Integrative medicine treatment for Vitiligo

iad-vitiligo-apr21Vitiligo, is a non-contagious pigment skin disorder where pale to white patches appear on the skin surface. Vitiligo usually starts as small spots and then spreads to other parts of the body giving white color. The course and severity of the disease or extent of body involvement differ in each patients.

Vitiigo is the mal functioning of the Melanocyte which is responsible for producing melanin pigment that gives normal color to the skin and hairs. World over the prevalence of vitiligo is 0.5-2% and in India it is 0.5% to 8.8% which is considered as high. IAD is one of the reputed names for vitiligo treatment in Kerala serving patients from all parts of the country. In IAD we offer the latest treatments for vitiligo through an integrative approach.

Ayurveda describes vitiligo as switra, due to the discolouration (shwetha).There are several sub-varieties of disease, even within the same patient, and attributes them to derangements and dominance of thridoshas (three energy principles), motion(vatha), metabolism (pitta) and structure(kapha). The patches appear on the lips , tip of fingers or toes or the white patches associated with white hair is termed as difficult to treat condition . However we found integrative treatment beneficial in these condition also

Three sub types of vitiligo based on the dominance of three energy principles, which is analysed throughthe local skin pathology or sthaniya vikruthi. The lesions present in hairy areas such as upper and lower extremities, face, chest and abdomen, are generally treatable. The non-hairy areas such as nipple, umbilicus, genitalia, lips, mouth cavity, tip of fingers and toes are difficult to cure.

The causes for Vitiligo may be genetic or Auto immune. According to homoeopathy it may also arise after viral or bacterial infection (past history of Jaundice or Typhoid fever) or over scar tissue following cut, burn or chronic ulcer. Generally the Vitiligo appears due improper, inappropriate food combinations, regular intake of spicy and junk food, exposure to chemical and emotional stress. In ayurveda, the cause for Vitiligo is described as consumption of incompatible food (virudhahara), food which takes a longer time to digest (guru ahara ), non-vegetarian food, citrus fruits and spicy foods.

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Treatment available for vitiligo in general are; Topical corticosteroids and tacrolimus, Photochemotherapy, Narrowband UVB therapy, PUVASOL, Vitamin supplements, Cosmetics, Sunscreens in non-Asian populations.

There are over 100 drugs listed in Ayurveda as, herbalized ghee preparations similar to paste (Ghritha), semi-solid preparations taken per oral by licking (Avaleha), herbalized oil preparations (Thaila), fermented solutions (Asava-Arista), tablets (Vati/Gutika), preparations containing processed mineral and metallic salts (Rasoushadha), topical applications (Lepa), herbal preparations similar to mixtures (Kashaya) and simple or compound powders made up of medicinal plants (Churna).

Integrative treatment at IAD:

Ayurvedic treatment for vitiligo, is considered as one of the best approaches to treat the condition. Such treatments for vitiligo are also proven methods to treat the disease. But results are mainly depends on the condition of the patient. Here is the relevance of integrative medications which helps to identify the medicinal options for each patient and helps them to get the best available treatment.

The integrative medicine treatment for vitilgo at IAD is delivered as an Out Patient based care and hospitalization is not required. However the patient examination by the team of multi system doctors requires half a day or one full day during initial consultation. Initial medications are given for one to three months, depending upon the severity of the disease and associated issues. We observed follicular or marginal re-pigmentation after the initial 3 months of treatment and continue thereafter.

The steps of consultation at IAD include,

  • Patient recruitment for integrative management
  • Initial counseling secession by a nurse counselor with PPT
  • Examination by Ayurveda, Allopathy and Homoeopathy doctors
  • Integrative diet evaluation and calculating the BMI
  • Woods lamp investigation to assess the extent of the disease
  • Laboratory investigations (Biochemistry , lipid profile, LFT,RFT and urine examination)
  • Photo documentation with the consent of the patient
  • Training on yoga protocol if indicated.
  • Follow ups at periodic interval

The multisystem doctors evaluate the patients based on their respective sience, so as to conclude on cause, pattern of the disease and about patient. Ayurveda describes 16 categories of clinical guidelines, which are wholistic and includes those specific to Vitiligo. Drugs to treat Vitiligo are selected by vikruthi, identified through sthaneeyavikruthi table, for each patient. The integrative medicine treatment is pivoted on allopathy, disease pattern, outcome, medicine and patient safety measures are from biomedicine. Both biomedicine and Ayurveda recognize the staging of disease. Homoeopathy recognises vitiligo on the basis of the totality of symptoms which is equivalent to provisional diagnosis in biomedicine and samprapthi in Ayurveda. The totality of symptoms is based on cause, prodrome, character, location, extension, concomitants and modality. In homeopathy the psychological symptoms and the physical generals carry more weightage than the past history, family history and systemic examination. In our treatment Homoeopathy focuses on controlling the mental symptoms, cravings, desires, aversions and co morbidities. Near normal repigmentation is the primary outcome measure in our treatment.

Integrative Diet evaluation: the pattern and quantity of food intake and the digestion process is analyzed by a dietician through 24 hour recall method, which follows the diet recommendation. Regulating and adjusting the constituents of the food, restricting the 17 types of incompatible food patterns are the considerations while recommending the diet for vitiligo patients. The food is considered to be incompatible when it is against patients digestion process. Homeopathy physician assesses a patient focusing on desires, aversions and cravings in food.

We have managed over 700 patients using integrative medicine treatment and observed good repigmentation in those who are adherent to the integrative treatment regimen. The associated issues, problems in sun exposure hinders the outcome of the treatment.Photo therapy is the gold standard in the management of vitiligo in western medicine. However it is not been successful in producing complete relief to all patients of vitiligo and continues to be unavailable and expensive in rural India.

Patients who wish to take the integrative medicine treatment for Vitiligo at IAD are advised to come for two days during the first consultation after fixing an appointment either through email (iadorg@gmail.com )or phone call at 04994 240862.