this or that piece of “cutting-edge” research proving, yet again, that #vegetables and fruit are not only good for you but are absolutely essential to maintaining physical and mental health and warding off chronic diseases like diabetes and heart disease, as well as cancer and dementia. It does seem faintly ridiculous that teams of expensive and highly trained medical researchers should still be going over such old ground and coming up with conclusions that mothers down the ages have taken as self-evident common sense – i.e. that we should all eat our greens!
I am being flippant, of course. I realise that there is always more to learn about precisely why fresh fruit and veg is so very beneficial and why green vegetables, specifically, have such a potent effect on our health and wellbeing. After all, it is one thing for mankind to observe, over thousands of years of anecdotal evidence, that Hippocrates was right to attribute medicinal properties to a healthy diet in general and to vegetables in particular. But it is quite another to identify every one of the individual vitamins, minerals, amino acids, and other macro-, micro- and phytonutrients in each family, genus and species of vegetable and fruit and study the part they play in all the complex physiological processes of the human body! The more the scientific community can learn about this, the more positive spin-offs will result in terms of new treatments for a whole variety of diseases.
So, I do believe that this is an area of research that is important, and possibly all the more so given that intensive farming methods over the past 60 years or so have resulted is very significant decreases in the nutritional content of our crops (see table 9 of this authoritative document) as well as an increase in the residual levels of pesticides and other contaminants.
The net result of this declining nutritional quality in our crops is that a person who enjoys normal health would need to consume much greater quantities of greens and other fruits and vegetables than their grandparents did in order to derive the same health benefits. That news is bad enough, but what about the person with a health condition which leaves them deficient in certain nutrients to start with? How many buckets full of green, leafy veg would that person have to munch their way through on a daily basis in order to compensate? More than is practical or humanly possible, I would guess!
Antioxidants are a prime example of this. Antioxidants are the naturally-occurring chemicals that fight off harmful free radicals that would otherwise run amok on a daily basis causing damage to the body at a cellular level. The high antioxidant content of vegetables and fruits is a key reason for their effectiveness in maintaining good health and protecting against chronic disease, cancer and the ageing process. Large doses of antioxidants are needed on a daily basis for the average person just to counteract the ongoing process of oxidisation that is an inevitable result of simply being alive. For a person suffering from poor health to maintain this status quo typically requires even larger daily doses of antioxidants, far more than can necessarily be absorbed by eating well (even assuming the digestive system is not compromised). This is why supplementation, on top of a balanced diet, is sometimes necessary and why it can make all the difference (as it did for me).
Scientists now know that vitiligo sufferers accumulate abnormally high concentrations of hydrogen peroxide (H2O2) in their skin, leading to the inactivation of catalase and glutathione peroxidase (two of the antioxidants that would normally protect it from free radical damage). This means that the skin loses antioxidants at a much faster rate than would be normal in a healthy individual leaving it in a permanent state of oxidative stress and resulting in damage to the DNA of the skin and the blood and to the loss of pigment. Unfortunately, research has not yet identified the root cause of these elevated levels of H2O2. But, until this cause, and a way of fixing it permanently, is found it is pretty clear to me that one of the most important things anyone with vitiligo can do every day in order to offset oxidative stress and avoid further loss of pigment is to consume very high levels of antioxidants, which almost certainly will require high quality supplementation as well as a diet rich in vegetables.
A final thought on this subject – for now, at least, since it is a favourite of mine – is that the question of whether a vegetarian diet is better for vitiligo than a non-vegetarian diet is often debated and no clear conclusion ever reached, as far as I can tell. Personally, I have never stopped eating meat (although I prefer veg) and yet I have regained virtually all of my lost pigment. Yet some other vitiligo friends swear by eating vegetarian. As I have been writing this blog post I find myself wondering if the key to this question is in fact nothing to do with the presence or absence of meat in a person’s diet. I actually suspect that the reason some people find a vegetarian diet beneficial to their vitiligo is because not eating meat simply leaves more space on their plate for additional vegetables and therefore additional antioxidants!
Talking therapies can help
A common complaint among #vitiligo sufferers is that their doctors lack an appreciation of the psychological effects of their unexplained and progressive pigment loss. I don’t doubt that there are many medical practitioners out there who are sensitive and sympathetic to their vitiligo/ #leukoderma patients. But I do know from personal experience - and from the many stories I hear from other vitiligo sufferers - that the mainstream medical profession (at least here in the West) - is not famous for its great bedside manner when it comes to this misunderstood and under-represented skin disorder.
Just because vitiligo is not life-threatening and just because there is no definitive cure many doctors seem to take the view that a simple diagnosis is all that is required of them. If you are very lucky, you might get some scraps of additional information but these are, more often than not, along the lines of: “yes – it is vitiligo; no – it won’t kill you; no – there’s no cure; go away and live with it and don’t let it worry you; my job here is done”.
If it weren’t for organisations like The Vitiligo Society in the UK, the American Vitiligo Foundation and their counterparts in other countries around the world, organised support for those who have to live with this condition would be thin on the ground. Above all, without the internet, social media, blogs and online support forums like Vitiligo Friends, people with leukoderma would still feel as isolated as I did growing up before the world wide web was ever conceived.
It’s true, I know, that awareness of vitiligo has never been as high as it is today (though I do wonder if that would be the case without the publicity surrounding Michael Jackson) and that research has never been as well funded as it currently is. But vitiligo is still very much the poor cousin in the world of #dermatology and I am baffled as to why that should be. A person’s skin colour is a key component of their identity, their culture and their self-image. To have it change randomly, piece-meal and virtually overnight can be distressing, frightening, depressing, alarming, devastating, stigmatising… I could go on ... If you have been affected by vitiligo you probably know what I'm talking about.
In view of all the above, I was encouraged today to come across a new(-ish) UK charity called Mind and Skin whose aims revolve around using talking therapies to improve the quality of life for people whose skin conditions cause them psychological distress. Here is their "About Us", taken from their website:
Mind and Skin is a charity that aims to improve the daily quality of lives for skin disease sufferers. We will provide “talking therapies” for our service users. We help dermatology patients by increasing their self-esteem, reduce stress and manage the physical and psychological aspect of their condition.
The charity will generate new research to lobby and influence health care policies so that dermatology patients can be offered “talking therapies” from their local health care provider. We aspire to promote improved communications between Government, all health related officials and their patients.
Mind & Skin is a psychodermatology charity that was established late 2013 in the county of Sussex.
We are the only dedicated psychodermatology charity in the UK. We have a board of trustees who are responsible for the direction and governance of the charity. The charities services are delivered by a combination of staff members, volunteers and official advisors.
In my opinion, this is very worthwhile work and I wish everyone involved with Mind and Skin success in communicating their message and making a difference to a lot of lives in ways that the medical establishment so often fails to do.
What part has collagen supplementation played in my repigmentation?
Given that biology and chemistry were among my least favourite subjects at school, it strikes me as ironic that I now spend a significant chunk of my spare time sifting through medical research and actually enjoying the process. My aptitude for science has not increased one iota since school days but my motivation certainly has. A keen desire to learn as much as possible about the likely causes of - and best treatments for - #vitiligo (or #leukoderma) drives me to surf the backwaters of the internet, dredging up the submerged treasures I find there, endlessly hopping from tab to tab, clarifying, defining and cross-referencing the scientific hieroglyphs that float to the surface. This activity often causes me to wish I had studied science instead of humanities at university and leaves me fascinated and frustrated in equal measure.
The reason I mention this is because I want to stress (as I do throughout my website) that I am not remotely qualified to talk with any authority about science or medicine. I am simply someone who has had vitiligo all my life, has stumbled upon a treatment that has worked exceptionally well for me and is now trying to figure out which particular elements of that treatment are the critical ones and, above all, why… as well as whether there are any missing elements that could make the treatment even more effective. This is why I continue to search, ask questions and pose hypotheseses. As ever, I am always glad to receive feedback from anyone affected by vitiligo as well as from anyone whose understanding of physiology is greater than mine (which leaves the field wide open!)
The question I have been asking the omniscient gods of google this week is “what – if any - is the significant relationship between vitiligo and collagen?” This question has been going round in my mind for some time now, partly because collagen is one of the natural substances I have been taking as a supplement ever since I started on the nutritional protocol that led to my repigmentation, and partly because several of my recent internet searches and correspondences have pointed to possible links between collagen and vitiligo that I was not previously aware of. This post will be a bit longer than usual, so please bear with me as I explain my reasons for posing this question.
In case you haven’t read the story of how I went from approximately 80% depigmented to virtually fully repigmented, I achieved this, quite unexpectedly, as a result of trying out several nutritional supplements simultaneously. I had decided to try two supplements (Boost and Bronze) in case they might improve my vitiligo and I also decided to take two more (Five a Day+ and Collagen) in the hopes of improving my health in general, and my poor digestion, chronic fatigue and arthritis in particular. With hindsight, I ought to have tried each of these supplements in turn so that I could identify which ones produced which results. But I didn’t expect to have to be scientific about it. I didn’t really have high hopes for any of the supplements because nothing I had tried previously for any of these chronic symptoms had ever made much difference. To my utter disbelief, my arthritis improved very significantly within just two or three weeks (which I put down to the collagen supplement, since this effect is quite well documented) and to my even greater surprise and delight, I began to get freckles of new pigment in some of my vitiligo patches just a few weeks later (which I attributed to the Boost capsules, because they contain many of the nutrients that are most closely associated with the production of melanin and to the Five a Day+ which is a potent antioxidant and alkaliser). I also noticed a marked improvement in my energy levels (most likely the effect of consuming daily doses of the green “superfoods” contained in the Five a Day+ formulation). And, last and possibly least in terms of unexpected results, I found that the carotenoids contained in the Bronze supplement did what it said they would on the label: they gave my skin a very slightly tanned effect, even my white patches. This had the effect of reducing the contrast between my vitiligo patches and the rest of my skin (which was actually a bit of a surprise because I had expected my normal skin to look darker too and for the contrast to remain much the same).
I won’t repeat the whole story of my continued repigmentation here because it is all on the website. Suffice to say that I was so ecstatic to have found something that was actually reversing my vitiligo, after nearly 5 decades of disappointment and resignation, that I decided to share this experience on the internet so that other people who had been told by their doctors that they “just have to go away and live with it” could take some hope from my story and possibly achieve the same sort of results from trying the same approach too.
I decided to indicate on the site which supplements I thought were responsible for which results, basing this on my own perception, observations and some educated guesswork involving a lot of research on the individual ingredients. My conclusion was (and still is) that – as far as effectiveness against vitiligo is concerned - the key supplements were Boost and Five a Day+. I felt, based on some more online research, that the effectiveness of Bronze was purely cosmetic and probably only suited to individuals with fair skin. And I assumed that the effectiveness of the collagen were limited to my arthritis (although I did also notice a very marked improvement in the quality of my hair, skin and nails too – all of which are evidently commonly reported benefits of collagen supplementation). Of course, if someone wanted to replicate my vitiligo protocol exactly, they would take all four supplements (and add in some regular, moderate sun exposure, which is also part of it). I have been hesitant to suggest this course of action because of the expense involved in adding two products into the equation when I was not convinced that this was absolutely necessary.
However, I am now wondering if collagen was, in fact, part of the reason I achieved such good results. Here is some of the information that has prompted me to consider this possibility:
1. Collagen is the principal structural protein that holds the skin together: the quantity and quality of your skin's collagen is a major factor in the health and appearance of your skin. So it is not unreasonable to consider a possible link between the health of one’s skin and the proper functioning of the collagen present in the skin.
2. This article maintains that collagen damage occurs in vitiligo and that the degradation of collagen may be the result of free radical damage (which is known to be a feature of vitiligo). This would support the theory that my repigmentation was not only due to the extremely high levels of free-radical-fighting antioxidants in Five a Day+ but that the addition of a collagen supplement may have been effective in compensating for collagen damage.
3. Vitiligo is thought to be an autoimmune condition and to occur in greater frequency in patients with another autoimmune disease than in the general population. There are a number of autoimmune diseases (Collagen Vascular Diseases) in which the body attacks its own collagen. So, maybe there is some sort of link there (?)
4. Current research has found an abnormality in vitiligo patients in the basal layer of their epidermis, which is where the melanin-producing cells called melanocytes are found. An abnormality of the collagen molecules in the area of the skin just below the basal layer (in the basement membrane, where the dermis meets the epidermis) can evidently lead to detachment of the melanocytes, resulting in the loss of pigment in sites of trauma (i.e. places on the body that are prone to friction or injury). This would account for what is known as the Koebner response.
I don’t pretend to comprehend all the science behind these four points, so my impression is based as much on intuition as it is on knowledge. But reading about this area of research has led me to believe that collagen supplementation is indeed likely to have been one of the factors involved in my repigmentation.
50 years spent thinking about my patchy skin
Not everyone with vitiligo allows it to dominate their thoughts. I admire those individuals who are able to put their white patches into healthy perspective and simply get on with their lives. However, I can’t begin to estimate how much time I have spent over the years thinking about my patchy skin – and that in spite of being a pretty positive person by nature. It must be hundreds of thousands of hours in total. But the ways in which I have thought about it have changed many times during the last 5 decades, sometimes subtly and sometimes dramatically.
I find it strange to think that there must have been a moment when, as a young child, I first noticed a small white patch on my left ankle and wondered what it was. It was probably no more than a fleeting and idle thought at that point. I certainly don’t remember actively worrying about my skin until I was about 7 years old. It was around this age that I lost the pigment on my right eyelid, causing it to look pink, and developed several white lashes. This was when I first started to feel self-conscious about my appearance and my anxiety only intensified when a trip to the doctor’s surgery left me believing that there was nothing that could be done about this thing called vitiligo and that it would probably just get worse. (“But, never mind – at least it’s not life-threatening!”) Of course, my doctor was right about my vitiligo getting worse but it was to be many decades later that I would discover, by sheer fluke, that he was wrong in his opinion that nothing can be done to improve the condition.
So, as I reached my teens – a stage of life fraught with insecurities in the best of circumstances – I began to obsess over each new patch of white skin and to live in dread of where and when the next one would emerge. There were times, of course, when I would be able to forget about the whole thing. These were liberating times when I could convince myself that I was just the same as all my friends and could enjoy life in the same way as them. But, inevitably, something would always happen (an innocently curious comment or a deliberately unkind remark about my blotchy hands or my panda eyes) to remind me that my identity was gradually being stolen by an unseen and malevolent force. My attention then turned increasingly to strategies for concealing the patches and avoiding situations that might draw attention to my blotchy and unpredictable skin colour. I could actually feel myself losing my spontaneity and my sense of being part of the human race. I literally lost the ability to feel comfortable in my own skin.
During my 20’s and 30’s my pigment loss accelerated and this fact haunted me. I tried to push it to the back of my mind while I lived my busy life but it was always there, lurking like some evil ghost just outside my field of vision, and whenever I looked in the mirror there it was . Anyone who has been through this process will recognise the pattern of self-pity, anger, denial, hope, despair and even bargaining with God if he will just make the white patches go away. My vitiligo was often the last think I thought about at night and the first thought to enter my mind on waking. I can remember several occasions when I dreamt vividly that I had been cured, only to wake up to reality with the sinking feeling of a condemned convict. Happily, I was never suicidal – I hasten to add that, as far as I know, most vitiligo sufferers never contemplate such drastic action. Sadly some do and no amount of common-sense reasoning to the effect that worse things happen at sea (not to mention on cancer wards) will necessarily change their state of mind. One recurring thought that kept me from the worst extremes of depression was that there was no sense in asking the question “why me?” because the inevitable answer would be “why not me?”
By the time I reached my 40’s I had gained a degree of acceptance. For one thing, I no longer suffered from the teen / 20-something’s preoccupation with looking perfect and, for another, I had more or less come to terms with the probability that there would never be a cure for vitiligo in my lifetime so I might as well stop railing against something that simply cannot be helped. It’s not that I stopped thinking about it – more that I was able to think about it with less emotion and more detachment. So it almost felt like a fitting reward for making my peace with vitiligo when unexpectedly, at the age of 50, I found a treatment that actually started to revive my lost pigment and which has restored nearly all my original colour (roughly 80% of which had disappeared over the years).
Four years on (and still improving), I am finally at a stage in my life when I could so easily forget that I ever had vitiligo. Except for some remaining mottling on hands and feet and a slightly more freckled appearance than I had as a child on all of the areas that have re-pigmented, the effect when I look in the mirror today is of a face and body that are all one colour again (literally my dream come true). And so now my way of thinking about vitiligo has changed again. It still occupies my thoughts – probably more than it did five years ago - but now the reason I think about it so much is altogether more positive. I think about it because I want to, because it interests me and because I want to tell others that they have good reason to be hopeful. I spend a lot of my time nowadays researching the subject (which I find fascinating), writing my blog and corresponding with other vitiligo friends.
So, if you have vitiligo and find it occupying your thoughts more than you would like, I will give you the advice that I would give to my younger self (if I just had a time machine!): “thinking about it is fine, even a bit of self-pity is fine, but despair is not. The doctors who tell you to go away and live with it because nothing can be done are wrong. Use your thinking time to plan, research and be proactive about finding the best treatment for you.” If I had had the benefit of that advice when I was younger, maybe I would have been more proactive about finding an effective protocol and enjoying the benefits of my re-pigmentation sooner.
My name is Caroline.