Vitiligo is a long-term condition where pale white patches develop on the skin. This happens when the cells that make pigment (melanin) are destroyed1. It can affect any area of the skin, but it’s more noticeable on the face, neck, hands, and in skin creases2.
The choice of treatment depends on several factors, including age, the extent and location of skin involvement, the disease’s progression, and how it affects your life2. This article explores some alternative therapies, supplements, and dietary modifications that may provide support for individuals with vitiligo.
Alternative Therapies for Vitiligo
Several alternative therapies have been proposed for vitiligo, although research on their effectiveness is often limited. Some of the commonly mentioned therapies include:
- Ginkgo biloba: This herb may help restore skin color in some people with vitiligo2. It’s believed to have anti-inflammatory and antioxidant effects, potentially protecting melanocytes from damage9.
- Alpha-lipoic acid: This antioxidant may help restore skin color when used with phototherapy2.
- Green tea extracts: Green tea is a source of antioxidants that may help reduce inflammation and support managing vitiligo symptoms9.
- Capsaicin: Found in chili peppers, capsaicin may have some positive effects on vitiligo symptoms due to its anti-inflammatory properties9.
- Aloe vera: Known for its soothing and anti-inflammatory properties, aloe vera may help manage vitiligo symptoms9.
It’s important to remember that these therapies may not work for everyone, and more research is needed to confirm their effectiveness and safety. Always consult with a healthcare professional before trying any alternative therapy, especially if you are currently undergoing conventional treatment for vitiligo.
Supplements for Vitiligo
Certain vitamins and minerals have been suggested to play a role in managing vitiligo. Here’s a closer look at some of them:
Vitamin B12
Vitamin B12 is an essential nutrient found mainly in animal products15. Most adults require 2.4 mcg daily15. It’s crucial for various bodily functions, including DNA synthesis, nerve function, and red blood cell formation16. Some studies indicate that vitamin B12 may be helpful for repigmentation in vitiligo patients10. It’s believed to work by inhibiting the production of homocysteine, which can impair melanin synthesis20.
A lack of vitamin B12 can cause neurological problems, such as vision problems, memory loss, and pins and needles21. In one study, patients with vitiligo were given tablets containing 1 mg of vitamin B12 (cyanocobalamine) and 5 mg of folic acid twice daily for 3 months22. Another study found that oral supplementation with folic acid (10 mg per day) and vitamin B12 (2,000 mcg per day), combined with sun exposure, resulted in some repigmentation after three to six months in about half of the participants23.
There may be a link between vitiligo and pernicious anemia, a condition that can lead to vitamin B12 deficiency24. While this is uncommon, vitiligo patients with pernicious anemia may need vitamin B12 injections24.
Vitamin B12 can be obtained from food sources like meat, fish, poultry, eggs, and dairy products, as well as from dietary supplements25.
| Supplement | Properties | Dosage | Side Effects | Sources | Impact on Management of Vitiligo |
|---|---|---|---|---|---|
| Vitamin B12 | DNA synthesis, repair, and methylation; nerve function; red blood cell formation 16 | 1 mg cyanocobalamine twice daily (in combination with folic acid) 22 or 2,000 mcg per day (in combination with folic acid and sun exposure) 23 | Headache, nausea, tingling sensations (with high doses) 26 | Meat, fish, poultry, eggs, dairy products; dietary supplements 25 | Repigmentation induced with supplementation along with sun exposure, complete repigmentation on following complete therapy 10 |
Folate
Folate, also known as vitamin B9, is crucial for cell growth and function, DNA synthesis, and red blood cell formation27. It plays a vital role in fetal development and helps prevent neural tube defects during pregnancy28. Some studies suggest that folate may be beneficial for vitiligo, especially when combined with vitamin B12 and sun exposure11. Folic acid and vitamin B12 supplementation, combined with sun exposure, can induce repigmentation better than either the vitamins or sun exposure alone30.
While some studies suggest that vitamin B12 and folate levels are decreased in vitiligo patients, others have found no significant difference31. More research is needed in this area.
| Supplement | Properties | Dosage | Side Effects | Sources | Impact on Management of Vitiligo |
|---|---|---|---|---|---|
| Folate (Vitamin B9) | Cell growth and function; DNA synthesis; red blood cell formation 27 | 5 mg twice daily (in combination with vitamin B12) 22 or 10 mg per day (in combination with vitamin B12 and sun exposure) 23 | Nausea, confusion, sleep disturbances (with high doses); serious allergic reactions (rare) 33 | Leafy green vegetables, fruits, beans, fortified grains | Repigmentation induced with supplementation along with sun exposure, complete repigmentation on following complete therapy 10 |
Vitamin D
Vitamin D is essential for calcium absorption, bone health, and immune function35. It also plays a crucial role in immune health and may help reduce the risk of autoimmune diseases38. Studies have shown that vitamin D levels are often low in vitiligo patients39. Vitamin D may help prevent the destruction of melanocytes and reduce vitiligo activity40. Some studies suggest that high-dose vitamin D therapy may be effective in reducing vitiligo activity41.
Vitamin D3 increases tyrosinase activity and melanogenesis in vitro, which may lead to repigmentation in vitiligo skin lesions42. Vitamin D analogues, such as calcipotriol and tacalcitol, combined with topical corticosteroids or NB-UVB phototherapy, could potentially enhance therapeutic outcomes for vitiligo43.
| Supplement | Properties | Dosage | Side Effects | Sources | Impact on Management of Vitiligo |
|---|---|---|---|---|---|
| Vitamin D | Calcium absorption; bone health; immune function 35 | 1,000–4,000 IU (25–100 mcg) of vitamin D3 daily 41 | Nausea, weakness, confusion (with excessive intake) 37 | Sunlight, fatty fish, eggs, fortified foods | Decreases disease progression when supplemented with standard therapy 10 |
Polypodium leucotomos
Polypodium leucotomos is a fern extract with antioxidant and photoprotective properties44. It may help protect the skin from sun damage and reduce inflammation46. Some studies suggest that it may be beneficial for vitiligo, especially when combined with phototherapy45.
Polypodium leucotomos extract may not only provide photoprotection at the time of exposure but also potentially reverse the damage of previous UV exposure48. It’s used to prevent certain skin problems, including sunburn, eczema, psoriasis, vitiligo, and skin cancer49.
While Polypodium leucotomos has an excellent safety profile, it has not been clinically tested in children under 18, pregnant women, or breastfeeding mothers50. In one study, 720 mg of oral Polypodium leucotomos extract was administered in three doses (240 mg every 8 hours)51.
| Supplement | Properties | Dosage | Side Effects | Sources | Impact on Management of Vitiligo |
|---|---|---|---|---|---|
| Polypodium leucotomos | Anti-inflammatory, antioxidant, photoprotective, and immunomodulatory properties 44 | 720 mg in three doses (240 mg every 8 hours) 51 | Generally considered safe, with minimal side effects; potential for allergic reactions (rare) 52 | Fern extract (available as oral supplements and topical creams) | Combining Polypodium leucotomos with PUVA leads to increased repigmentation 10 |
Nigella sativa
Nigella sativa, also known as black seed oil, has anti-inflammatory, antioxidant, and immune-modulatory properties54. It has a wide range of potential benefits beyond vitiligo, including anti-inflammatory, antioxidant, analgesic, and antimicrobial properties55. Some studies suggest that it may be beneficial for vitiligo, potentially by promoting repigmentation54. It may be particularly helpful for repigmentation in sensitive skin areas like the genital region57.
In one study, a thin layer of 20% w/w ointment of Nigella sativa was applied on the affected area twice daily58.
Nigella sativa has been used in traditional Chinese medicine, Arabian medicine, and Ayurveda for various conditions, including asthma, bronchitis, and skin infections59.
| Supplement | Properties | Dosage | Side Effects | Sources | Impact on Management of Vitiligo |
|---|---|---|---|---|---|
| Nigella sativa (Black seed oil) | Anticancer, immunomodulating, and anti-inflammatory properties 54 | Topical application: thin layer of 20% w/w ointment twice daily 58 | Nausea, allergic reactions (in some individuals) 60 | Black seed oil (available as oil, capsules, and topical creams) | Topical administration considerably increases repigmentation 10 |
Vitamins with Less Evidence
While the vitamins mentioned above have some evidence to support their potential role in managing vitiligo, there are other suggestions with even less scientific backing. These include:
- Vitamin E: Some people believe that vitamin E, an antioxidant, may be beneficial for vitiligo61. However, more research is needed to confirm its effectiveness. Individuals with vitiligo generally exhibit significantly lower serum concentrations of vitamin E62.
- Beta carotene: This precursor to vitamin A is thought to have antioxidant properties and may be helpful for vitiligo20. However, more research is needed.
Diet and Vitiligo
While there is no specific “vitiligo diet,” some dietary modifications may be helpful. There is no evidence that confirms a direct link between nutrition and vitiligo, but some studies suggest changing your diet or adding supplements could have a positive impact63. A healthy diet, rich in fruits, vegetables, lean protein, and whole grains, may help reduce oxidative stress, support the immune system, and improve the condition of the skin in people with vitiligo64.
What to Eat
- Antioxidant-rich foods: Fruits, vegetables, nuts, and seeds are high in antioxidants, which may help protect melanocytes from damage64.
- Omega-3 fatty acids: Foods like oily fish, flaxseeds, and walnuts are rich in omega-3 fatty acids, which have anti-inflammatory properties65.
Foods to Avoid
Some individuals with vitiligo report that avoiding certain foods may help improve their symptoms. However, evidence for these recommendations is limited and largely anecdotal. Some of the foods often mentioned include:
- Gluten: Some people with vitiligo believe that avoiding gluten may help improve their symptoms64. However, there is no conclusive evidence to support this claim66. One study looked at a young woman with vitiligo who removed gluten from her diet and saw early and extensive repigmentation of facial lesions67. She experienced most benefits within the first month and noticed stabilization by month four67. Existing research supports the connection between celiac disease and vitiligo, focusing on the importance of considering celiac disease in individuals with vitiligo due to potentially overlooked non-specific intestinal symptoms68. Both celiac disease and vitiligo are associated with similar diseases, including autoimmune bullous disease, inflammatory bowel disease, autoimmune thyroiditis, autoimmune gastritis, and type 1 diabetes69.
- Inflammatory foods: Processed foods, sugary drinks, and foods high in trans fats may promote inflammation, which could potentially worsen vitiligo63. Specific examples include processed meat, white bread, soda, and desserts70.
- Depigmenting agents: Some foods, like certain fruits and vegetables, contain hydroquinones, which are known to have depigmenting effects71. However, the amount of hydroquinones in these foods is likely too low to have a significant impact on vitiligo71.
Diets with Less Evidence
- Plant-based diet: Some individuals with vitiligo report that following a plant-based diet may help improve their symptoms67. However, there is no strong evidence to support this claim.
Conclusion
While conventional treatments remain the mainstay of vitiligo management, alternative therapies, supplements, and dietary modifications may offer additional support for some individuals. It’s crucial to approach these therapies with caution and consult with a healthcare professional before trying them, especially if you’re currently using other medications73. Remember that the effectiveness of alternative therapies may vary.
Some of the most promising alternative therapies and supplements for vitiligo include Ginkgo biloba, vitamin B12, folic acid, vitamin D, Polypodium leucotomos, and Nigella sativa. However, more research is needed to fully understand their role in managing vitiligo and to determine the optimal dosages and treatment durations.
A healthy diet, rich in antioxidants and omega-3 fatty acids, may also be beneficial. While avoiding certain foods, such as gluten and those high in inflammatory agents, may help some individuals, the evidence for these recommendations is limited.
It’s important to remember that alternative therapies should complement, not replace, conventional treatments for vitiligo. Always discuss your treatment plan with your healthcare provider to make informed decisions about your care.
Research has shown that some individuals with vitiligo use various complementary and alternative medicine (CAM) approaches, including supplements and topical therapies4. A large-scale study involving 3,541 vitiligo patients provided insights into their demographics, disease characteristics, and treatment experiences, highlighting the diversity of vitiligo patients and the need for personalized approaches1.
It’s also important to be aware that certain drugs can induce vitiligo, such as topical imiquimod and interferon74. This highlights the complex relationship between medications and vitiligo and the need for careful monitoring and individualized treatment plans.
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