Vitiligo, also called leucoderma (translating to ‘white skin’) is a condition in which pigment-making cells in the skin (the melanocytes) are destroyed, resulting in sharply defined patches of skin with no pigmentation. Depending on the type of vitiligo, these patches may grow in size over time. Melanin produced by melanocytes serves to protect the skin against damage from ultraviolet light, and as such, depigmented regions are more at risk of sunburn. People of all skin colours can suffer from vitiligo, though the condition is obviously more noticeable in those with darker skin.
Susceptibility to vitiligo appears to be genetic, and seems to be related to gene variants that are involved in the immune system. It’s thought that some environmental trigger causes the immune system to attack and destroy the melanocytes, but the exact cause of vitiligo is not well understood, nor is there any known cure. Treatments aimed at addressing vitiligo include immune system-suppressing steroids applied to the skin and controlled exposure to ultraviolet light to stimulate repigmentation. However, there’s some evidence that certain supplements may also ameliorate the condition, or even have a curative effect in a proportion of patients.
This article isn’t medical advice. You should consult with a doctor before taking any supplements, as they may interact harmfully with some drugs and could worsen other medical conditions.
What is it?
Also called kutki or picroliv, picrorhiza kurroa is a herb used in a branch of traditional medicine originating in India. Notable active chemicals include picroside I and picroside II, which are able to bind to receptors on the surface of immune cells and thereby affect immune function. They also have antioxidant properties, meaning that they are able to neutralise damaging molecules called reactive oxygen species (ROS) that are produced by the metabolism. Picrorhiza Kurroa appears to protect the liver against some toxins, which may have some relevance to vitiligo, as there is an associations between vitiligo and autoimmune liver disease.
What’s the evidence?
There has only been one relatively small study on the benefits of picrorhiza in vitiligo, but the results of that study are fairly convincing. The study used a double-blind, placebo-controlled design, meaning that neither the participants nor the researchers administering the treatment knew whether the treatment was fake or real. 30 participants from age 7 to 44 took 200mg of dried picrorhiza twice daily for three month periods, alternating with one month periods in which they received a placebo. Throughout the study, the participants were also receiving phototherapy. Around 90% of participants showed greater response to picrorhiza and phototherapy than to placebo + phototherapy, and 27% showed complete resolution of their symptoms. However, we can’t confirm the effectiveness of picrorhiza kurroa from just a single study, so more research is needed.
What is it?
Ginkgo biloba, commonly known as ginkgo or the maidenhair tree, is a native Chinese tree of which the leaf extract is sometimes taken as a dietary supplement. This extract has been studied for its potential health benefits, most notably its proposed ability to improve memory and cognitive function in the elderly and in people with dementia. However, this research is still largely preliminary. Terpene lactones and flavonols are thought to be the main active components of ginkgo. Many of these molecules have anti-inflammatory and anti-oxidant properties, and appear to protect the heart and blood vessel walls against damage in animal models.
What’s the evidence?
There have been several studies on the effects of ginkgo supplementation in vitiligo. The better of these studies was a randomised, double-blind placebo-controlled trial in which 47 participants took either 40mg of ginkgo or a placebo three times per day, over a period of 1-6 months. The group receiving the real treatment had a statistically significant reduction in the rate at which their vitiligo spread, and experienced more repigmentation of affected areas than those receiving the placebo. Ten patients in the treatment group had complete or near-complete repigmentation of affected areas compared with two patients in the control group. Similar outcomes for treated patients were reported by another study, but that study did not have a control group and so the results don’t carry a lot of weight. As in the case of Picrorhiza Kurroa, these are promising findings that require further investigation to confirm.
What is it?
Polypodium Leucotomos, often referred to as either ‘Fernblock’ or ‘Heliocare’ is a herb that has been investigated for possible benefits for skin health. Studies on Polypodium Leucotomos suggest a variety of protective effects against skin damage from UV(B) radiation. These benefits appear to be partly due to anti-oxidant and anti-inflammatory properties of the herb’s active chemicals, including promoting the production of a protein called p53. p53 is most well known for its role in preventing cancers, but also appears to suppress inflammation while protecting the genome (DNA) from damage. Supplementation with Polypodium Leucotomos appears to be beneficial in many skin conditions, and has been explored as a treatment for vitiligo.
What’s the evidence?
More evidence is needed to draw a firm conclusion about whether Polypodium Leucotomos is beneficial in vitiligo or not. So far, however, studies have failed to find a statistically significant benefit for Polypodium Leucotomos supplementation. In a randomised, double-blind placebo-controlled trial, 50 participants with vitiligo received phototherapy combined with either Polypodium Leucotomos or a placebo (250mg three times a day) for 25-26 weeks. Though there was a trend towards greater repigmentation in the treatment group, this association was just shy of reaching statistical significance. There’s therefore no evidence currently that supports Polypodium Leucotomos for vitiligo, but more research is warranted.
We tend to draw a hard distinction between drugs and supplements, when in reality these can and should be considered to be the same thing. Unfortunately, supplements are often less well-studied, partly because regulators such as the FDA do not classify them as drugs, and so their distributors do not need to prove their efficacy to the extent that is required of pharmaceutical companies. When choosing to take supplements for vitiligo, it’s important to recognise that the evidence is limited and that you might not derive any benefit. Considering that vitiligo has no cure and that side effects appear rare, the above supplements may be worth trying in addition to conventional therapies, but a doctor should always be consulted first as supplements may be dangerous in certain medical conditions or in combination with certain drugs.
Picrorhiza kurroa, an ayurvedic herb, may potentiate photochemotherapy in vitiligo: https://doi.org/10.1016/0378-8741(89)90009-3
Ginkgo biloba for the treatment of vitilgo vulgaris: an open label pilot clinical trial: https://doi.org/10.1186/1472-6882-11-21
Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo: https://doi.org/10.1046/j.1365-2230.2003.01207.x
Treatment of vitiligo vulgaris with narrow-band UVB and oral Polypodium leucotomos extract: a randomized double-blind placebo-controlled study: https://doi.org/10.1111/j.1468-3083.2006.02132.x
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