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  What is Vitiligo?Vitiligo is a disease of skin pigments called melanin. Rather, it is a disease where there is a loss of skin pigment or color. Vitiligo affects about 2% of world population and close to 8% of Indian and Mexican populations. Vitiligo is not a serious disease, medically speaking. It's social significance is more than medical importance, as it does not cause any major harm to the body. In simple words, vitiligo is caused by one or two of the following processes: 1. Melanin cell destruction, leading to loss of color on skin There is no exact cause known for the above processes. There are some theories which are considered responsible for the above processes in vitiligo. The probable causes of vitiligo are explained elsewhere on this site. In brief, genetic and immunological factors are considered responsible for vitiligo and vitiligo treatment. . Due to destruction of the melanin (pigment) cells due to lesser known processes (largely what is called as an auto-immune disorder) the normal skin starts loosing pigments from various parts of the skin, in a varying speed and extent. Our experience at Vitiligo clinics based on the treatment of over 5000 cases, suggests that there is a strong genetic factor in the background of most cases, especially those who have extensive vitiligo or those who have vitiligo affecting the finger-tips, toes, lips or the genitals. The indication of strong genetic factor is observed in the form of family history of one or more of the auto-immune diseases such as vitiligo, alopecia areata, diabetes, under active thyroid, cancer, rheumatoid arthritis or allergies. The vitiligo sufferers are observed all over the world, including the white skin communities. However, epidemiologically most cases are recorded in India (8.8%) and Mexico. Estimated 1-2% of the Americans have vitiligo as per the survey made by the American Academy of Dermatology. Males and females are affected equally, inclusive of children age group. It may begin at any age. Childhood vitiligo is common. We have registered cases as young as three months old, to late onset vitiligo at the age of 80 years. At Life Force, we have under our care practically most nationalities (from over 170 counties) with different skins (genetically speaking) presented to us with vitiligo; who have given us opportunity to understand this disease better. In short, vitiligo is not as serious disease as it has been thought about. Symptoms of VitiligoThe typical appearance of Vitiligo is a milky white de-pigmented spot or spots. It may vary from a single white spot to multiple spots. The shape too is a variable. In some cases generalized de-pigmentation observed all over the body. It has a tendency to start as a single spot and gradually grow in size and number. It may present with a single or several spots on limbs or abdomen or back and then spreading to other parts of the body. Some cases showing affection of the mucocutaneous junctions such as finger-tips, corners of the mouth, private parts, around eyes. The spread of the disorder is usually slow and progressive. Symmetrical appearance on both the sides of the body (say, on the legs, hands, etc.) is common. In rare cases one finds vitiligo spreading all over the body. Spread of vitiligo: Associated Systemic Disorders: It may be noted that the sufferers of Vitiligo need not be unduly scared of the above disease conditions, as they should not be regarded as the complications of Vitiligo in every case. Causes of VitiligoVitiligo is a disease of which the exact cause is not fully understood. However, there is increasing understanding about the processes involved in the development of Vitiligo. T In most cases there are multiple causes responsible for vitiligo. However, there are theories suggesting a. Autoimmune links: The cells fighting among themselves leading to destruction of the melanin, is one of the reasons. There are other immunological factors as well. One of the studies has suggested role of some neuropeptide (NYP) which may damage melanin. Such neuropeptide may be released in response to skin injury or emotional stress; again suggesting a combination of causative factors. b. Hormonal connections: Affection of certain hormones such as Thyroid hormones or Melanocyte Stimulating hormone may be responsible for vitiligo. c. Genetic tendencies d. Neural theory e. Autocytotoxic theory As per this theory, there is self-destruction of melanocytes and hence the melanin. This could be a result of genetic, immunological, neural or stress factors. There are factors, internal and external, which either predispose or trigger or maintain the process which leads to development of vitiligo. In most cases, more there may be a mix of causes. The familial incidence of 20 to 30% is observed in the family members. If one or more of the parents have vitiligo, there are more chances of one developing the same. However, it is not a rule. At the same time, numerous cases of vitiligo do not have a relevant family history of Vitiligo. We have made an important observation through a study that most patients with vitiligo has one of the family members (father, mother, grand parents on either side, uncle, aunt or siblings) suffering from one or more of the following diseases:
a. Vitiligo A study at our center also shows that the patients who have either extensive vitiligo or those developing vitiligo spots on both sides of body (bilateral symmetrical) have a strong genetic element. Vitiligo and Hypothyroidism (Under active thyroid): Research suggests that Vitiligo and Hypothyroidism (Under active thyroid) often are predisposed by the same gene (NALP1 gene). All patients of Vitiligo are suggested to get Thyroid profile done every six months. Thyroid profile entails blood sample study for T3, T4 and TSH (Thyroid stimulating hormone) hormones at a small cost. Other factors: The precipitating factors have been identified as due to pressure of tight clothes (such as on the waist) or certain occupational hazards such as wearing certain rubber hand gloves. Long term intake of certain drugs is found to produce this pigment disorder. In many cases, especially in children, we often have no clue why one develops vitiligo. All said and done, there is definitely an abnormal process of melanocyte destruction and defective melanocyte formation, governed by known or unknown factors. It may be noted that some of the above remarks are based on our study of over 4500 cases and they may not be found in the standard dermatological text books. We are still learning and exploring vitiligo, like many other disease. Like many disease conditions, the exact causation yet remains a mystery! Treatment for vitiligoHomeopathy offers proven vitiligo treatment for the cases of vitiligo which do not have extensive spread.
• Controlling the spread of Vitiligo by attempting to correct the immune system What does the treatment do? The scientific and documented study at vitiligo clinics show that the homeopathic vitiligo treatment helps achieve:
• Enhances melanocyte formation by stimulating the natural process called melanogenesis Dr Rajesh Shah, M.D. expertise : What is the duration of treatment for Vitiligo :
• Extent of vitiligo: Fewer spots respond faster and better than larger number of sports Most patients show improvement within initial four months, in form of re-pigmentation or slowing down of spread of vitiligo. Vitiligo cure success varies from patient to patient. How to get started with the treatment: Chances of vitiligo recovery?The chances of recovery, regimentation and vitiligo cure depend on several factors. Based on our extensive study and research, we would like to share some of our observations with you. It may be noted that the standard medical text books do not clearly suggest what we have described on this page, based on our clinical experience. It has to be also noted that we are simply sharing our view point based on a study of over 5000 cases of vitiligo at Life force. Following notes are simply suggestive and not conclusive as there may be exceptions. 1. Cases which can find excellent results: 2. Cases which can find very good results: 3. Cases which can find good results and better control: 4. Cases which can find poor results but fair control: 5. Cases which find very poor results and no treatment is suggested: It may be noted that above information is based on clinical observation. There are many factors which influence the course and treatment of Vitiligo, which is out of the scope of this article. The above remarks give broad idea to the patients about the prognosis of Vitiligo. It is not possible to give visuals of all sorts of cases which are either treatable or not treatable; however, just to give you glimpses of the extent + curability, please examine three cases, showing mild, moderate and severer extent of Vitiligo. Mild cases are curable, moderate cases are partly curable and controllable; while severe cases are incurable and controllable, using homeopathy. These images and information is more empirical. There can be many variants and variations. Diet in VitiligoDietary instruction for Vitiligo patients: :: Foods that are excessively sour should be avoided. Vitamin C (ascorbic acid) is known to inhibit the production of the melanin, the color pigment. Patients with vitiligo are suggested to refrain from citrus fruits, sour yogurt, sour pickles, etc. Non-vegetarian food are better avoided, as much as possible, as they act as a foreign body to pigment cells. It has been observed that industrial chemicals (such as mercury) could enter our body through sea food, especially fish; which better be avoided. There may not be enough scientific evidence to prove how these foods worsen vitiligo but our clinical experience has shown that many patients report worsening of their vitiligo from these items and hence they are better avoided. The author of this write up is of the opinion is that the since the process of melanin formation calls for physiological pH, in the process where tyrosinase converts tyrosine to dihydroxyphenylalanine (DOPA) and then to dopaquinone, intake of sour food may work adversely, hence hampering the process of melanogenesis. How to find a good vitiligo doctors for your vitiligo treatment?Vitiligo is not common in most parts of the world, especially in the western countries. As a result, many regular doctors are not adequately trained to handle or treat vitiligo patients. Some doctors may not have a ‘clinical eye’ to diagnose vitiligo without investigations. Most doctors may not have a simple devise such as a Wood’s lamp, which can help the doctor to diagnose vitiligo without a biopsy. It is important for you to find out answers to some of the following questions, when it comes to the treatment of vitiligo:
a. Ask your vitiligo doctor if he or she is confident about the diagnosis of vitiligo in your case. Coping up with vitiligo1) Coping up with vitiligo as a patient: First of all, you need to get convinced for yourself that vitiligo is a not a serious illness. Vitiligo is much less serious than allergy, colds or asthma that over 20% of the world population suffers! Apart from making a change in your appearance it does not harm you in any way. Vitiligo is not a serious disease at all. What is more important is a positive attitude towards vitiligo. Do not feel embarrassed, ashamed, depressed, or worried about how others will react. Do not avoid social situations and parties. Let people around you know once and for all that you have some color problem with your skin. There are many products out there to provide excellent camouflage of vitiligo spots. Consult a doctor who specializes in dealing with vitiligo cases. 2) Coping up with vitiligo as a parent: Children usually cope best with vitiligo when their parents themselves are not over anxious about it. Your own over consciousness may create more problems for your child than the actual vitiligo. Learn to overcome that. Let your child know that vitiligo is a benign skin problem and it is not serious. Educate your child on how to answer his friends, teachers and relatives if they enquire about vitiligo. S/he should be taught to answer firmly and carelessly about the insignificant nature of vitiligo. Communicate with some of the close relatives (grand parents, aunts, uncles, neighbors and teachers) informing them about vitiligo, requesting them not to discuss it with your child. Avoid discussing your child’s vitiligo repeatedly. Moreover, avoid negative discussion about vitiligo during the child’s presence. Examination of the spots is better done when the child is asleep. When your child questions you whether anything can be done for this or not, explain your child that this condition can be treated to certain extent like any other skin ailment. Support your child, and encourage him/her to get involved with activities and hobbies. Do not allow vitiligo to interfere with your child’s joy of living and his self esteem. Do not restrict your child from wearing clothing which may expose some white spots on the skin. Do encourage your child to continue attending social events, other activities like swimming, hiking, sports, parties, etc. Help your child to boost self confidence and let vitiligo not come on his/her way of growing as a person. 3) Coping up with vitiligo as as a citizen (who does not suffer from vitiligo): Vitiligo is a benign, non-infectious condition of the skin. Those who suffer from it do also suffer from some emotional trauma associated with vitiligo. As a civilized person it is our duty to have healthy outlook towards those who suffer from Vitiligo. Do not stare at a person with vitiligo. It is considered bad manners to embarrass any one suffering from vitiligo! Do not discuss with the sufferer as to what is this, how did it happen, etc which might make him feel more embarrassed. Patients with vitiligo do not need pity or sympathy. They simply need understanding.
(c) Copy Rights: Dr Rajesh Shah, MD |
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