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Vitamins for Vitiligo

Updated on December 5, 2012

Anyone Can Get It

It’s a common idea that unpleasant things always happen to someone else, but there are many ailments and conditions that don’t care if you are a prince or a pauper – everyone has the potential to be affected.

It has emerged that Michael Jackson, the prince of pop, was affected with a skin condition called vitiligo.

Despite many people believing that Michael Jackson bleached his skin to gain his pale complexion, he confessed on an Oprah Winfrey show in the 1990s that he was actually a vitiligo sufferer. Vitiligo is a skin condition that affects the pigmentation of a person’s skin, which generally causes irregular lighter patches.

It is obviously more noticeable on darker skin tones, but people with a fairer skin colouring can also become victims of it. With Michael Jackson being a very high profile celebrity, a skin disorder such as this could have seriously affected his career and he obviously managed the condition well even though vitiligo is a skin disease that is progressive, some sufferers can go many years without any noticeable new affected areas.

White blood cells, which are the autoimmune system’s soldiers if you like, see melanocytes as the enemy and, therefore, begin to attack and kill them. Melanocytes are the cells that create melanin, which is what gives our skin its colour. The pigmentation stops once the melanocytes start to disappear causing the blotchy white patches that occur all over a vitiligo patient’s body. It is thought that people with generalized vitiligo have perfectly normal autoimmune systems, other than the fact that they identify melanocytes as potentially harmful and attack them.

Vitiligo generally starts to manifest itself on the hands and wrists and face of a sufferer and, over time, will spread inwards to the torso and, as the smaller white spots merge with others they start to form larger white patches.

Vitiligo, which is also known as leukoderma, can strike at any age and, in the United States, it is thought that as many as 1 person in 100 has vitiligo to some degree or another. There are no physical symptoms connected to vitiligo other than depigmentation, but it can have social and psychological effects on those people who suffer from it, because of its unsightly nature. Vitiligo is not contagious so there is no fear of it spreading that way. However, it is a progressive condition and will spread in the person who has it, although the rate at which this happens is extremely variable with some patients not developing any further patches for decades.

There are several different types of vitiligo which can affect people and they are classified as follows:

1. Generalized Vitiligo

a. Universal Vitiligo – This type speaks for itself really and it is when the depigmentation of the skin is almost total.

b. Acrofacial Vitiligo– This is where the extremities are most affected, such as hands, feet, face and head, with little or any occurring on the centre of the body. This is generally how vitiligo first manifests itself.

c. Vitiligo Vulgaris – This refers to scattered whiter patches spread across the body.

d. Mixed Vitiligo – As you would imagine, this is a combination of the acrofacial and vulgaris types of vitiligo.

2. Localized Vitiligo

a. Focal Vitiligo– This is where areas of depigmentation are confined to a relatively small area. These can sometimes be easily camouflaged with make-up or self-tanning products if they are not hidden by the patients clothing.

b. Segmental Vitiligo – This type of vitiligo is commonly found in children, where the areas of depigmentation occur on only one side of the body.

c. Mucosal Vitiligo – It is only the mucous membranes that are affected with this type of vitiligo. For example the tissue that lines the inside of the mouth.

The symptoms of vitiligo are quite simple and manifest themselves in different areas. The most obvious symptom is the loss of pigmentation which leaves irregular whiter patches on the skin. There may also be loss of pigmentation in the hair and eyelashes, the eye retina or even the lining of the mouth (mucous membranes).

It is possible that some patients may experience severe itching at times when the depigmentation process is active. Because vitiligo may be caused by a vitamin B12 deficiency, a vitiligo sufferer may also have symptoms connected with the vitamin B12 deficiency. Thesymptoms include depression, anaemia, decreased sensory perception, fatigue and loss of memory.

When diagnosing vitiligo, doctors will ask the patient about family medical history to see if there are any previous cases of the disorder. They will also ask about any recent skin traumas such as rashes or sunburn. Sometimes a biopsy or blood sample is taken and sometimes both. Another diagnostic tool a doctor can use in determining if a patient has vitiligo is to use a Woods light.

If vitiligo is present, then it will glow under the ultra violet light.


What Causes Vitiligo Then?

The causes of vitiligo are still relatively uncertain, but it is thought that there is a strong possibility of inheriting this particular autoimmune skin disease and there is on-going genetic research into this theory. The genetic connection is suspected because vitiligo has also been associated with other autoimmune disorders such as under or overactive thyroid glands, corticosteroid hormone deficiency, psoriasis, adult-onset type 1 diabetes and pernicious anaemia (failure to absorb vitamin B12 which causes a subnormal red blood cell level) to name but a few. Very little is known about this genetic factor and consequently a great deal of further research will be necessary.

Approximately 20 per cent of patients with vitiligo have a member of their family who also suffer with it, which suggests a genetic casual factor and, because very little is actually known about this genetic casual factor, research continues into this theory.

Some of the causes of vitiligo are believed to include the following

· Faulty melanocytes – the cell responsible for producing melanin, our skin pigment. Certain vitamin deficiencies can cause faults in the cell. A Vitamin B12 and folic acid deficiency can increase the levels of homocysteine in the body which can lead to oxidative stress to the skin.

· Autoimmune system attacks - kin pigment

· ved to be

· many researches to to this disorder.g disorder.f the tunnel for derstand the cThis is where the autoimmune system destroys the melanocytes erroneously. In generalized vitiligo, melanocytes are singled out by an otherwise normally functional autoimmune system.

· Damaged nerves – possibly following an illness or an accident.

· Contact with toxic chemicals – there are a whole host of reasons for avoiding toxic chemicals.

The causes of vitiligo are still not very well understood, but it appears to be the result of several factors; genetic (as outlined earlier), neurogenic, biochemical and immunologic are the factors considered to be responsible for the onset of vitiligo.

Can it be Treated Effectively?

The good news for those with the condition is that vitiligo is a skin disorder that is treatable, although 100 per cent skin repigmentation may not be achievable and treatment can take more than two years to reach maximum effectiveness. A great deal of extensive research is being conducted throughout the world in the treatment and management of vitiligo, notably in Europe, the US and also in Asia and new genetic and biomedical technologies are influencing how doctors approach the problem. It is thought that a better understanding of vitiligo will bring about more effective and faster treatments for it.

In the meantime it is important for a patient to try to learn to cope with the condition. It is an inescapable fact that when a condition affects a person’s appearance it will more than likely have far-reaching social and psychological effects over time and it is important for someone with a condition such as vitiligo to seek out the support of their family and friends and, more widely, other people who have the condition. Finding out all about vitiligo through research on the internet and books from the library will help a sufferer understand the condition a little better and will also reassure them that it is treatable and that there is light at the end of the tunnel for them.

Coincidentally, it is believed that vitiligo can be affected by stress levels and, because the condition itself can promote stress, it could be something of a self-perpetuating disorder.

What is the Significance of the Vitamin B12?

Vitamin B12 and vitiligo have been linked in some of the research that has been carried out into this disorder over the years. In various studies it has been shown that patients suffering with vitiligo have low levels of the vitamin B12. This finding has led many researchers to conclude that vitiligo may be caused by a nutritional deficiency, particularly the B vitamins.

Several studies have been conducted into vitamin B12 and vitiligo and, without going too much into the science of it, much lower levels of vitamin B12 were recorded in vitiligo sufferers in comparison to control subjects.

In 1997, a study was published in Acta Dermato-Venereologica and it showed some very positive results regarding using vitamin B12 as an effective treatment for vitiligo. Conducted over a two year period, 100 vitiligo patients were given doses of Vitamin B12 and folic acid and exposed to sunlight or a UVB lamp as a way of treating their condition. The results were very encouraging with 6 per cent of patients gaining complete repigmentation over that period, 52 per cent noticed significant repigmentation to various degrees, whilst 64 per cent experienced a complete halt to their depigmentation. This study reinforces the earlier research that suggested that a vitamin B12 deficiency was a possible cause of vitiligo.

So What Is Vitamin B12?

Vitamin B12 is a complexly structured water-soluble vitamin which the body uses for metabolism. There are four variations of the vitamin, also known as cobalamin, and half of the body’s store of vitamin B12 can be found in the liver, which is where the dietary intake of vitamin B12 is converted into bioactive cobalamin. The four types of vitamin B12 are known as cyanocobalamin - which is commonly found in vitamin B12 supplements and is a synthetic form of the vitamin, hydroxocobalamin, methylcobalamin and adenosylcobalamin – all of which are bioactive forms of viutamin B12 with adenosylcobalamin being the form that is most present in the liver.

Vitamin B12 is acquired through the consumption of meat, vegetables and dairy products. The vitamin is only produced by bacteria and therefore a lot of it is lost during the washing process of vegetables, because the bacteria is usually found in the soil and roots. Vitamin B12 is much more reliably gained from animal sources, particularly liver and is present in dairy products, eggs, milk and poultry. Fish and shellfish also contain vitamin B12 as well as cereal bars, energy drinks and breakfast cereals.

A vitamin B12 deficiency can occur when either the body is not getting enough vitamin B12 food sources or the body is failing to absorb the vitamin properly. A healthy nutritional diet would need an intake of 2 – 3 micrograms of vitamin B12 on a daily basis. If the body is failing to absorb vitamin B12 then a supplement is advisable.

How does Vitamin B12 Work With Vitiligo?

As stated earlier, studies of vitiligo patients highlighted low levels of vitamin B12 and this deficiency helped the destruction of melanocytes which are responsible for producing the skin’s pigmentation melanin. Studies have shown that, at the very least, vitamin B12 can inhibit or even halt the rate of depigmentation in 64 per cent of the patients involved in the research, with more than half experiencing a degree of repigmentation. It is fair to say that these tests were carried out using folic acid and sunlight in addition and so it is advisable to include these two aspects when considering treating vitiligo with vitamin B12.

So What is Folic Acid?

Folic acid is in the same group of water soluble vitamins as vitamin B12 and it is also called vitamin B9, vitamin Bc and folate. Whilst folic acid can be taken as a dietary supplement it can also be found in various foods such as leafy vegetables, egg yolk, cereal bars, yeast, liver and kidney. Folic acid can also be found, although in lower levels, in corn, citrus fruits, broccoli, beets and beer. Beer is a strange one, however, considering that alcohol consumption is a factor in the acceleration of vitamin B9 deficiency!

Raw food is best for providing folic acid because, being water soluble, it can be absorbed in the cooking fluid and also cooking heat tends to destroy it. Folic acid also comes under attack from the acids in the stomach and so it is advised not to take folic acid on an empty stomach.

Folic acid is closely linked with vitamin B12 and it is believed that a folic acid deficiency could actually cause a vitamin B12 deficiency. Both folic acid and vitamin B12 are used by the body in certain biochemical processes and consequently a deficiency in either could turn into a concern.

Whilst it has been established that combining folic acid, vitamin B12 and sunlight, will give very good results in the treatment of vitiligo, It is also clear that each on its own is not so effective.

How Does Folic Acid Work Against Vitiligo?

Vitiligo patients typically have high levels of homocysteine, which is generally associated with low levels of vitamin B12 and folic acid, which the body uses to convert the homocysteine into the amino acid cysteine. When homocysteine oxidises it creates free radicals onto the skin. This places oxidative stress on the melanocytes, reducing melanin production as the melanocytes are destroyed. This is manifested in the paler patches of skin typical to vitiligo.

Folic acid is effective as an antioxidant, thus reducing the oxidative stress to the skin. The result is that no more melanocytes are destroyed and melanin production can resume. At the very least this should put a stop to the depigmentation process and in many cases it will allow pigmentation to recommence. It should be stressed that this is not an overnight solution or a quick fix and repigmentation, if it does occur, will be a rather lengthy process taking several months or even a couple of years.

Conclusion


Whilst vitiligo is not a debilitating disease, it does cause concern due to the physical and emotional stress that suffering from it could have on the patient. This physical and emotional stress could well lead to psychological problems. Mild cases, where the patches are not visible, because they are hidden by clothing, or are quite small, can sometimes be disguised to give the vitiligo sufferer more self-confidence. Creative use of make-up and fake tanning products will certainly be quite effective in hiding the problem.

Vitiligo can affect absolutely anyone of any age and, indeed, it is thought that 1 per cent of the population has this disorder to some extent. Around half of the patients with vitiligo are diagnosed under the age of 20 and up to 95 per cent before the age of 40 and it affects both males and females regardless of their race. Skin colour is immaterial although vitiligo obviously stands out more in those patients who have darker skin tones.

However, simply hiding a problem never makes that problem disappear and, given that vitiligo is a progressive disease, camouflaging the condition will only be effective until such time as the vitiligo worsens and it becomes impossible to hide it any longer.The only real course of action is to get the vitiligo treated, whilst ensuring the right kind of foods are being eaten and in the right quantities. If natural foods are unavailable or insufficient, then it is possible to take vitamin B12 and Folic acid supplements, making sure that you don’t go over the recommended daily intake.

Although research into vitiligo is on-going, it has been shown that a combination of vitamin B12, folic acid (vitamin B9) and sunshine (a UVB lamp can be substituted for the sunshine) can be effective in halting the progression of vitiligo. The success rate using this formula is very encouraging according to a 1997 study published in Acta Dermato-Venereologica, 64 percent of patients observed that depigmentation had stopped. In the same study 6 per cent of patients experienced total repigmentation, whilst as many as 52 per cent noticed repigmentation to some extent.

Vitamin B12, folic acid and vitiligo seem to be inseparable. A deficiency in the vitamins seems to be one of the causes of vitiligo due to higher levels of homocysteines which, together with free radicals, put the skin under oxidative stress. It follows therefore that supplementing these vitamins must be a positive step in treating the condition. It must be remembered, however, that this treatment is not a quick fix and the results will only be seen after a couple of years.

There is much research being conducted across the world into vitiligo and, with the advent of newer biomedical technology and improved genetic techniques, it is hoped that in the next few years there will be a better understanding of vitiligo. This will facilitate more effective and faster treatments of vitiligo and may also provide the same for other autoimmune diseases.

There is a wealth of information and support available for vitiligo and this, combined with all the advances mentioned earlier, gives cause for an optimistic outlook for the future of those that have this condition.

Education is just as important as treatment in many disorders, because understanding the condition helps to allay a sufferers fears, particularly, as in the case of vitiligo, when there is cause to be optimistic about treatment and the amount of research that is being conducted into the problem.

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