- Best Results4-12 months
- Treatment Recovery0-1 days
- Procedure Time2-10 minutes
- Skin SpecialistYou
- Duration of ResultsVariable
- Back to Work0 days
Vitiligo Home Therapy
DIY treatments can be considered in cases whereby specialist access is limited. Diets, coupled with antioxidants such as vitamin C, E, green tea, ginkgo & vitamin B supplementation can give marginal improvements. Topical psoralens are of historical value, however if combined with natural sunlight, can re-pigment areas of vitiligo.
FactsFacts on Vitiligo DIY treatments
- In office treatments are gold standard for vitiligo
- Some patients may want to try DIY home remedies
- Diet & supplements can be adjunctive therapy
- Topical creams can be sourced online
- Creams & natural phototherapy can give some results
- Microneedling for stable vitiligo looks promising
Can diet make a difference?
You will find many advertisements wanting to sell you a vitiligo diet. Here is the summary-
Eat foods high in antioxidants. This includes leafy green vegetables, fish, fish oil & nuts. Antioxidants can protect your body & skin from UV rays & pollution.
Exceptional cases of vitiligo can respond to a gluten free diet. Google search gluten & give it up. If your vitiligo improves, it is a fluke.
Low acidic foods can in theory improve skin inflammation. Though it is far-fetched, avoidance of citrus juices, tomatoes & others won’t kill your taste buds.
What supplements can help with vitiligo?
Most supplements are aimed at reducing inflammation & oxidative stress to your pigment cells known as melanocytes. Oxidation can lead to cellular damage, as this has been shown to be one of the causes of vitiligo.
Vitamin B deficiency can be associated with pernicious anaemia. This is an autoimmune disease, like vitiligo. There are low quality studies that have demonstrated the benefits of Vitamin B3, B6 & B12.
Vitamin C is the most potent antioxidant in the body. It is a water-soluble vitamin that requires supplementation via leafy green vegetables & citrus fruits. Therein lies the paradox. Applied topically, vitamin C can reduce free radicals that damage melanocytes. The flipside is that ascorbic acid is one of nature’s most powerful tyrosinase inhibitors, meaning it achieves the very opposite of what we would like for vitiligo, namely vitamin C inhibits pigmentation Hence if you would like to supplement, take a tablet and don’t use a cream.
Vitamin D makes more sense. Oral and topical supplementation has shown to be beneficial in some cases of vitiligo. Taking 150+% more than the RDI is safe.
Ginkgo biloba is another well accepted herbal supplement, there are some studies in the dermatology literature. Though it is controversial (as to the true effects), I am not against it. The worst-case scenario is that it is placebo, however placebo can work in 25% of the time.
What are other herbal supplements that can help treat vitiligo?
Indian gooseberry or Phyllanthus emblica fruit extract, vitamin E, and carotenoid combinations can be useful (in loose studies). Given the banal nature of berries, fruits & tocopherol, supplementation may be indicated, as adjunct to phototherapy.
Polypodium leucotomos (PL) is a tropical fern that has been shown to protect against UV radiation– induced damage. Green tea is another potent antioxidant. Studies are weak, however, as placebo can be useful, supplementation can be considered.
Psoralen plants including Psoralea corylifolia (used in India) & Ammi majus Linnaeus can be useful if you do not have access to phototherapy. These are naturopathic psoralens that are still in use In India & the Middle East. Your dermatologist / village physician / witch doctor may sell you a derivative of psoralen medications. Be guided by them. I have no experience in herbal medicine.
What creams can be used to treat vitiligo?
The majority of creams that have been shown to be effective in pigmentation require a prescription. These include tacrolimus, pimecrolimus, PGE analogues, 5FU & potent topical corticosteroids. Powerful creams have side effects, hence their regulation.
Having said this, if you are creative, you can find some of these topicals online via pharmacies in India & Canada. A relatively safe cream is pseudocatalase. This can be bought online from Amazon. You can apply this twice a day & combine it with microneedling. Another topical application that has a good amount of research is topical tacrolimus, sourced from India. Apply once a day to white areas. Combine with microneedling 1-2 times a week. Try to source a 0.1% ointment.
Disclaimer: I am not suggesting you substitute medical therapy for DIY treatments. These suggestions are for those who don’t have access to dermatological care, including access to phototherapy.
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What is pseudocatalase cream?
Pseudocatalase is a synthetic cream used in the treatment of vitiligo. It is thought to work by reducing hydrogen peroxide. This cream was trending in the 1990s, however today we have more effective topicals. If you would like to try a DIY application of pseudocatalase you can –
- Apply twice a day to the white patches of vitiligo
- Allow the Pseudocatalase cream to vanish into the skin and completely dry before applying any other topical agents.
- Expose the affected skin to narrowband phototherapy (Ideally clinical)
- Broader upper cheekbones means less dermal fillers.
If there is no response after 3 months, the therapy should be stopped, and other options evaluated. Treatment may be stopped if regimentation occurs. You can also add sensible microneedling prior to application.
Treatment with pseudocatalase is considered to be safe with no known systemic side effects. I personally do not prescribe pseudocatalase as there are many more effective creams.
Do DIY creams work?
Not a good idea to try. Various plants including lime, lemon, citrus fruits, bergamot contain furanocoumarins. These are essentially psoralens that react with sunlight to produce a phototoxic reaction. Post-inflammatory hyperpigmentation is a wanted side effect in the context of vitiligo. If you are so inclined to try natural stuff, review the section on this website. You are far safer with supplements like vitamin B, C, D, E & a tablet or two of ginkgo biloba.
Psoralea corylifolia (used in India) & Ammi majus Linnaeus are plants that have been used in ancient times to treat vitiligo. They do have value in countries like India & Africa where narrowband phototherapy is limited (or super expensive). I know they can work; I have no experience in herbal or natural remedies. Discuss this with your village physician.
*Warning: If you have vitiligo, do not put vitamin C on the affected areas. Vitamin C is a potent antioxidant; however it is also a potent inhibitor of tyrosinase, the enzyme that produces pigment.
Can home phototherapy units be effective in threatening vitiligo?
Accurate calibration of power (fluence) & wavelengths depends on the brand of home phototherapy. I have experience with German companies who manufacture home units. I do think they produce calibrated & consistent power levels; however the device is not reliable as in 20% of cases they break down within a year of use.
There are many other brands out there, ranging from cheap Chinese made devices all the way to more expensive US & European brands. The instructions will vary according to the manufacturer. A sensible way to start is to find a baseline then increase the time by 10% per application, aiming for treatments every second day – much like how we use clinical units.
Can microneedling help pigment vitiligo?
In the past 2 years there has been an increase in the number of evidence-based publications on the use of microneedling to treat vitiligo. The results are promising.
To summarise –
- Microneedling alone can improve vitiligo.
- Microneedling coupled with medically prescribed topicals such as tacrolimus, PGE analogues & 5 Fluorouracil give better results than microneedling alone.
- Microneedling is relatively safe & inexpensive.
- This should only be done on stable, not progressive vitiligo. If you perform microneedling incorrectly, you have the potential to make your disease worse.
How to microneedle?
Read the above so you have a crystal-clear understanding. Obviously, my suggestion is that you undertake medical treatments in a dermatologist’s office as the first line. If you are stuck in a village in the middle of India or Africa, & the nearest dermatologist is 1000 miles away and if you can understand the risks, you can try this. Always take a baseline photo before you treat.
- Buy a stamper if possible. This is safer than a derma roller. 0.1 to 0.2 mm needles, don’t use anything longer.
- Stamp every 10 days. Clean the area, stamp 3-4 times over. If possible, obtain some tacrolimus online, if you can’t find any, get some Latiesse or bimatoprost eye drops. Another option is pseudocatalase cream (Amazon). Apply to stamped areas within 30 minutes.
- Expose the stamped areas to sensible mid-day sun three times a week. The exposure times may vary depending on the latitude you live. This may range from 3 to 20 minutes.
- Complete 10 cycles over 3 months, re-take the photos & compare.
How successful is microneedling?
Medically supervised microneedling can re-pigment between 20-50% of cases. The fastest response reported has been with a chemotherapy ingredient called 5 Fluorouracil.
For DIY home use, obviously you are not going to play around with chemotherapy. The use of PGE analogues or bimatoprost (resource search) is probably the easiest to obtain followed by tacrolimus from dodgy Indian online pharmacies. If you can get 30% pigmentation at 3 months, this is considered good. You need comparison photos to gauge progress. If you are too lazy to take a photo, don’t attempt any DIY procedures.
I suspect that in the next few years, studies will show that phototherapy combined with microneedling & topicals will yield great results.
Is natural sunlight bad for you?
Natural sunlight is a double edge sword. UVB can be beneficial for most cases, as it can encourage melanin production & melanocyte migration. It can also cause sunburn, making your vitiligo worse. The problem with sunlight is that it also contains UVA, all of the spectrum of UVB (unlike narrowband UVB) as well as the visible spectrum of light.
If you want maximal UVB, it will be found in the midday sun (UVA is relatively constant). Hence you will require exposure for 2 to 40 minutes depending on where you live. If you have no access to phototherapy, a sensible method of activating topical psoralen is exposure to natural sunlight. Be guided by your physician as they have experience in determining your ideal exposure time. This depends on your skin type & the latitude of where you reside. Do not spill over any phototoxic/photoactive agents to normal skin or these areas will look like crap (post inflammatory hyperpigmentation). You have been warned!
Disclaimer: I practice first world dermatology in Australia, though I am well versed in natural DIY treatments & home remedies, I am not in the position to advise you on application frequency & times. Your physician can do so.
How do dermatologists treat vitiligo?
Here is how I view DIY treatments & how I fit into the big picture of treating vitiligo. If DIY treatments are not harmful- go for it. If you respond, it is one less person that requires medical therapy.
For patients that see me, I do not prescribe you fairy dust. Dermatologists prescribe medications & clinical phototherapy. My standard of practice is to combine phototherapy with topical CS ointment, calcineurin inhibitors & other pigment stimulators. I am open minded; I encourage adjunctive therapy.
Davin’s Viewpoint on DIY treatments
I am realistic. Even though dermatologists don’t endorse DIY treatments, I do believe that education is the correct thing to do. This especially applies to those who may live away from dermatology access, or do not have Medicare.
A sensible start is supplementation with omega fatty acids, oral vitamin B, C, D & ginkgo biloba. Believe in this adjunctive treatment and one in four patients may improve. It is called placebo.
If you can get hold of some pseudocatalase (it is an outdated treatment) you can use this with natural phototherapy. Obviously if you have fair skin, this may not be the best treatment. Failing that, be resourceful, find some bimatoprost online. Possibly in India or Canada. Get yourself a 0.1 to 0.2 mm stamper. Stamp every 7 to 14 days, then apply the solution. Add 5-20 minutes of mid-day sun. This is basic treatment as I must work on the assumption of the lowest common denominator reading this. If you email asking where to find the stuff mentioned above, this denominator is you.
In closing, be safe. Do not burn yourself or vitiligo will worsen. All the best, thank me later.
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