INTRODUCTION OF VITILIGO
Vitiligo is a skin disorder in which, skin loss of its colour, Vitiligo is caused by melanin deficiency.
Vitiligo occurs when the skin cells(melanocytes) that produce pigment (melanin) in your skin and gives colour to skin get damaged or die and are unable to perform their function (pigment production). Vitiligo can affect any part of the body, colour loss can occur in any part of the body like- skin, eyes, hair. It is more noticeable in people with dark complexion in comparison to people with light complexion.
Vitiligo is a chronic autoimmune disorder that causes loss of skin colour in patches (or hypopigmentation of skin), white spots or patches appear on the skin of those areas of the body where skin cells (melanocytes) are damaged. This is a long-term disease, it is only cosmetic condition, and it affects beauty, skin looks cosmetically ugly .it is not a contagious disease.
According to Ayurveda vitiligo can be correlated with shwitra kustha. It is a type of kustha roga, shwitra means white patch. Vitiligo is caused by due to doshas imbalance, Pitta and Vata doshas impairment can cause skin disorder like shwitra. Bhrajaka pitta is responsible for skin colour, therefore due to imbalance in bhrajaka pitta and vata dosha white spots appear on the skin. Initially these white spots or patches are small and few in number but as the destruction of melanocytes cells continues, depigmentation progresses.
UNDERSTANDING OF VITILIGO
Types of vitiligo-
-Generalized vitiligo -It is a most common form of vitiligo and also called nonsegmental vitiligo. In generalized vitiligo loss of skin pigment (hypopigmentation or depigmentation) does not occur in just one part of the body rather loss of pigment occurs in the whole body.
-Segmental vitiligo (localized vitiligo) – In segmental vitiligo depigmentation occur in one side of the body rather than in the whole body. segmental vitiligo is unilateral and asymmetrical depigmentation, In Segmental vitiligo the white spots spread very rapidly in the beginning and then stop spreading.
-Acrofacial vitiligo (affects- face, hands, feet)- Also called localized or focal vitiligo, depigmentation in Acrofacial vitiligo occurs on skin of the face, hands and it also affects around the body openings and depigmentation them too.
-Mucosal vitiligo (affects mucous membrane)-Depigmentation occurs in mucous membranes of mouth and genitals.
According to Ayurveda, (Acharya sushruta)-There are three types of shwitra.
-Vataja shwitra- Roughness of lesion and skin destruction.
-Pittaa shwitra- Colour same as lotus petals, burning sensation.
-Kaphaja shwitra- Whitis, thick lesion with itching.
CAUSES OF VITILIGO
Autoimmune response- In the vitiligo, the body’s immune system mistakenly attacks the melanocytes of the skin, thereby destroying the skin cells (Melanocytes), these melanocytes are responsible for formation of skin, hair eye pigment. Due to destruction of melanocytes, formation of melanin does not occur or reduces, which leads to depigmentation in skin, hair and eyes.
Environmental factors- Ultraviolet radiation-ultraviolet radiation exposure can trigger vitiligo.
Chemical contact- occupational exposure to a chemical or repeated exposure to a melanocytotoxic chemical.
Emotional stress- Due to high levels of emotional stress, there is a possibility of increased exposure of melanocytes to reactive oxygen species.
Trauma- Physical trauma like -heat, burn (sunburn, chemical burn), skin injuries (cut, scratches), pressure, rubbing on skin can be trigger of vitiligo.
Pollution-pollution increased the risk of vitiligo by 3 times- Industrial pollution, Agricultural pollution, Households pollution, Chemical in cosmetics- hair dye, Perfumes.
-Genetics factors, Parasites, Iron and copper deficiency, oxidative stress, low nutrients.
-Hormonal changes- Hormonal changes during puberty, menopause, pregnancy, delivery and emotional stress can trigger vitiligo.
According to Ayurveda vitiligo (shwitra kustha) caused by impairment of pitta and vata dosha, dosha contaminate the blood. This disease occurs due to contamination of blood.
Food factors- Incompatible food (milk with salt), spicy food (increase pitta dosha), Imbalance diet, excessive consumption of honey, fish, lakucha, radish. Consuming milk, curd, buttermilk, meat together. Excessive consumption of heavy, greasy, flour-based food products. Eating even when you are suffering from indigestion.
Behavioral factors – Sleeping during the day time, Stopping the urge to vomit when you feel like it.
-Exercising even when you are unable to digest your food, Panchkarma is not done properly.
-Drinking cold water and taking bath in cold water suddenly in case of heat, fear and after exertion.
-Disturbed sleep (increase vata dosha)
SYMPTOMS OF VITILIGO
Pale or white patches on the skin (hypopigmentation/lack of pigment or depigmentation/loss of pigment).
-White patches areas- face, hands, ear, nose, eyes or one side of the body or whole body.
-Premature greying of hair or whitening of hair (scalp, eyebrows, beard, eyelashes).
-Sensitivity of sunlight or sunburn increases in the affected area.
-Discolouration of retina.
Redness of lesions, skin destruction, burning sensation and thick lesion, itching, thirst, horripilation, discolouration of skin, greasy, hardness of skin.
-Psychological stress due to discolouration of skin and changes in appearance-difficulties in relationship, behavioral changes, alcohol dependence, emotional impairment, suicidal thoughts, sleep disturbance, depression, anger issues, anxiety and consider themselves separate from society.
-Increase risk of autoimmune disorders-some people may have vitiligo as well as another autoimmune disease- specially- Type 1 diabetes mellitus, Rheumatoid arthritis, psoriasis, severe anemia.
PREVENTION OF VITILIGO
By following some points you can prevent vitiligo or reduce the risk of getting vitiligo-
-Follow a balanced diet (which include – fresh fruits, fresh vegetables and whole grains also include – Omega-3 fatty acids (walnuts, flaxseeds) in your diet, maintain vitamin D), healthy lifestyle, daily exercise for 30 to 40 minutes.
-Stress management with meditation, pranayama, yoga, get enough sleep (7 to 8 hours per night) and social support and family support are very effective in reducing stress and providing emotional support and strength.
-Avoid spicy food and incompatible food, sunburn.
-Stay hydrated, keeps your skin healthy and consume the easily digestible food to avoid indigestion.
-Avoid the consumption of excessive alcohol and smoking because smoking and alcohol increase the risk of developing vitiligo.
-Consume antioxidant rich foods like- berries, leafy greens, seasonal fruits and vegetables.
-Maintain adequate vitamin D through supplements, sun exposure.
Avoid ultra violet radiation- by use of clothes that covers your arm and legs and also use of hat to protect your head, face, neck and wear sunglasses to protect your eyes and also use sunscreen.
-Avoid trigger such as – emotional stress, physical trauma (skin trauma such as -skin injuries, burns and cuts), certain chemicals (avoid exposure to harsh chemicals), indigestion and dairy products.
In Ayurveda vitiligo is correlated with shwitra. Shwitra (vitiligo) occurring due to imbalance of doshas, by follow these preventive measures, doshas in the body remain balanced and by maintaining doshas balance and proper digestion of food, chronic autoimmune skin disorder like vitiligo can be avoided.
DIAGNOSIS OF VITILIGO-
History- Medical history- family history
-personal history- recurrence of symptoms
Physical examination- Visual inspection of skin for signs- white patches and area of patches.
Diagnostic tests- biopsy of skin
-Blood tests to rule out autoimmune disorder.
-Wood’s lamp examination (for detection of depigmentation of skin)
TREATMENT OF VITILIGO
Firstly manage stress with reading or listening to music, meditation, yoga, pranayama, daily exercise, follow a balance diet and healthy lifestyle and get proper sleep, avoid the trigger such as- skin damage (such as sunburn or cuts), stressful events, certain chemicals, harsh products etc. Avoid the consumption of alcohol and smoking, eat antioxidant rich foods.
According to Ayurveda- vitiligo is cause by aggravation of pitta and vata dosha so, detoxification (panchkarma) should be done to remove these doshas (toxins) and once the disease is cured through the detoxification(panchkarma), there is no risk of that disease recurring. Once the body is purified through detoxification treatment to mitigate the doshas should be undertaken.
MEDICINES- Medicines are given after detoxification (panchkarma)-
-Arogyavardhini vati- for better digestion (agnideepana)
-Khadirarista – blood purifier, bactericidal and best for skin disease.
-Bakuchi tail- for local application.
-Blood cleanser- eliminates toxins from blood
-Pitta balance
-Manjisthadi kwatha
-Vidanga churna.
CONCLUSION
Vitiligo is a chronic autoimmune disorder, characterised by – loss of pigmentation of skin or white patches / spots on skin. Healthy life style and healthy diet and enough sleep can manage the symptoms. Avoid the trigger can prevent the vitiligo, if any such symptoms are found in your body then definitely contact your health care professional.
