Picrorhiza (Picrorhiza kurroa) - This medicinal plant has a long tradition of use for immune dysfunction in Ayurvedic medicine, which may be beneficial to patients with vitiligo (thought to have an autoimmune component) (1). Picrorhiza also assists with digestion and research has shown that as many as 6 compounds in Picrorhiza have anti-inflammatory activity, inhibiting the COX-2 enzyme (2,3). When combined with the vitiligo drug methoxsalen, picrorhiza improves the effectiveness of the treatment in restoring normal skin pigmentation (4).

Ginkgo biloba - Oxidative stress appears to play a role in the pathogenesis of vitiligo, making antioxidant compounds useful in the treatment of this disorder. Fortunately, compounds in gingko exert antioxidant and immunomodulatory effects. A double-blind, placebo controlled trial showed that an extract of gingko could arrest the progression of vitiligo and possibly assist with repigmentation (5). Patients with slow-spreading vitiligo experienced a halt in depigmentation, while some noticed marked to complete repigmentation.

Vitamin B-6 - This essential vitamin plays a critical role in energy metabolism, nervous system function and immunity. Vitamin B6 is often given empirically for people with autoimmune disease. Research shows it is effective in treating skin disorders like acne vulgaris, polymorphic light eruption and seborrheic dermatitis (6). A topical preparation of vitamin B6 can strengthen the protective layer of the skin, the stratum corneum (7).

Vitamin B-12 and Folic Acid - A clinical study of patients with actively spreading vitiligo was conducted where subjects took a combination of vitamin B12, folate and vitamin C along with UVB treatments (8). The results showed that 100% of subjects had a halt in depigmentation, and induction of repigmentation in 6-8 weeks. Another study showed that the combination of vitamin B12, folic acid and sun exposure was more effective in inducing repigmentation than either of the treatments alone (9). As well, folic acid and B12 levels in serum are often lower in patients with vitiligo (10).

Khellin - An extract of Ammi visnaga, khellin is similar to the conventional vitiligo drug methoxsalen. In clinical studies, khellin has been shown to be quite effective in treating vitiligo (11,12). In one study, 41% of patients with vitiligo who used khellin plus UVA treatments experienced at least 70% repigmentation (13). Khellin is as effective as conventional PUVA therapy when combined with UVA (either artificial or solar), and does not cause adverse effects like PUVA (14). Khellin appears to stimulate growth and production of melanocytes (skin pigment producing cells) (15).

L-Phenylalanine - Clinical research shows that this amino acid produces good results in both children and adults with vitiligo, when combined with light therapy (16,17). A combination of oral and topical L-phenylalanine, sunlight or UVA and 0.025% clobetasol proprionate at night is especially effective for treatment of evolutive vitiligo on the face or in children, and is without side effects (18). Khellin encapsulated in L-phenylalanine stabilized liposomes shows dramatic results when combined with UVA (19). After 12 months of treatment, 75-100% repigmentation was observed on the face in 63% of subjects, on the back in 59%, arms in 58%, trunk in 57% and legs in 56%.

Lipoic Acid - A fat and water-soluble antioxidant, lipoic acid may be helpful for people with vitiligo, which appears to be related to oxidative stress (20). Research suggests that vitiligo is, in part, caused by poor antioxidant status, so supplementation with antioxidants like lipoic acid may improve the response to free radical production.

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