Everything that you should know about Vitiligo

Vitiligo is a disease characterized by the development of white spots due to the loss or reduction of melanocyte cells function, primarily in the skin, hair and eye retina. The number of people affected by Vitiligo is huge. In different regions, this figure ranges from 1% to 8% of the total population, and that are tens of millions of people.

The first mention of Vitiligo appeared in the ancient Egyptian papyrus. But despite years of research the doctors still have not come to a consensus about the causes of this disease and have not yet developed effective ways to treat and prevent Vitiligo.

Modern medicine defines a number of reasons, each of which may be a prerequisite to the appearance of Vitiligo.

• diseases of internal organs and endocrine glands (for example, thyroid disease is observed in 30% of patients with Vitiligo);

• disorders of the immune system;

• dysfunction of the nervous system and emotional stress;

• chronic inflammatory diseases;

• poisoning;

• sunburn;

• heredity;

• presence of parasites in the body

Regardless of whether was the reasons triggered the manifestation of Vitiligo, we must understand that this is not a disease of the skin. Spots are just signals telling us about the failure of normal work of the organism, an imbalance in the emotional sphere, in relation to itself.

Vitiligo is a good reason for all of us to listen to ourselves, to look at ourselves from the outside, correct our lifestyle, diet, thinking, relationships with the loved ones. Vitiligo may be an impetus to get tested, to bring order to our body, gives ourselves time to become a calmer and happier people.

1. Learn more about what is Vitiligo. On the Internet you will find lots of information, tips and stories of healing. Read the forums! The more you know, the better you feel and the easier it is to navigate and choose the right path of healing your problem.

2. Visit a qualified doctor and confirm the diagnosis. Make sure you have namely Vitiligo, and not a fungal infection (ringworm, shingles, lichen, etc.)

3. Perform complex examination of the body to identify and, where possible, eliminate the causes of disease. Check the gastrointestinal tract, the liver, thyroid, undergo the treatment from parasites, identify the deficiency in macro and micronutrients (copper, iron, zinc). Pay close attention to the treatment of your teeth.

4. Establish order in the emotional sphere, stop getting nervous. All experts, without exception, are unanimous in their opinion that stress is one of the main reasons that can precipitate Vitiligo. On the other hand the appearance of such white spots often plunge people into depression forming in such a way a vicious circle! It is necessary to get out of the depressed mood and start enjoying the life. Therefore, a psychotherapist very often becomes the main physician for a patient with Vitiligo.

1. Give up the idea that for 100$ or 1,000$ you can buy a miracle cure that will save you from stains in just one week. If it were so simple, people like Michael Jackson or the Russian billionaire Abramovich would get rid of this problem a long time ago.

2. Do not rush! To obtain good results, you will need time and patience.

3. Forget the words: «It will not help me», «I do not believe in success»!

   It will help you! According to the statistics, 80% of patients get a positive result after the first months of treatment.

4. There is no universal method for treating Vitiligo. If something has not helped one patient, it will help the other. Every person is unique. You have to find your way of healing, your combination of medical factors. Nobody will do that for you except yourself.

Nowadays the problem of effective and proper treatment of this disease remains unresolved in view of the fact that the causes and mechanisms of Vitiligo still remain unknown.

Many factors that contribute to the emergence of Vitiligo, necessitates a comprehensive treatment of this disease. This disease cannot be cured by the only one, even the most effective drug or method!

The main goal of therapy is to remove the Vitiligo cosmetic defect and restore natural skin pigmentation. The task of identifying and eliminating the source of the disease is still not resolved.

1. PUVA therapy.

   PUVA is a type of ultraviolet radiation treatment (phototherapy) used as an immunomodulatory treatment for severe skin diseases. PUVA stands for Psoralen (P) and ultraviolet A (UVA) therapy. Ultraviolet (UV) light therapy has been used for many years to treat varied recalcitrant skin diseases, but today it is almost completely replaced narrow-band UVB radiation and laser therapy. In PUVA therapy, the patient is exposed first to Psoralens (drugs containing chemicals that react with ultraviolet light) and then to UVA light. PUVA therapy is not as effective as narrow-band UVB radiation, and also has a number of side effects due to the use Psoralens.

2. Narrow-band therapy.

   Medium-wave ultraviolet radiation of a narrow spectrum (wavelength around 311 nm, of UVB type; most popular device is Dermalight 80) has been increasingly used in the treatment of skin diseases in recent years. It causes fewer side effects than PUVA by using lower doses of ultraviolet radiation. During the a narrow-band therapy there is no rigid need for photo sensitizers, only on request, but the studies show that it is much more efficient.

3. Laser treatment.

   Laser is a pulsed light source with a wavelength of 308 nm. Laser treatment is not much different from ordinary phototherapy; the only difference is the intensity of the particles flux (much more intensive for laser therapy). The treatment is usually carried out in specialized clinics only, with use of the expensive equipment, which leads to the high cost of the procedures.

   Having the narrow-band phototherapy lamps, you can achieve similar results at home.

4. Skin transplantation.

   The method of transplantation of depigmented skin (flap autotransplantation).

5. Medications for topical treatment.

   1. Melaginin Plus - 50% alcohol extract of human placenta, with a high content of calcium (0.2-0.5 mg ml);

   2. Protopic;

   3. Pimecrolimus (Elidel);

   4. Vitilem+ comprising the Little duckweed (Lemna minor);

   5. Parsnip and St. John's wort alcohol tinctures;

   6. Sunscreen creams with a protection index 15-100;

   7. Masking cosmetics.

6. Treatment in the specialized clinics in Cuba and the Dead Sea.

7. Alternative medicine.

   Alternative medicine also offers many ways to beat Vitiligo.

   Homeopathy, acupuncture, body cleansing, Chinese medicine, herbal oils and all of these methods have their fans and you can successfully combine them with traditional treatment.

   Here are the most popular recipes, easy to produce and affordable for all and everyone.

   Little duckweed (Lemna minor)

   Duckweed is a small plant, floating on the water surface having a rounded or flat lenticular stem and a single root immersed into the water. It can be found almost everywhere except the Arctic. Flowering time is May, September. When preparing products of this plant you can use all of its parts. It can be collected throughout the summer preferably not in village ponds, but only on the quiet forest lakes, which are well away from any habitation. Duckweed is effectively used in the treatment of Vitiligo. Czech Republic produce the tablets called "Vitilem +" and gel "Vitilemna" both comprising duckweed extract. It has been suggested that its therapeutic effect is not associated with photosensitivity, but is based on immunomodulation. It means that duckweed treats the sick melanocytes, and they upon restoring start working as should be. Thus, the duckweed removes the cause of disease rather than its consequence. In view of this the combined use of duckweed with herbs containing furocoumarins and UV radiation is fully justified.

   Recipes of preparation of the duckweed.

   There are three basic recipes for preparation of the duckweed home remedies:

   • Tincture

     Infuse 1 glass of the fresh dried herbs in a bottle of vodka during 2-3 days exposed to the light, and then during 4 weeks in a dark place. Take 20 drops in a glass of water 3 times daily before meals during the first week, 30 drops - during the second week, 40 drops - in the third week, and starting from the fourth week, take 50 drops in a dose.

   • Powder

     Powdered duckweed is recommended for the young children. Crush the dried herbs into a powder and give your child 1 teaspoon 3 times a day. You can also use powdered duckweed mixed with honey at a ratio of 1:1 (1 tablespoon of honey and 1 tablespoon of duckweed).

   • Mixture

     Mix fresh washed chopped duckweed with honey in equal quantities. Take a teaspoon 2-3 times a day. Store in the refrigerator. Fresh chopped duckweed can be used as compresses on the affected skin (10-15 minutes per day).

   St. John's wort

   Many people who want to try home remedies for Vitiligo turn to St. John's wort. St. John's wort increases the skin's responsiveness to sunlight, which can bring color back to your skin. Take St. John's wort as a supplement in a topical form or you may choose to mix it with other ingredients to make a drink. However, if you are pregnant or nursing, do not use St. John's wort. The topical form of St. John's wort involves adding a tablespoon of its leaves to one cup of boiling water. Let it steep for half an hour, then strain out the leaves. Rub this into your skin where the melanin has gone, twice a day.

   To make the drink, mix one part St. John's wort herb, one part oregano herb, one part of calendula flowers and one part of chamomile flowers. Take a teaspoon of this mixture, then add a cup of boiling water and let it steep for at least 15 minutes, but no more than 20 minutes. Drink half a cup of this twice a day for one month.

   Patients with Vitiligo can use the tea comprising the St. John's wort herb or oil. St. John's wort oil or extract should be applied to the affected area 2-3 times a day. The therapeutic effect of St. John's wort oil is due to phytoncide action of the diantron, hypericin and pseudohypericin derivatives contained in the plant, as well as the presence of flavonoids, essential oil and tarry substances.

   St. John's wort oil is made from fresh St. John's wort herb during its flowering: chop the flowers and grass with a knife, place them loosely to the jar and topfill it with the sunflower oil, or even better with the olive oil. Expose the jar to the sun light for 14 days and after squeeze everything through a cheesecloth filter. This oil is an excellent remedy for burns, wounds, fractures and the treatment of Vitiligo.

   St. John's wort extract: chopped fresh herb is placed in a glass jar. Filled with 70% alcohol, brewed in a dark place at room temperature for 2-3 weeks, and then the grass is filtered and pressed.

During the procedure the skin should be clean and dry (without cosmetics, fat etc.)!

The procedure can be started in 30 seconds after the lamp has been switched on.

The lamp should be placed 3-4 cm away from skin (and not closer than 2 cm!). This distance should be always the same to supervise accurately the dose of irradiation and exposition time.

Some lamps models are equipped with a hairbrush, which will help to fix a lamp at a distance of 3 cm from skin. For the other models it is recommended to insert some short lamp shade into a fixture plafond, for example, the cardboard strip made independently, it will help to maintain the necessary distance to skin and to avoid imposing of irradiation zones.

To reduce the total dose of ultra-violet irradiation, it is recommended to protect the sites of not changed skin around the not pigmented sites, which appear under the lamp influence. It is essential for ultraviolet sensitive zones and for sites not covered by clothes (for example, auricles, face). You can use masks or any sun-protection cream with the protection factor (SPF UVB) not less than 15-20.

Initial time of irradiation for face and other sites with thin skin is 10-20 seconds, on sites with thicker skin (elbows, knees, hands, feet) is 30-40 seconds.

The lamp relocation from one site of body to another is performed without switching the lamp off/on. It is necessary to avoid imposing of zones during irradiation (it can cause burns!).

The same site of body should be treated not earlier than in 48 hours after the previous procedure. It is desirable to keep the register of procedures, indicating the procedure date, duration of irradiation, and site name.

With each sequent procedure the irradiation time of a concrete site of body should be increased for 10-20 seconds (for the face only for 5-10 seconds (!), on elbows, knees, hands, feet for 20-30 seconds), till the optimum therapeutic dose is reached - MED (minimum erythermal dose) at which the not pigmented stains get lasting pink or weak-reddish colour and keep it throughout 1-2 days, thus almost till the following irradiation procedure (the erythermal skin reaction should be defined in 24 hours after the irradiation). Further time of irradiation of the given site should not change. If the skin of the given site ceases to react to a used dose of irradiation (adapts), irradiation time again can be carefully increased.

If strong reddening of the given site of body appears it is necessary to suspend the procedure, and in the subsequent to carry it out with smaller duration. Avoid burns!

It is convenient to divide the pathology zones into 2 or 3 groups, to carry out the irradiation of each group in a separate day (then you will spend your time on procedures almost daily, but the duration of each procedure will be reduced).

Soon after the procedure (in several hours) it is desirable to apply moisturizing cream or gel on skin (it is recommended to moisturize the skin as well on days without irradiations). Possible interaction with other treatment agents

It is not recommended to use UV-treatment in combination with photosensitizing drugs - Bergapten (as PUVA-therapy) as the risk of burns and other undesirable by-effects is great.

It is considered that the narrow-band phototherapy can safely be supplemented with such external preparations as "Melagenina Plus" lotion - Cuba, containing the extract of human placenta (it is applied on the sites shortly before the irradiation, and on days between the procedures), and gels containing pseudokatalase, vitamins and microelements - "Vitises" - Germany and "Vitix" - France, (they are applied on the sites and around them twice a day: in the morning and in the evening).

During an intercourse break (and if it is required, and during the course of treatment) it is possible to apply a local immunosuppressive agent twice a day - a cream of "Elidel" (Pimecrolimus) or Protopeak cream.

Properties: "Melagenina Plus" lotion is skin pigmenting agent, stimulating synthesis of melanin and skin reproduction.

Formulation: 100 ml of lotion contain 50 % spirit extract of human placenta; calcium chloride - 100 mg.

Indications: Vitiligo, skin depigmentation as a result of burns of any origin.

Application method: Apply once a day, spreading it with fingers on not pigmented skin sites. Can be applied on children, pregnant and nursing women. If the treatment is applied correctly, in 3-7 days the not pigmented site will redden, with the subsequent gradual blackout and skin repigmentation.

In the beginning of the treatment 40 % of patients have new sites of hypopigmentation or the size of the existing stains increases. Such effect is temporary and has no value in relation to the treatment forecast.

To increase the effect it is recommended to combine the application of "Melagenina Plus" lotion with narrow-band therapy. It is more convenient to carry out the procedures in the evening, after shower, to apply the lotion on the damaged sites and to process them with lamp. If there is no lamp, it is better to carry out the procedure in the morning, so that after spreading the lotion on the not pigmented sites, expose the sites to solar irradiation (to sunbathe 20-30 min).

Recommendations: do not apply the lotion with the help of a wadded tampon, a towel, a fabric etc.; use only fingers of your hands. It is possible to apply it together with other medicines, except corticosteroids, psoralens and which counteract the efficiency of melagenina. It is allowed to use makeup preparation, but only in 45 minutes after the lotion application. You can take a shower, wash and cook not earlier than in an hour after lotion application. It is necessary to stop the medical melagenina treatment of children, who suffer from children's diseases, such as measles, scarlet fever, rubella and similar, till they completely recover from the given illness. It is desirable to carry out a photo or video shooting of the course of treatment to register changes.

Interaction with other medical agents: In order to avoid possible medicinal interactions, please inform your physician about the reception of other medical agents.