Leucoderma (Vitiligo)

Colour of our skin,hairs and iris(eye) is decided by Melanin pigment. Melanin is produced by melanocytes,these are cells in skin layers which works under control of Melanocyte Secretory Hormone of brain. When these melanocytes reduce production of Melanin pigment ,skin starts to loss it’s colour and becomes white . There are many disorders which are caused by deficiency of pigmentation of skin,and all they are grossly known as Leukoderma. Few disorders are caused by inability to produce Melanin pigment by Melanocytes ( Melanin producing cells), while other disorders are caused by absence of Melanocyte cells or due to destruction of melanocytes later on.
In Vitiligo Melanocytes starts to destroy and reduce the pigmentation of skin. Clinically vitiligo appears as milky-white,irregularly oval patches of skin. These patches are more or less symmetrical. Most common places are hands, wrists, face, neck, knee and openings of body as around eyes, lips, nose etc. These patches are small at beginning but enlarge gradually. Hairs growing in these patchy area also lost their colour and becomes white. The exact reason not yet clear. But many theories are behind this condition.
At least 1% of population, world wide suffers by Vitiligo.

Production of Melanin-

The melanocyte cells transform the peptide tyrosinase into two different forms of melanin, which then is spread throughout the dermal cells and the keratinocytes via melanosomes to darken tissue.

Causes of Vitiligo

Many theories are described about causation.

A. Autoimmune Theory-
It is known vitiligo appears in conjunction with several other autoimmune disorders, such as juvenile diabetes mellitus, Addison’s disease, pernicious anemia and additionally organ-specific antibodies can often be seen in patients with vitiligo. Now this theory is accepted as most common cause of Vitiligo. Autoimmune means body’s own immune system develops antibodies against Melanocyte cells ,which start to destroy them . Few other Autoimmune diseases may be present in cases of Vitiligo as – pernicious anemia, diabetes mellitus and disorders of thyroid.

B. Genetic theory-
About 20% patients have strong family history of Vitiligo. Genetic factors probably play a key role in the pathogenesis of vitiligo, but the exact cause is unknown.

C. Self Destruct Theory-
In process of producing melanocyte pigment, melanocytes produce some pre-metabolites as dopa and dopachrome. These metabolites are toxic for Melanocytes,but usually Melanocytes have counteract measures against these substances. But sometimes Melanocytes lost this lost this ability to counteract these toxic substances. In that condition Melanocytes destroyed by these toxic substances.

D. Neural theory-
Sometimes peripheral nerves endings may secrete some cytotoxic substances which damage melanocytes. This theory is supported by cases of segmental vitiligo, in which a whole dermatone is hypo-pigmented due to destruction of melanocytes in that dermatone.

E. Convergence Theory-
After genetic studies, researchers have begun to lean towards a multi-faceted etiology for vitiligo. This theory states that genetic influences have a role in causing vitiligo in addition to other elements, such as stress, accumulation of toxic compounds, infection, autoimmunity, mutations, and impaired melanocyte proliferation.

Factors Important from Homeopathic Point of view-

A. In some cases Mental states of patient- shock,anxiety,tension,depression, constant grief may causes changes in skin pigmentation.

B. Suppression of other skin diseases, cauterization for skin growths like warts,moles, lot of external application of strong chemicals on skin may cause vitiligo.

C. Melanin formation depends on enzyme Tyrosinase activity.Normal vitamin levels are prerequisite for tyrosinase activity.

D.Intestinal disturbances and infections as Chronic amoebic dysentery and intestinal giardiasis may cause mal-absorption of tyrosin,which is a important substance for melain pigmentation.

E. Family history of Vitiligo, Tuberculosis and Diabetes is very important for Homeopathic treatment.

Treatment-

Modern allopathic science offer following way of treatment-

1. Immuno suppressive treatment- Because vitiligo is a autoimmune disorder,so topical Corticosteroids are used to cure small vitiligo patches. But in big patches systemic corticosteroids therapy may be more harmful due to its side effects in comparison to its benefit.

2. Phototherapy and Photo-chemotherapy-
Many artificial ultra violet radiation ( UV) methods are offered with less and more success. Among them PUVA, BUBV,NBUVB and Laser methods are used.

3. Surgical Treatment-
Grafting of skin patches with melanocytes is done for pigmentation of Vitiligo patches.

Homeopathic Treatment-

Scope- Homeopathy cures 60% cases of Vitiligo in 1 to 3 years. Another 25% cases which continue Homeopathic Treatment for 3 years show very good recovery from 60-80% cases. 15% cases which have very large and bilateral de-pigmented spots never get good recovery. For permanent cure by homeopathy it needs for patient to start treatment earliest, continue it for 1 to 3 years, cases which are bilateral takes longer time, big spots take much time and patience is needed.

There are numerous medicines for Vitiligo. Few are described here.

A. Thuja- It is an Anti Sycotic medicine . In homeopathy all the chronic diseases are supposed to be born from any one of the three Miasms – Psora,Sycosis,Syphilis.
In cases where Vitiligo develops after Vaccinations and recurrent inoculations,Thuja works very finely. In cases where other skin growths like warts are present with Vitiligo lesions Thuja helps. In cases with Tuberculosis history,where Bacilinium is prescribed, Thuja must be given first,cause Bacilinium works very good after Thuja.

B. Sulphur- It ia great Anti Psoric medicine. This medicine is indicated where there is – History of suppressed Sycotic and Syphilitic miasmatic symptoms, suppressed diarrhea, dysentery,jaundice,typhoid fevers etc. Symptoms of sulphur must be present in the case as- Burning soles,palms, heat in eyes,anus,vagina or other openings of body. Irritable and obstinate person. Sometimes this medicine can aggravate the symptoms, in that case Sulphur must be stopped.

C. Bacillinum- In cases where history or family history of Chest diseases found as Tuberculosis, Asthma, Bronchitis,Pneumonia, Pleurisy. Present symptoms may be Loss of weight,Loss of appetite, Flat chest,Prominent ribs and clavicle.

D. Cuprum Aceticum- Cuprum is important part of melanin pigment. And most of the time Copper deficiency is found with Vitiligo. this medicine show very impressive and remarkable results in many cases.

E. Sepia- In female Vitiligo patients Sepia is indicated very frequently. Where coexisting symptoms are irregular menses,scanty and painful menses, leucorrhea, pruritis, dysparunia and patient is very cold .
Nausea,morning sickness,vomiting,motion sickness,headache all these symptoms indicate Sepia. But sepia does not cure completely a patient and many of times Natrum Mur is needed to complete the recovery started by Sepia.

H. Hydrocotyle- hydrocotyle indicated in cases of suppressed skin eruptions. It is very helpful in cases where history of filarisis is present.

I. Acid Nitricum- This medicine indicated where spots of vitiligo found on muco-cutaneous junction as lips,nose,nipples,glans penis,vulva etc. Cracks may coexist with these white spots. In patients with desire to eat strange things as chalk,pencils etc. indicate towards Acid Nitricum.

J. Mercuris Sol- In patients with history of dysentery with mucus and blood. Patient which feel worse in night, extreme salivation in night, perspiration in night in bed. Patients of mercuris sol can not tolerate both extreme cold and hot weathers.

K. Ars. Sulf. Flav.- This medicine is used very much ,even in cases which are not indicated for this medicine. Patients who are -very irritable,quarrelsome,fear at night in dark, very suspicious, weeping in night, aversion from milk, desire warm things to eat, itching worse in cold weather and better by warmth of bed- only indicated for this medicine with marvelous outcome.

L. Cantharis V – This medicine is indicated in cases where Vitiligo start after burn in some part. Cases where injury on skin caused by Burn starts whiting of skin can be cured by this medicine.

M. Ami Visnaga- This medicine is used externally on vitiligo spots in Mother tincture form. External use increase the rate of improvement.

Beside these medicines Syphilinum, Medorrhinum, Natrum Mur, Lycopodium, Ars Iod, Rastinon, Cobalt and so many other medicine help in to recover the vitiligo spots.