vitiligo treatment

the objective of vitiligo treatment is to satisfy the cosmetic needs of the patients and provide emotional security.
in india where vitiligo carries a dire social stigma, nearly all patients desperately wish to be treated. among fair skinned caucasian’s, however treatment may be optional and simple reassurance may suffice.
Despite much detailed knowledge of biochemistry and physiology of melanin pigmenttation, there is a lack of regularly effective, predictable and safe methods for controlling the degree of melanization of the skin.

Nevertheless, untill the necessary further advances are made to achieve such control, many disorder of pigmentation can be managed at least with partial success by taking due precaution and carefully chosen therapeutic measures.
In the management of patchy hypomelanosis, the contrast between normal and deficient melanized areas can be minimized by avoidance of pigmentogenic stimuli like exposure to sun. to chronic irriation, to repeated trauma( as people with vitiligo diathesis have tendency to develop vitiligo even on slightest trauma ) otherwise cosmetic making agents, pencake make- ups or stains.

The management of vitiligo is not purely medicinal but conservation treatment is also a must along with therapeutic measures.
The most important step in conservative treatment is PSYCHOTHERAPY, both of patient and his relatives
1) As already stated in preface the vitiligo patient loses confidence and start considering himself inferior to other. people around him also add to his misery by isolating him. this they do from sheer ignorance about the disease since ancient time this disease is being considered as leprotic in nature.

hence the beliefe that it is unfectious and hereditary which generates fear in the minds of people and the patient. the patients remains so depressed that he dose not take the medicine properly, dose not take proper precautions. thus to increase the general awarnce of the people by making them understand the NON-INFCTION and NON0- HEREDITORY nature of the disease is an important step towards managment of the disease with out which cure is imposible.

2) patient should be strictly instructed not to take ANTIBIOTICS especially broad- spectrum antibiotics during any intercurrent illness.patient may feel that the antibiotics have helped him in combating the present illness but the chief complaint remains either same or in most of the cases enhance the disease and provides hindrance in the path of action of our remedies.

3) As long as the cause is overlooked, no disease can be cured. Likewise whenever the Etiological factor in same disturbances of pigmentation. psychotic vitiligo skin disorder are removed or corrected. the repigmentation has been found to appear and the disease found to be cured or partially corrected.

4) Lastly butt not the least the NUTRITILONAL STATUS of a vitiligo patient especially in active and progressively increasing cases is not be neglected. The diet plays a major role in this disease. it is considered mainly due to deficiency of copper and protein.

Thus diet of such patient should include more of protein and copper containing articles.
Protein can be obtaind from food articles like cheess, butter, milk, and almond.
germinating grams and soyabean are very rich source of prtein. even beal fruit in the form of syrup jam, jelly can be taken from articles like common salt, banana, leafy vegetables.in our pathy we don`t recommendany diet restrictions except avoidance of vitamin c containing articles like lemon, citrus fruit etc.

However ayurvess condemn use of contrary food like milk and cured, curd with sour dishes and radish, milk or curd with fish or flesh. they recommend green or red radish beets roots, carrots, plums,spinach, black carrots also wheat flour with barn removed are very good as diet.

psoralen prsent in plants as celery, figs, parsley carrots may also play a role in physiology and biochemistry of normal humen skin.
Thus we see how all the above written conservative measures from an important aid to the therapeutic measures, which is as useless alone as a meal without salt.

Now coming to the therapeutic part of this project. it is to be clearly understood in verybegining of this section that no single remedy, no specific remedy is there for this disease. physician consider ARS. SULPH. FLAVUS as its specific. yes it is very true that ASF in kent`s lesser writings has been considered top ranking for various pigmentary disorders of skin but then it can`t be said to be the only similimum or specific hence giving ASF in all cases of vitiligo should be strongly condemned every case is the new case and the physician shouldn`t be prejuiced and should keep the individuatly in mind`is taught to us by our bible THE ORGANON right from the beginning , so after becoming physician we shouldn`t forget it and try to maintain the individuality of every new case.

that is why i have restricted the use of ASF to a minimum extent and only in cases where patient had no other complaints except remedy depigmentary patches and no constitutional remedy was coming prominently have tried ASF and one more drug tuberculinum, about which i have written in subsequent page.

During my practice of 10 years, the most successful remedies i discovered in case of vitiligo bringing partial or complete cure or in other words showing satisfactory results, I have written their most characteristic features here i would like to mention that these remedies were given on mental symptoms (REVO LUTIONIED HOMOEOPATHY), condtitutional basis, (CLASSICAL method ) and in 4-5 meteria medica I consulted, I never found the word ‘vitiligo’ under these remedies but that dose not mean that we should not prescribe them if they are bringing positive results for other complaints associated with vitiligo then they are certainly going to vitiligo cure and which may not have been prominent during proving and can be added in their symptomatology as clinical symptoms.

AYURVEDIC TREATMENT
In Ayurvedic treatment much important is given to the diet along with medicines. the local application of babchi oil is recommended by them. they also advice light application of the freshly cut surface of greenish-black walnut husks often producing satisfactory staining lasting for two weeks.
too vigorous use may produce irritation and vesiculation. they also advice the patient to use copper utensils as copper chloride deficiency is considered to be major cause of vitiligo.

ALLOPATHIC TREATMENT
the most common allopathic treatment for vitiligo is psoralen therapy. 8-methoxypsoralen, a substance originally obtained from a plant. has a property of increasing the sensitivity of the skin to sunlight. 10 mg can be taken twice daily, the skin being exposed to natural sunlight about 3 quarter of an hour later for gradually increasing periods.
alternately a 1 % solution of same substance in alcohol is painted on the effected areas, exposure to sunlight taking place 12 hour late, beginning with a few seconds only .

The use of psoralen tablets along with exposure to UVA radiation (PHOTOCHEMOTHRAPY) cannot be given to children befor anterior chamber of eye is well developed to protect the retina (that is by age of 10years).
Moreover in light skinned people, this treatment gradually intensify the pigmentation of the normal skin arears, thus increasing the conspicuousness of the remaining depigmented areas resulting in an unsatisfactory cosmetic appearance.
They also recommend injections of creude liver extracts with vitamin B complex and multivitamins by mouth when it is active and progressive.

CUCL2 1-3mgs daily capsules or mixure form /IV injection 200 micrograms. The regiment is continued till vitiligo skin disorder becomes quiescent i.e. No new lesion develops and margin becomes hyperpigmented. Usually 2-3 months is required for this object.

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