Vitiligo- An Ayurvedic Perspective

Vitiligo goes by various names; from its scientific one leucoderma to white patches in common English to switra in Ayurveda. It is a chronic skin disease occurring due to the improper distribution of melanin beneath the skin surface. It is also referred to as impaired melanocyte production.

Vitiligo may be hereditary, caused as a side effect of some medication, radiation, or chemotherapy. In most people suffering from Vitiligo, the causes differ completely from the ones mentioned below.

Ayurvedic Perspective of Vitiligo

According to Ayurveda, our skin (twak) is affected by doshas, specifically, Vata (Air) and Bhrajaka Pitta(fire) and these doshas play a vital role in causing Vitiligo.

The factors that cause skin diseases or kusta are the same as those of vitiligo or switra. The body tissue or dhatu level affected by both is also the same. Vitiligo differs from other skin diseases as it includes discoloration of the skin without any discharge. Apart from the skin tissue the other parts and senses of the body function normally in the case of Vitiligo.

As per Ayurveda, there are some direct and some indirect causes of Vitiligo. The indirect causes are more of religious myths and beliefs that have been followed since time immemorial by certain sects of the society. They include:

Causes Of Vitiligo

• Viruddhahara (incompatible food)
• Chardivegadharana (suppression of vomiting),
• Atibhojana (excess food intake)
• Atyamla, Lavana, Madhura, Katu Rasa Sevana (intake of sour, sweet, salt, and pungent food excessively)
• Navanna, Dadhi, Matsyabhakshana (heavy intake of fresh grains, curd, and fish)
• Vipra‑guru gharshana (teasing and disrespecting the elders)
• Papakarma (sinful acts)

Due to one or a combination of more than one reason mentioned above, the three doshas of Vata, Pitta, and Kapha found in our body get aggravated. These doshas also involve the skin, blood (Rakta), muscles (Mamsa), and the water content of our body (Udaka). The degree of involvement of these elements of our body determines the kind of skin disease one has.  If lymph (Rasa) and blood (Raktha) are significantly involved, it causes vitiligo.

Among these, Vata variety is difficult to cure. The various doshas involved also create different types of lesions on the body in case of vitiligo.  The ones caused by Pitta dosha are more difficult to treat while the ones caused by Kaphaja are nearly impossible to treat. When talking in terms of their physical manifestation in terms of lesions, the condition where the lesions appear with black hair and are thin, non-matted, newly originated, and caused due to other than burn reasons, are curable. The lesions which are very white in color and chronic in nature are incurable. The lesions appearing in palm, sole, genitalia, and lips are also incurable.

Symptoms of Vitiligo

The symptoms of Vitiligo may vary from simple white patches to red, rose, or white color patches. The extent and rate of color loss from vitiligo vary from person to person.

It may also affect the hair and the inside of the mouth along with the skin in the case of some people.

The discoloration is first noticeable on the sun-exposed areas such as the hands, feet, arms, face, and lips.

In most cases, the white patches spread to cover most of the skin and are irreversible. In rare cases, the patches stop spreading even without taking any form of treatment.

Though Vitiligo has no cure yet the treatment may help to stop or slow the discoloration. In some cases, the skin color becomes a little closer to normal at the most.

Some Other Ancillary Vitiligo Symptoms Include:

• Patchy loss of skin color
• Premature whitening or graying of the hair on scalp, eyelashes, eyebrows or beard
• Loss of color in the tissues that line the inside of the mouth and nose (mucous membranes)
• Loss of or change in color of the inner layer of the eyeball (retina)

Vitiligo patches may be localized or spread all over the body. The location of the patches depends on the type of vitiligo affecting the person.

• Spread over the body- This characterizes the most common type of Vitiligo called generalized vitiligo. In this case, the discolored patches often progress symmetrically on corresponding body parts.
• One side or part of the body- This type of Vitiligo called segmental vitiligo, affects people at a younger age. It persists for a year or two before subsiding.
• Localized Vitiligo- It affects only one or a few areas of the body.

Vitiligo Treatment in Ayurveda

Ayurveda treatments are very safe, natural, and nutritive rejuvenative. It follows Panchakarma as the first line of treatment for the successful treatment of many diseases.

For Vitiligo, the treatment begins with Virechana karma (medicated purgation) and is followed by a  lubricant therapy. The treatment consists of correcting the imbalanced body energies, cleansing the blood of toxins, and administrating herbs that help in restoring skin color.

Poor digestion is one of the factors behind Vitiligo as it leads to a build-up of toxins in the tissues. In order to restore regular digestion, certain dietary restrictions are also imposed along with lifestyle changes:

Avoid pitta aggravating foods such as sour fruits, marshy fish, new cereals, processed food, jaggery, sesame  seeds

Increase consumption of vegetables that are bitter in taste, like drumsticks and bitter gourd

Avoid consumption of foods having opposite properties to each other such as having fish and milk together.

Herbs like Asana, priyangu, and malapu are quite beneficial in case of vitiligo

Have a sound and adequate sleep daily

Curtail over-expose to excessive cold or heat conditions

Ayurvedic Medications for Vitiligo

Ayurveda Recommends Four-Step Initial Therapy as the First Line of Treatment for Vitiligo. The Stepwise Treatment Includes:

Purification Therapies (Shodhana Karma) – This step uses a herbal decoction of Psoralia corylifolia (Bakuci Kwatha) and Euphorbia neriifolia (snuhi). This medicine causes multiple bouts of purgation or purification in the body of the patient. Bakuchi oil is an Ayurvedic medicinal oil prepared from the dried fruits of P. corylifolia and sesame oil.

Oil Massage – Massage is done using oils that are selected on the basis of the patient’s condition and symptoms (rogi pariksa) and disease (roga).

Exposure Of Lesions To The Sun – The lesions on the body are exposed to sunlight for as long as the patient can bear the heat (Soorya pada santhapam ).

The Patient Is Given Some Gruel (Peya) For The Next 3 Days – If he experiences bullae arise after a sunbath then they are punctured using a sterile needle. For the last 3 days, the patient is administered a decoction (kwatha) made of Ficus hispida (malayu), Pterocarpus marsupium (asana), Calllicarpa macrophylla (priyangu), Peusedanum graveolens(satapuspa), Coleus vettiveroides(ambhasa), and an alkaline extract of Butea monosperma (palasa ksara).

This decoction is given along with an alcoholic preparation of jaggery which is called phanitha in Ayurveda. On these last 3 days of therapy, the diet followed should be salt‑free and should contain buttermilk.

After this initial therapy, any of the following ayurvedic medicines can be taken either alone or in a combination. The ayurvedic treatment prescribed for Vitiligo is designed separately for each patient as the medications differ from case to case.

The various factors taken into consideration by practitioners while prescribing Vitiligo medicines are the age of the patient, location of the white patch, past medical history, stage of the disease (spreading of in control), and the colour of the hair follicles on the white patches.

Herbs – Mineral Preparation of Ayurvedic Medications for Vitiligo

Topical Applications (Lepa) – Lepa means a paste in Ayurveda that can be applied over the body.

Ankollakadi Lepa, Avalgujadi Lepa, Bakucyadi Lepa, Balyadi Lepa, Bhallatakadi Lepa, Bhringarajadi Lepa, Gandhakadi Lepa, Girikarnika yoga, Grhadhumadi Lepa, Gunjadi Lepa, Gunjaphaladi Lepa, Katukalabvadi Lepa, Manasiladi Lepa, Maricadi Lepa, Panca Nimbava Lepa, Pathyadi Lepa, Patrakadi Lepa, Putikadi Lepa, Talakadi Lepa, Triphaladi Lepa, and Vayasyadi Lepa. Bakuci bija yoga, Bakuci prayoga, Bhadrodumbarikadi yoga, Dhatryadi kwata, Kakodumbarika kasaya, and Khadiradi Kashayam.

Simple Or Compound Powders Made Up Of Medicinal Plants (Churna) – Bakucyadya Churna, Kakodumbarikadi yoga, Khadira saradi Churna, and Pancanimba Churna

Herbalized Ghee Preparations That Are In The Form Of A Paste (Ghrita) – Jatyadi Ghrita, Mahamarkara Ghrita, Mahaneela Ghrita, Mahatiktaka Ghrita, Maha vajraka Ghrita, Neelaka Ghrita, Neeli Ghrita, Neeli nyadi Ghrita, Somaraji Ghrita, and Tiktaka Ghrita

Semi-Solid Preparations Taken Orally By Licking (Avaleh) – Bhallatak avaleha and Vidangadi loha.

Herbalized Oil Preparations (Thaila) – Thaila or “Tel” denotes oil in Ayurveda.

Some of the oil which prove effective in the treatment of Vitiligo are Aragwadhayadya Thaila, Citrakadya Thaila, Jyotishmati Thaila, Kusta Kalanala Thaila. Kusta raksasa Thaila, Laghu maricadya Thaila, Maha Vajraka Thaila, Manasiladya Thaila, Maricadya Thaila, and Visha Thaila.

This oil is applied to the body through a massage (Abhyanga) and is administered through the nostrils along with an oil massage of the face. It can also be given orally to the patient (Pana).

Fermented Solutions (Asava‑Arista) – Kanakabindvarista and Madhwasava.

Tablets For Vitiligo (Vati/Gutika) – Swayambhu Guggulu, Triphala Gutika, and Brhat Swayambhuva Guggulu.

Mineral Preparations – These are formulations that contain processed minerals and metallic salts (Rasousadha). Chandraprabha Vati, Galitakustari Rasa, Khageswara Rasa, Kustebhakesari Rasa, Medani Sara Rasa, Pittala Rasayana, Tarakeswara Rasa, and Vijayeswara Rasa form this list.

Some Other Ayurvedic Treatments Prescribed by Ayurveda Practitioners

• An Ayurvedic preparation consisting of dried ginger, black pepper, pippali, and leadwort root fermented in cow’s urine can be given internally to the patients
• A paste of several herbs with Psoralea corylifolia can be used for external application
• Psoralen stimulates repigmentation by sensitizing the skin to ultraviolet light. Purified psoralen extracts in the tablet or capsule form are also used for the treatment of vitiligo in modern medicine. It is found in P. Corylifolia as the major secondary metabolite in it.

4 Home Remedies for Vitiligo

There are certain home remedies that one can follow to reduce some of the symptoms of Vitiligo. These remedies can be practiced along with the Ayurvedic treatment that one is taking.

A paste of Bakuchi (Psoralea Corylifolia) and coconut oil can be applied over the white patches. Expose the affected areas to early sun rays (morning sunlight) for 15 minutes. The morning sunlight is not harsh and is beneficial in Vitiligo treatment but one should stay away from the harsh day sunlight.

Boil about 500 gm of turmeric in 8 liters of water until it shrinks to a liter. Filter this solution and add about 500ml of mustard oil to it. Apply this mixture twice a day on the Vitiligo patches.

Soak 50 gm of tamarind seeds in water for 3-4 days. Grind them to a paste after drying them out well. Make a  paste with this powder with water and apply it to affected areas daily, until the patches disappear.

Turmeric powder mixed well with mustard oil can also be applied on the white patches for relief.

Benefits of Ayurveda in Vitiligo

Treatment of Vitiligo through Ayurveda gives long-lasting benefits as it aids in cell growth and improves the blood flow.

The herbal preparations help in the case of immunodeficiency as well by producing good quality bone marrow (majja).

Ayurveda works towards neutralizing the Vata dosha in the body which is one of the key factors behind Vitiligo.

Ayurvedic Vitiligo treatments also have stress-relieving properties that soothe the nerves.

The medicines flush out the toxins from the body and from the skin cells particularly.

Ayurveda clears the mucus from the intestinal tracts which make for better absorption of vitamins and minerals in the body. It is believed that a lack of Vitamin B12, copper, and folic acids also triggers Vitiligo in some cases.

Ayurveda also includes some form of physical exercise like Yoga as part of its treatment. Yoga relieves stress and makes the body accepts ay form of medication in an effective manner.