Leucoderma And Vitiligo

White patches and loss of pigment in certain parts of your body are signs of skin diseases called vitiligo and leucoderma. They are disorders that cannot be cured, but can be managed.

The goal of any treatment for vitiligo is to either stop or slow the progression of depigmentation.

Here is what you need to know about leucoderma and vitiligo.

Leucoderma And Vitiligo

Leucoderma and vitiligo are both long-term skin disorders. It is quite difficult to differentiate two people suffering from these diseases as both have similar appearances on the skin. Both cause patches of the skin to appear white. With time, these patches may increase in number.

Difference Between Leucoderma And Vitiligo

The only difference between the two skin diseases is their cause.

Vitiligo occurs when pigmentation cells, called melanocytes, stop producing melanin for the skin. Vitiligo is mainly caused by autoimmune conditions, hormonal changes, acute emotional trauma or stress, recurrent episodes of jaundice or typhoid fever, prolonged antibiotic treatments or corticosteroid treatment.

Leucoderma will strictly occur following a physical trauma such as a cut, burn, or ulceration. Complete erosion of melanocyte cells after an accident or injury could

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cause white spots even after healing of the injured area. The scar which will then form will ultimately convert into a white patch which might sometimes enlarge in size over time.

Plastic allergy which develops from slippers or other wearable is seen culprit for Leucoderma in many cases.1

Deodorant allergy or perfume allergy is also responsible for a white spot as seen in some cases.2

Studies have also shown that people having an existing case of vitiligo should avoid harsh soaps, sanitizers, or other alcohol-based gels for hand wash as these may trigger skin irritation.3

Both these skin diseases are not contagious and can affect any individual irrespective of their race or age.

It can

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change a person’s life. These skin disorders may change the appearance of a person for life. This may affect the person’s self-esteem. It may also cause the person to give in to depression.

The characteristics of both these diseases are the same and hence their treatments are very often similar.

Types Of Vitiligo

There are two types of vitiligo: non-segmental vitiligo and segmental vitiligo.4

1. Non-segmental Vitiligo

This is the most common type of vitiligo. The patches appear on both sides of the body with some measure of symmetry. It mostly affects those parts of the body exposed to the sun like the face, hands, and neck.

It can also be seen in other areas which include the following:

  • Backs of the hands
  • Arms
  • Eyes
  • Knees
  • Elbows
  • Feet
  • Mouth

Non-segmental vitiligo is further divided into subcategories.

  • Generalized vitiligo – No specific area or size of patches; this is the most common type.
  • Acrofacial vitiligo – Mostly occurs on the fingers or toes.
  • Mucosal vitiligo – Depigmentation generally appears around the mucous membranes and lips.
  • Universal vitiligo – Depigmentation covers most of the body; this is very rare.
  • Focal vitiligo – One, or a few, scattered
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    white patches in a discrete area is observed. It most often occurs in young children.

2. Segmental Vitiligo

Segmental vitiligo has a different form and is less common. This condition spreads more rapidly but is considered more constant and stable than non-segmental vitiligo. Segmental vitiligo is more noticeable in early age groups.5

Ayurveda And Vitiligo

Studies have shown that ayurveda has had a positive effect in treating patients suffering from vitiligo.6

A balanced, healthy diet with nutrients from a variety of sources can be helpful in vitiligo.

According to complementary and alternative medicine (CAM) practitioners, there are foods that are considered either beneficial for or detrimental in vitiligo.

Foods To Avoid When You Have Vitiligo

Some ayurvedic specialists insist that certain foods are harmful to the body when a patient is suffering from vitiligo.7

These include the following:

  • Citrus fruits and juices
  • Fruits like grapes, papayas, blueberries, and pears
  • Tamarind
  • Tomatoes
  • Milk and dairy products
  • Chocolate, coffee, and cocoa products

Let’s examine the reasons why these foods should be avoided when you have vitiligo.

Citrus fruits can cause problems for some people, though not for others. Tomatoes are rich in citric acid, the next prevalent acid is malic acid, followed by ascorbic acid. All these acids are skin lightening agents and thus should be avoided by those suffering from vitiligo.

Blueberries and pears contain natural hydroquinones, which are depigmenting agents, and should thus be limited or avoided.

Grapes and tamarind contain tartaric acid which also aggravates skin lightening.

Milk and dairy products are rich in lactic acid which is also another skin-lightening agent.

Nickel is found in foods such as instant tea (green or black), cocoa, and chocolate. Nickel is eliminated through sweat, so consumption of high concentrations of nickel can cause a cutaneous reaction. If a patient is allergic to nickel and is suffering from vitiligo in the areas prone to sweating

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such as the shoulders, flanks, buttocks, and sacrum, foods containing nickel should be avoided.

Some people recommend red meats or other foods be avoided, but there is no evidence of these impacting vitiligo unless there is some underlying allergy to the products.8

There are certain foods that experts recommend avoiding although there is no credible evidence supporting it. These foods include sour or pickled food items, tinned foods or drinks, oily or spicy foods, fish, and eggs.

Eating barbecued meats increases the production of oxygen free radicals and carcinogens in the body as well as lowers levels of antioxidants. People suffering from vitiligo should also reduce their intake of fast foods and other instant foods that are high in calories and have less nutritional values. They must increase their antioxidant intake through fruits and vegetables.

Foods To Include When You Have Vitiligo

Oxidative stress is an over-accumulation of hydrogen peroxide in the skin. Every person develops hydrogen peroxide in the skin, as a result of natural biological processes. An enzyme called “catalase” normally breaks down the hydrogen peroxide in

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the skin into water and oxygen. People with vitiligo may have a problem manufacturing, using, or delivering catalase to the skin.

People suffering from vitiligo do not produce enough antioxidants, and in particular catalase, to combat oxidative stress in the skin. Thus, patients are advised to take foods rich in antioxidants.9

Antioxidant-rich foods include the following:10

  • Fruits like pomegranates, grapes, oranges, lemons, grapefruits, pineapples, strawberries, kiwi, and blueberries
  • Nuts (e.g., walnuts, cashew nuts)
  • Seeds like sunflower seeds, black sesame, and perilla seeds
  • Olives
  • Black beans
  • Red clover
  • Ginger
  • Vegetables like beets and red cabbage
  • Green leafy vegetables like spinach, broccoli, and kale
  • Agaricus bisporus (common/cremini mushrooms)

The fruits mentioned in this list are also the fruits that should be avoided. However, although some specialists insist that vitamin C is harmful in vitiligo because of its skin whitening properties, there are a few others who believe the advantages of vitamin C as an antioxidant outweighs the risk of hypopigmentation, and recommend that patients take vitamin C at a dosage of

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0.5-2 grams daily.11

Omega-3 fatty acids are poly-unsaturated fatty acids (PUFAs) that are known to be beneficial for psoriasis and autoimmune diseases. It may also be beneficial in vitiligo due to its anti-inflammatory, antioxidant, and antidepressant effects.

Remedies For Treating Vitiligo

These are a few traditional remedies that have been used to treat vitiligo.12 These remedies cannot cure the disease but can help manage it.

  • Psoralea seeds should be steeped in the juice of ginger for three days. The fluids should be renewed every day. The seeds should be rubbed with hands to remove their husks, dried in the shade, and powdered. One gram of this powder should be taken every day with fresh milk for 40 days continuously. The powder can also be applied to the white spots.
  • Babchi seeds combined with tamarind seeds are also useful in treating vitiligo. These must be steeped in water for three days; later, they should be shelled and dried in the shade. They should be ground into a paste and this can be applied on the white patches. If you notice any reactions like reddening of the spot, itching, or any oozing of fluid, this must be immediately discontinued. If there are no adverse reactions, the paste can be applied for 40 days.
  • Red clay used for leucoderma is found by the river side or on hill slopes. The clay should be mixed in ginger juice and applied over the white spots once a day. The copper contained in the clay seems to bring back skin pigmentation and ginger juice serves as a milk stimulant, facilitating increased blood flow to the spots.
  • Radish seeds paste is valuable in the treatment of the disease. About 35 grams of these seeds should be powdered in vinegar and applied on the white patches.

Ginkgo biloba, a herb, has been studied in a clinical trial. Results from this trial indicate that the herb may restore skin color and stop vitiligo from worsening. In the ginkgo biloba trial, 10 patients given ginkgo biloba had noticeable or complete return of skin color.13

How Dermatologists Treat Vitiligo

Besides reviewing your medical history and performing a physical exam, dermatologists may also treat the disease in the following ways.14

As mentioned earlier, these treatments cannot cure the disease; the rate of depigmentation may be slowed down.

1. Using Cosmetics

Cosmetics including makeup, a self-tanner, and skin dye can hide the obvious effects of vitiligo and is a safe way to make it look less noticeable.

However, these may have to be reapplied at regular intervals and can be time consuming. It may also make your skin look unnatural.

2. Applying Medicines To Skin

Dermatologists may suggest the use of certain topical medicines. These are prescribed to be used on a small area of your skin. Topical medicines work best on those people with darkly pigmented skin. Topical medicines are most effective on certain areas of the body like the face.

The topical medicines may have side effects on the skin, and those using these medicines should be monitored carefully.

3. Using Light Treatment

Dermatologists use light treatment for vitiligo. If the patient has widespread vitiligo, then the patient has to be seated in a light box; if the patient is only suffering from a few patches on the skin, then the patient receives excimer laser treatments. This is most effective on the fact and least effective on the hands and feet.

This treatment requires a certain time commitment from the patient’s end. The patient is required to attend two to three treatments per week for several weeks.

4. Employing PUVA Light Therapy

In this therapy, dermatologists use UVA light and a medicine called psoralen to restore skin color. Psoralen may be applied to the skin or taken as a pill. This treatment is about 50 percent to 75 percent effective in restoring pigment to the face, trunk, upper arms, and upper legs.

Psoralen can affect the eyes, so this treatment requires eye exams before starting treatment and after finishing treatment.
To help prevent serious side effects, patients need to be carefully monitored.

5. Depigmentation

Depigmentation is a treatment that very few patients opt for. This removes the remaining pigment from the skin, thereby making the skin completely white. This treatment can take one to four years. The treatment can be used for those adult patients where other treatments have failed and they are left with very little pigment on the skin.

Vitiligo and leucoderma are skin diseases that anyone can acquire and they are not contagious. Let’s not ostracize or judge people based on their appearance.

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