Complementary and alternative therapies (CAT) for Vitiligo

Overview
Complementary and alternative therapies are sometimes used by people with vitiligo. Complementary or natural treatments for vitiligo include herbal preparations, nutritional supplements, and an outdoor salt bath treatment called climatotherapy.

If you choose to try one or more complementary or alternative treatments, it’s important to check with your doctor first so they can alert you to potential interactions and correctly interpret any side effects.

What does it involve?
Most complementary treatments for vitiligo have not been studied in clinical trials, and there’s limited proof they’re safe or effective in treating vitiligo. There’s some evidence, however, that the following unconventional treatments may be effective:

Gingko biloba and other plant extracts
The most promising example is gingko biloba extract - a plant native to China with antioxidant and anti-inflammatory properties - which demonstrated potential for restoring skin color and slowing the spread of vitiligo in one small clinical study.¹

Other oral and topical herbal preparations have been shown to help manage symptoms of vitiligo in scientific studies. They include: Green tea polyphenols, extracts of green tea leaves; capsaicin, an active component of chili peppers; and curcumin, derived from the spice turmeric.^2,3

Vitamins
Studies have documented some effectiveness of vitamins A, B12, C, D, E, and folic acid in repigmenting skin when combined with phototherapy - and in cases where the person was deficient in one or more of those nutrients.^3,4,5

Alpha lipoic acid
Recent studies underscore the safety and effectiveness of this antioxidant – commonly found in vegetables, tea, wine and fruits – in promoting repigmentation in vitiligo. Benefits were seen when taken orally, in combination with conventional vitiligo treatments.³

L-Phenylalanine
An essential amino acid found in eggs, chicken, liver, beef and other foods, L-phenylalanine is a precursor to the natural pigment melanin. It’s proven to be effective in treating vitiliginous patches as an oral or topical treatment, in combination with phototherapy.³

Resveratrol
This antioxidant and anti-inflammatory – found in wine, peanuts and cocoa – has shown benefits in recent studies treating vitiligo together with psoralen and UVA (PUVA) phototherapy.³

Dead Sea climatotherapy
Dead Sea climatotherapy, a protocol that involves bathing in the Dead Sea followed by increasing sun exposure, has enhanced repigmentation in people with vitiligo.⁶ Treatment includes a short swim and sunbath twice daily for three to four weeks between March and October. Climatotherapy is one of few treatments considered safe for all people with vitiligo, including pregnant and nursing women.⁶

Melagenine
An alcohol extract of human placenta, Melagenine has been proposed for the topical treatment of vitiligo. A pilot study found it to be effective, in combination with ultraviolet exposure, for repigmenting scalp vitiligo. A new formulation with calcium (Melangenina plus) stimulated repigmentation with no side effects. More data is needed to confirm effectiveness.³

Results
Some people claim that one complementary or alternative treatment or another helps their vitiligo. However, most natural or complementary treatments have not been studied in rigorous clinical trials to establish their safety and effectiveness and in many cases, more research is needed.

Constraints
Some topical or oral complementary treatments can cause interactions with medications. Some natural treatments may exacerbate other health conditions.

Health insurance may not cover complementary or alternative modalities. Some complementary treatments can be expensive.

External resources

References

1. Vitiligo: Diagnosis and Treatment. (n.d.). Retrieved December 2, 2019, from https://www.aad.org/diseases/a-z/vitiligo-treatment.


2. Gianfaldoni, S., Wollina, U., Tirant, M., Tchernev, G., Lotti, J., Satolli, F., … Lotti, T. (2018). Herbal Compounds for the Treatment of Vitiligo: A Review. Open Access Macedonian Journal of Medical Sciences, 6(1), 203–207. doi: 10.3889/oamjms.2018.048


3. Gianfaldoni, S., Tchernev, G., Lotti, J., Wollina, U., Satolli, F., Rovesti, M., … Lotti, T. (2018). Unconventional Treatments for Vitiligo: Are They (Un) Satisfactory? Open Access Macedonian Journal of Medical Sciences, 6(1), 170–175. doi: 10.3889/oamjms.2018.038


4. Juhlin, L., & Olsson, M. J. (1997, November). Improvement of vitiligo after oral treatment with vitamin B12 and folic acid and the importance of sun exposure. Acta Derm Venereol, 1997 Nov;77(6):460-2, https://www.ncbi.nlm.nih.gov/pubmed/9394983
   


5. Elgoweini, M., & Din, N. N. E. (2009). Response of Vitiligo to Narrowband Ultraviolet B and Oral Antioxidants. The Journal of Clinical Pharmacology, 49(7), 852–855. doi: 10.1177/0091270009335769


6. Czarnowicki, T., Harari, M., Ruzicka, T., & Ingber, A. (2010). Dead Sea climatotherapy for vitiligo: a retrospective study of 436 patients. Journal of the European Academy of Dermatology and Venereology, 25(8), 959–963. doi: 10.1111/j.1468-3083.2010.03903.