Vitiligo is a disorder that causes loss of skin color in some parts of the body, resulting in the development of white patches on the skin. This happens when melanocytes, the cells that make melanin are destroyed. Melanin is the pigment that gives your skin its color and also protects it from the sun’s ultraviolet radiation. Without melanin, the skin loses its color.
Signs and symptoms of vitiligo
The main sign of vitiligo is the appearance of tell-tale white patches on the skin, that can be localized or may affect various parts of the body. There is no way to predict if these spots will spread and to what degree. In some people, these white patches spread quickly while in others they may not spread at all. For some, vitiligo may take years to spread.
Signs of vitiligo include:
- Appearance of white patches on the skin, especially in the areas that are more exposed to the sun like face, hands, feet, arms and lips. Vitiligo can also occur in the armpit, eyes, genitals, elbows, nostrils and around the mouth.
- Appearance of white patches in the retina (inner layer of the eyeball)
- Premature greying of hair on areas that are affected by vitiligo
- Loss of pigment in the mucous membranes, such as inside the mouth and nose
The precise cause of vitiligo is not known. Although several hypotheses have been suggested to explain the onset and progression of vitiligo, studies suggest that autoimmune theory may be the most qualified. This indicates that in susceptible individuals, an overactive immune system mistakenly destroys melanocytes, the pigment-producing cells in the skin.
Scientists suggest that there could be various other factors that may increase one’s risk of developing vitiligo.
- Autoimmune disorder
- Extreme stress or sudden trauma
- Major infections
- Severe sunburn
- Exposure to certain chemicals and toxins
- Deficiency in minerals and vitamins
- Neural abnormalities
These treatment options are not always completely successful and also pose some significant side effects. For example, topical corticosteroids can cause skin atrophy or thinning of the skin and photochemotherapy may increase one’s risk of skin cancer.
Can nutritional supplements really help controlling vitiligo?
Autoimmune disorder is considered one of the key mechanisms behind the destruction of melanocytes. According to this theory, some people have an overactive immune system that perceives melanocytes as a potential threat and starts attacking them, leading to the loss of pigment and occurrence of white patches on the skin.
Studies show that patients with vitiligo often have at least one simultaneously existing autoimmune disease , particularly autoimmune thyroid disorders, such as Hashimoto thyroiditis and Graves’ disease.  In addition, people with autoimmune disorders such as scleroderma, psoriasis, diabetes, lupus, alopecia areta, Addison’s disease, rheumatoid arthritis and pernicious anemia, have an increased risk of developing vitiligo.
Studies also suggest that oxidative stress, caused by free radicals, is another underlying cause of destruction of the melanocytes. In addition, people suffering from vitiligo are found to have very low levels of antioxidants – substances that neutralize free radicals and limit the oxidative damage often triggered by both internal and environmental factors such as excessive exposure to UV radiation, pollution, toxic chemicals and even high levels of emotional distress.
Uncontrolled free radical damage, in the absence of sufficient antioxidant support, has come to be known as the initial pathogenic step in the degeneration of melanocytes in people with vitiligo.  Recent studies also support the role of antioxidant imbalance in the development of this condition.  Reduced levels of antioxidants such as beta-carotene, ubiquinone (CoQ10), vitamin E, vitamin C, ferritin, and metallothionein may result in excessive generation of free radicals observed in melanocytes affected with vitiligo.
People affected by this condition are often found to have abnormally low levels of certain vitamins like B12, folic acid, vitamin C, zinc and copper. Could supplementing with these nutrients help the condition? Nutrients that can regulate the immune system and work as antioxidants and an anti-inflammatory to limit oxidative damage can play a huge role in controlling the disease and have been suggested as possible safe therapies to manage vitiligo. 
1. Vitamin B12 and Folic Acid
It is believed that patients with vitiligo are more likely to have pernicious anemia and vitamin B12 deficiency. Vitamin B12 and folic acid deficiencies are strongly associated with increased levels of homocysteine in the blood, which may contribute to destruction of melanocytes in vitiligo. (Both vitamin B12 and folic acid play a critical role in eliminating homocysteine from the blood by converting it into methionine. Homocysteine is known to cause inflammation and is considered a significant biomarker of atherosclerosis, heart disease, dementia and even Alzheimer’s.)
This study showed a strong link between serum homocysteine levels and the extent of vitiligo, further suggesting that homocysteine levels in the blood could be viewed as a new biomarker of the extent and activity of vitiligo. Since increased levels are associated with vitamin B12 deficiency, the researchers concluded that “aggressive supplementation may benefit vitiligo patients.” 
Many studies show that supplementation with vitamin B12 and folic acid may improve the outcome in vitiligo treatment.   In addition, vitamin B12 may help prevent depression and anxiety, common side effects in people suffering from the condition.
It is important to note that absorption of vitamin B12, either through foods or oral supplements, can be negatively affected due to many factors, such as pernicious anemia, intestinal disorders, weight loss surgery, excessive use of antacids, and prolonged use of Metformin (diabetes drug). In such cases, vitamin B12 injections or liposomal B12 supplements achieve better results in improving absorption and improving levels of B12 in the blood. Another important recommendation is to take folic acid along with vitamin B12 as these two vitamins depend on each other to perform their roles.
2. Vitamin D3
People with autoimmune disorders have been found to have low levels of vitamin D3. In addition, low vitamin D levels are known to increase the risk of various autoimmune disorders including thyroid disease, multiple sclerosis, type 1 diabetes, lupus and rheumatoid arthritis. This begs the question - is low vitamin D status linked with vitiligo too?
This 2017 study found that vitiligo patients had significantly lower levels of vitamin D than the control group. It also reported that vitiligo patients had significantly higher levels of interleukin-17 (IL-17) in their blood. IL-17 is a cytokine that promotes inflammation. The researchers concluded, “Vitamin D represents a potential player in the complex pathogenesis of vitiligo.” 
Another study reported that Vitamin D reduces the levels of various cytokines that are implicated in causing vitiligo and concluded that “topical application of vitamin D might help in preventing destruction of melanocytes.” 
There are various mechanisms by which Vitamin D may help prevent vitiligo; for example, it:
- Works as an anti-inflammatory and lowers excessive inflammation in the body, including the gut. Inflammation in the gut and leaky gut syndrome are associated with vitiligo development.
- Is involved in skin pigmentation
- Increases tyrosinase activity and melanogenesis (production of melanin). Melanocytes contain vitamin D receptors.
- Has immunomodulatory properties and regulates the immune system. Vitamin D promotes the expression and functions of T regulatory cells, a type of immune cells that supress autoimmune response and prevent autoimmune disorders. T regulatory cells basically help the immune system differentiate between healthy cells and harmful foreign invaders.
3. Vitamin C
Many vitiligo patients are found to have vitamin C deficiency. In addition, improving vitamin C levels may help the condition as it:
- Works as an antioxidant and lowers oxidative damage in melanocytes
- Is required as an essential co-factor in the synthesis of collagen, which you need for healthy skin
- Is required for melanin synthesis
4. Zinc and copper
Zinc is an essential mineral that you need to maintain various aspects of your health – such as growth and development, immunity, reproduction, brain health and intestinal health. Interestingly, your skin contains nearly 6% of the total zinc of your body. Most of the zinc is concentrated in muscle and bone.
Studies show decreased levels of copper and zinc in vitiligo patients.  This 2017 study found reduced level of zinc in patients with vitiligo compared to healthy subjects. The researchers concluded that this important finding can underline the role of zinc in the development of vitiligo. 
Zinc appears to be helpful in controlling vitiligo primarily by: 
- Preventing destruction of melanocytes
- Supporting the body’s antioxidant system, inhibiting free radicals and protecting against oxidative stress, which is largely implicated in the loss of melanocytes
- Playing an important role in the production of melanin (melanogenesis), especially when used with other micronutrients such as copper, cobalt, nickel, iron, manganese, and calcium.
5. Gingko Biloba
Two small scale trials show that gingko biloba may be effective in treating vitiligo. In a 2003 double-blind placebo-controlled trial, the researchers found that 40 mg of gingko biloba given three times daily controlled disease progression in the majority of patients with limited and slow-spreading vitiligo. It also induced marked to complete re-pigmentation in 10 of these participants in the active group. 
Another small 2-month trial also reported the positive role of gingko biloba in managing vitiligo. The trial reported that consuming 60 mg of Ginkgo biloba achieved significant improvement; for example, the treatment stopped disease progression, achieved re-pigmentation of vitiligo lesions and reduced lesion area. 
Gingko Biloba appears to be useful in vitiligo management due its powerful antioxidant, anti-inflammatory and immunomodulatory properties. It is also known to improve symptoms of anxiety  and lowers cortisol levels in the saliva . Stress or anxiety are also known to trigger the development vitiligo in some patients. In addition, Ginkgo biloba is a safe and well-tolerated natural supplement.
This really highlights yet again that 'mother nature' has given human kind much of what it needs to survive and yet despite this, human nature and greed prevails to smother these natural and inexpensive remedies under profit targets and lies and deception.
- Gill et al. Comorbid autoimmune diseases in patients with vitiligo: A cross-sectional study. J Am Acad Dermatol. 2016
- Baldini et al. Vitiligo and Autoimmune Thyroid Disorders. Front. Endocrinol., 27 October 2017
- Maresca et al. Increased sensitivity to peroxidative agents as a possible pathogenic factor of melanocyte damage in vitiligo. J Invest Dermatol. 1997
- Xie et al. Vitiligo: how do oxidative stress-induced autoantigens trigger autoimmunity? J Dermatol Sci. 2016.
- Cohen et al. Alternative Systemic Treatments for Vitiligo: A Review. Am J Clin Dermatol. 2015
- Sabry et al. Serum levels of homocysteine, vitamin B12, and folic acid in vitiligo. The Egyptian Journal of Dermatology and Venerology. 2014
- Agarwal et al. Study of serum levels of Vitamin B12, folic acid, and homocysteine in vitiligo. Pigment Int 2015
- Juhlin et al. Improvement of vitiligo after oral treatment with vitamin B12 and folic acid and the importance of sun exposure. Acta Derm Venereol. 1997
- Aly, D. et al. Is There a Relation between Vitamin D and Interleukin-17 in Vitiligo? A Cross-Sectional Study. Dermatology, 2017.
- AlGhamdi et al. The role of vitamin D in melanogenesis with an emphasis on vitiligo. Indian J Dermatol Venereol Leprol. 2013
- Zeng et al. Decreased copper and zinc in sera of Chinese vitiligo patients: a meta-analysis. J Dermatol. 2014
- Mogaddam et al. Evaluation of the serum zinc level in patients with vitiligo. Postepy Dermatol Alergol. 2017
- Bagherani et al. HYPOTHESIS: ZINC CAN BE EFFECTIVE IN TREATMENT OF VITILIGO. Indian J Dermatol. 2011
- Parsad et al. Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Clin Exp Dermatol. 2003
- Szczurko et al. Ginkgo biloba for the treatment of vitilgo vulgaris: an open label pilot clinical trial. BMC Complement Altern Med. 2011
- Woelk et al. Ginkgo biloba special extract EGb 761 in generalized anxiety disorder and adjustment disorder with anxious mood: a randomized, double-blind, placebo-controlled trial. J Psychiatr Res. 2007
- Jezova et al. Reduction of rise in blood pressure and cortisol release during stress by Ginkgo biloba extract (EGb 761) in healthy volunteers. J Physiol Pharmacol. 2002