Vitiligo

I have now worked with a good number of people who have come to see me with Vitiligo and, whilst it is not a problem that will cause a person any physical pain, it can obviously still cause a great deal of emotional distress. As it says in the Merck, the 'bible' of modern medicine -- 'the disease (vitiligo) can be psychologically devastating'.

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Finding a good herbalist

Much of what's written in this article is entirely suitable for a person to work through themselves but, especially if things are quite bad, or you just know that you need further help, then there may be a great deal of benefit to you to go to whatever lengths necessary to find a good herbalist or truly holistic practitioner to guide you on to a safe and strong treatment program. There's a short write-up to suggest how you might go about finding such a person here

Vitiligo; gathering the cause

Having seen early in my practice how devastating the effects of vitiligo can be (a young female patient with the condition quite badly on her face and hands) I have studied it closely in all the patients who've come in with it since and continue to pay keen attention to anything that comes through on it in the medical literature. At some point in time, for some reason, the immune system takes up arms against a select few of the body's own pigment producing skin cells (the melanocytes) and damages them to the point that they stop producing any colour; why?

What I can say from my own experience with vitiligo, as well as many other complex health problems, is that one of the most useful and important questions you can ever ask a person is 'what was happening in your life around the time you first got sick?' Not always, but often, the answer to that question will tell you a great deal about what kind of issues are at the core of the problem and, as everyone understands, if you can treat the cause of a problem then you are on the way to curing it. With vitiligo I see four re-occurring patterns and, whilst more than one may be involved, one may clearly be the dominant cause and so need the primary attention.

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Overactive immunity

Given its description as an 'auto-immune' condition it is not surprising that a notable pattern preceding the development of vitiligo in some people includes the classic signs of a having had an overactive immune system, often for quite some years. These are people who have typically suffered less colds and flus than others but who's immune 'army' can get the wrong idea about who is friend and who is foe. For example, they may have a childhood history of allergies such as eczema or asthma or such conditions in adulthood as a recurring bad hay-fever or thyroid disease.

These are the kinds of pointers that suggest an overactive immunity may be the key driver to the vitiligo and if this is the case then a most helpful approach can be the generous use of Reishi mushroom extract (more about that here) as well as looking to find ways to empty out the allergy 'bucket' especially via removing undiagnosed food intolerances; more about that important subject here.

Obviously I can't advise someone without seeing them in person but if I see an overactive immunity as the driver for vitiligo I may also well ask my patient to use a course of sweating therapy (e.g. once a week for a month or so) to try to help vigorously 'bump' the immune system out of a stuck groove; more about this potent treatment here.

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Depressed immunity

Equally relevant to the connection between immune health and vitiligo is an immunity that, rather than overactive, has become weakened to the point of not dealing well with its daily challenges and there is a kind of break-down of immune health that eventually leads to the same place; flailing widely at friend (melanocyte skin cells) rather than foe (microbes, viruses, toxins etc.)

How a person might know that a low immunity was the key factor in the development of their vitiligo are such tell-tale signs as getting recurrent infections that take a long time to resolve or likewise experiencing wounds or injuries that take much longer than normal to get well.

In practice I find that many of my patients already know that they have a problem in this area and it is an observable fact that a depressed immune system is a major part of many chronic health problems that afflict people in the modern world. This is an area in which a holistic and comprehensive approach is so vital to a successful outcome that, rather than try to summarise the key points here I encourage you to take time to study the more detailed article on immunity here.


Two white blood cells amongst red cells under the microscope

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Hormonal imbalance

On several occasions I have observed in practice the history showing the vitiligo starting in a woman who had recently gone through a major hormonal change e.g. pregnancy or stopping/starting the pill.

If this is the case then there are two ways in which we might usefully engage with a natural approach. One is through the kinds of herbs and foods that help with the premenstrual syndrome and, if PMS is clearly a core issue in the regular cycle, then some of the suggestions in this detailed article here are likely to help.

Secondly, when it is needed, the careful treatment of thyroid health problems can do a great deal to help the kind of hormonal imbalance that may have driven the vitiligo into being. Thyroid problems are very tricky to determine and conventional blood tests really only help when things are very bad indeed. I have a section on the website that goes into some practical depth on how to both diagnose and treat thyroid problems and, if you are not sure about the origins of your vitiligo, this may be an important area to at least 'tick the box' in case this area really does need attention; you can find that article here.


The Thyroid; A small gland with a big effect on our health

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Stress & Tension

If the vitiligo began around the same time as you were experiencing some intense stress in your personal life then, though of course this can be a chicken or egg scenario as the skin creates its own stress, you should consider the possibility that an imbalanced immune function caused by excess stress may be the key driver to the vitiligo and some of the ideas in the section on tension and anxiety may be of the most practical help to you getting well; you can find that article here.

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Treatments that may help

With the need to try to understand and address the triggers and the causes firmly in mind I want to share three practical strategies that may serve to improve the condition itself that I and other practitioners have found to be very helpful indeed...

Bergamot oil

The first is the essential oil of Bergamot. Bergamot oil has substances in it called bergaptenes that have a strong ‘photosensitising’ effect on the skin. That means they make your skin more vulnerable to ultra-violet light. This is bad news for Bergamot if you are vulnerable to sun-burn and it is the reason that much of the commercial sale of Bergamot oil will have ‘Bergaptene-free’ in the fine print (you need to carefully check that this is not the kind you purchase). On the other hand, this ‘photosensitising’ action may help turn back on the melanocytes which are activated by ultraviolet light.

The technique is simple and easy to sustain for the kind of time frame you might need to get this to work. Take any kind of skin cream, moisturiser, oil, basically any kind of ‘carrier’ and put the drops of Bergamot oil into it before you apply whatever it is to the areas of your skin that are affected by the Vitiligo.

It is difficult to be specific with amounts here because each person will vary but as a general guide if I was treating an area the size of a large coin I would want 2 or 3 drops of the bergaptene-containing Bergamot oil to be in the mix of the carrier cream. For a larger area, for example one that covered the size of the palm of a hand, I would want to use about 8-10 drops of the Bergamot oil in the carrier. These are strong concentrations of essential oil and you need to know that for some people with extra sensitive skin these amounts I am suggesting here would be too strong. The way to go about this safely is to ‘patch-test’ your skin with a smaller amount and a weaker concentration of the Bergamot to see how your body feels about it first.

Bergamot smells pleasant so is not a hard thing to have on you in that sense but it also needs to be understood that the action of the oil will not last more than an hour or so. You need to have placed the Bergamot oil in its carrier on the skin and be exposing the affected area to sunlight within that one-hour time frame.

How long you should then have your skin in direct sunlight also depends on too many factors to make specific recommendations on here. How fair are you and so how prone to sun-burn? What time of day or time of year is it?

Getting too much sun will be just as harmful as not enough. You must already be aware that the loss of pigmentation means you are much more vulnerable to actual sun-burn. Let common sense be tinged with caution and above all be patient, this process is far more likely to help with a small regular exposure of sunlight over a period of many weeks to some ‘Bergamot-primed skin’ than it will over a time frame measured in any number of days. This treatment will not work for everyone, nothing does, but if you proceed with it carefully there is a good chance it will help and it is certainly worth trying.


Citrus bergamia (Bergamot)

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Ginkgo biloba

The second specific recommendation is to use the herb Ginkgo Biloba. There have been two small but good-quality positive trials on using Ginkgo for vitiligo that make it fairly certain that there is something helpful going on here. The first was in India and the second one was in Canada and both showed modest but significant improvements in helping vitiligo.

In my own clinical experience I believe Ginkgo has been effective in helping stop the progression of Vitiligo and that is no small thing as I am sure I don’t have to tell you. There are many commercial Ginkgo products on the market so, as always, it is hard for the buyer to know which is the best one, or even which ones are reliably what they say they are! What I can suggest is that the internationally active company Nature's Way make an excellent Ginkgo called Ginkgold (please note that I have zero financial involvement in this company).

This is another area where it may be of much help to be in touch with a registered herbalist to help guide your choice. Wherever you do get your Ginkgo you will need to take a daily dose (usually just 1 or 2 pills a day depending on the strength) for quite a few months before you can be sure if it is either reversing the spots/patches or at least stopping the spread. I have a more detailed article on Ginkgo which can be found here.


Ginkgo biloba

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Reishi mushroom

Thirdly is Reishi mushrooms. There is something extraordinary about these medicinal mushrooms that helps strengthen and settle an unsettled immune system and I believe they have been of great help to some of my own patients with vitiligo.

There are an enormous number of Reishi products on the market. Like every other herb it is truly a case of caveat emptor (buyer beware). In my opinion and along with a number of esteemed colleagues I believe that, at the time of writing, the best place to get Reishi mushroom is from JHS in the USA. http://www.jhsnp.com/ This is a company that only does mushrooms and it does them really well.

I know that JHS ship all over the world so if you do not have a herbalist or herbal supplier that already have them or can get them for you then you will still be able to do it yourself. I typically use between 2 to 4 a day of these mushroom capsules to get the best benefits (two a day for long term use, 4 a day when there is a current problem or symptom we are trying to help). You can read about Reishi in more detail here.


Ganoderma lucidum (Reishi mushroom)

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Cautions on khellin & cortisone

Khellin
If you research herbal medicines for vitiligo you will likely find recommendations for the herb Amni visnaga. This is the source of a drug called Khellin, which has been used with some success in the treatment of vitiligo, often whilst simultaneously using Ultraviolet treatments. I follow the old tradition of medicine that takes to heart the rule 'primum non nocere' which means firstly do no harm (a little more on this subject here) consequently I could not recommend anyone to take Khellin for their vitiligo as there is too strong a chance that it could cause liver damage - avoid.

Cortisone
I also know that hydrocortisone creams are often recommended for vitiligo however I do not feel there is good evidence to support the use of this strategy whereas there is evidence to show that the long term use of steroids on the skin can be harmful, others share the same concerns...

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Constitutional Health Note

Finally, you might benefit from learning about your constitution to know what kind of foods, herbs, exercises etc. will work especially well for your health in general as well as what might potentially help your immune system to get into balance and your skin to heal. As it happens the majority of the patients I have personally worked with who have vitiligo have been Bears but I have no way of knowing whether this is a significant pattern or just one of those weird statistical blips, in any case there is a brief introduction to this great subject here and a more detailed section on working out which constitution you are here.

Please understand that I cannot personally advise you without seeing you in my clinic.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!

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© 2011 R.J.Whelan Ltd