Vitiligo is a skin disorder where the skin pigment is lost in certain regions and discolored or white patches remain on the skin.
It occurs when skin cells are unable to function appropriately or when they die.
Though many causes for vitiligo progression have been suggested, its exact mechanism of pathogenesis is still unclear.
Sign of vitiligo is in the form of irregular depigmented normal feeling patches of skin that occur at extremities of the body.
They generally affect face, elbows, knees, wrists, hands, feet and genitals.
These skin lesions initially are small but often grow in size and shape.
Some lesions have increased skin pigment around edges while some are also characterized by itching.
Different factors have been suggested to cause vitiligo such as
- Genetic alterations
- Autoimmunity (when body recognizes its own cells as foreign bodies and attacks it)
- Oxidative stress
- Changes in skin pigment (melanin) or inflammatory disorders such as thyroiditis
Vitiligo is classified based upon the area it affects or by the factors that cause it.
Treating vitiligo is difficult and current treatments utilized include
- Application of steroids
- Medications to regulate immune response
- Depigmentation etc.
Turmeric, a spice native to India, has been used since ages to treat skin disorders as well as a cosmetic aid to lighten skin tone as per traditional medicine records.
Herein we shall understand the role and potential of turmeric to treat vitiligo.
Constituents of Turmeric
Turmeric is cultivated in India and many parts of Southeast Asia where it is revered as a herb and as a spice. It belongs to the ginger family.
Two major components contributing to its medicinal value are: volatile oil and curcuminoids.
Volatile oil contains components that are responsible for the pungent aroma of the spice.
Curcuminoids impart the vibrant yellow color to turmeric powder.
Curcumin, a major constituent of curcuminoids, is responsible for turmeric’s various biologically active properties and is highly researched upon.
It is the most potent candidate for treating disorders ranging from scabies to cancer.
Role of Turmeric in treating Vitiligo
Research studies and clinical trials stating the use of turmeric as a cure for vitiligo are limited but we will evaluate the role of turmeric on the basis of theoretical findings regarding its medicinal properties and evidence from Ayurvedic literature.
This section presents few of the properties of turmeric which theoretically seem to be helpful in curing and controlling vitiligo by acting on the factors that cause it.
1. Antioxidant property
Oxidative stress is an imbalance between body’s natural antioxidant defenses and its ability to produce reactive oxygen species.
Oxidative stress in vitiligo leads to increased production of hydrogen peroxide and reactive oxygen species in the skin.
This initiates DNA damage, lipid or protein peroxidation (degredation of fats and proteins by reactive oxygen) and inhibition of tyrosinase (enzyme that produces melanin).
Cell death occurs and inflammatory mediators like tumor necrosis factor-alpha, interferons, and interleukins etc. which inhibit production of melanin.
Turmeric, especially curcumin displays antioxidant property in the following manner:
- Scavenging of reactive oxygen species
- Inhibiting lipid peroxidation
- Increasing levels of antioxidant enzymes and decreasing agents that promote oxidative stress
- Modulation of protein Nrf2 which regulates body’s antioxidant responses
Through these mechanisms turmeric can control oxidative stress in vitiligo, prevent progression and facilitate repigmentation.
2. Anti-inflammatory property
The transient phase of inflammation in vitiligo is marked by loss of melanocytes (type of skin cell).
It is characterized by accumulation of immune cells such as T cells, macrophages which promote autoimmunity- produce proteins that recognize melanocytes as intruders and attack them.
Inflammatory cytokines such as Interleukin-1, tumor necrosis factor-alpha are produced which promote death of melanocytes and also inhibit their functioning.
Turmeric is touted as anti-inflammatory agent.
It demonstrates this property by inhibiting production of inflammatory mediators, suppressing activity of protein nuclear factor-kappaB which in turn downregulates activity of enzymes belonging to inflammatory pathways and also prevents infiltration and adhesion of immune cells at the site of adhesion.
In this manner turmeric can help control inflammation in vitiligo though it cases of inflamed vitiligo conditions are rare.
3. Skin regenerative property
Curcumin, the prime constituent of turmeric by means of antioxidant and anti-inflammatory mechanisms, helps in repairing skin.
Control of oxidative stress, modulation of biochemical pathways, regulation of enzymes, preventing inflammation are few of the techniques it uses to heal wounds and repair the skin.
This property could be of use in vitiligo to promote repigmentation.
Scientific research evaluating turmeric for Vitiligo
Following two studies investigate role of turmeric in treating as well as protecting against vitiligo and they present affirmative results.
A study conducted in Thailand compared the efficacy of UVB phototherapy with application of tetrahydrocurcuminoid cream and UVB phototherapy alone.
Exposing skin to UVB light from UVB lamps is a common treatment used for vitiligo.
The treatment can take over a few weeks to a few months and is said to improve repigmentation when combined with topical applications.
Tetrahydrocurcuminoids are hydrogenated versions of naturally existing curcuminoids and are said to have stronger antioxidant activity than their natural templates.
10 subjects with focal (scattered patches in one area) or generalized (wide and randomly distributed patches) vitiligo participated in this study.
The treatments were carried out twice a week for 3 months and degree of repigmentation was recorded each month.
Significant repigmentation was seen in both groups however repigmentation in combination group was slightly better in combination group in 8 and 12 weeks.
This suggested that turmeric has the potential of improving repigmentation in vitiligo.
A research conducted in University of Florence, Italy evaluated the role of extracts of turmeric and capsicum in controlling oxidative stress in vitiligo.
Oxidative stress is the prime cause of vitiligo. The study was focused on keratinocytes (a type of skin cell) which were found to be damaged in initial stages of skin lesion development.
Biopsies of such skin lesion from 12 patients suffering from nonsegmental vitiligo (type of vitiligo in which patches are symmetrically located) were performed.
The elements involved in the pathways causing damage and cell deaths of keratinocytes were assessed.
Elevated levels of such elements such as p38, nuclear factor-kappaB and p53 were observed while low level of ERK phosphorylation was seen in the damaged tissue.
Each of these mentioned proteins are involved in the cell signaling process and in normal conditions they are responsible for cell growth, differentiation and cell death.
Phosphorylation or addition of phosphate groups can activate proteins to promote or inhibit various signals. In the case of vitiligo all of these proteins were involved in bringing about cell death and damage.
The study showed that curcumin and capsaicin increased ERK phosphorylation which inhibited cell death and also suppressed formation of ROS and lipid peroxidation.
They increased the antioxidant defense of the cells. These results indicated that antioxidants such as turmeric when used at initial stages can control progression of vitiligo.
Ayurveda & Vitiligo
Traditional Siddha medicine is native to Tamil Nadu, a southern state of India and is part of the trio of Indian traditional medicine (Siddha, Ayurveda and Unani).
Siddha literature refers to vitiligo as ‘Ven Kuttam’ or white leprosy.
This literature mentions that if ‘Rajni’ –one of the traditional names for black turmeric, is utilized correctly then it can cure vitiligo.
The verse mentions the use of herbs such as Bhringaraja, Indravaruni in conjunction with turmeric to bring back the color in depigmented spots.
Based on this evidence P.R. Ramasamy, Head of Department of Special medicine, Govt. Siddha Medical College Hospital, Tamil Nadu, India formulated a Siddha medicine for vitiligo containing turmeric as the main ingredient.
The other ingredients used were Psoralea corylifolia, peeled onion and leaves of Holy Basil. A topical application was prepared and applied to skin lesions.
A significant improvement in repigmentation was observed in the patients at the end of the treatment.
Due to the presence of other ingredients, we cannot solely credit this effect to turmeric but it definitely suggests the healing power of turmeric in vitiligo.
A study carried out by Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, U.P., India focused on oral and topical Ayurvedic formulations to treat vitiligo.
This research concentrated on the role of the herb Psoralea corylifolia (Bakuchi) and an arsenic compound, Hartala in melanocyte regeneration.
However both the oral and topical applications contained turmeric in equal amount as Bakuchi, indicating that turmeric also aids in treating vitiligo in conjunction with other herbs.
The study consisted of 3 groups:
- Group I: oral & topical medications were administered.
- Group II: Only topical application was provided.
- Group III: Western form of treatment (UVA+oral medications) was given.
Group I showed 80% repigmentation, group II showed 50% while group III showed 90% repigmentation with sides effects like sunburn, gastric trouble etc.
The results suggested that Ayurvedic formulations can bring about same efficacy as Western treatment but without any side effects; however what is important here for us to note that the study employs turmeric in curing vitiligo.
Conflicting evidence over the use of Turmeric in Vitiligo treatment
One specific study’s results indicate that turmeric might be promoting oxidative stress in vitiligo.
Oxidative stress seen in vitiligo patients is marked by high levels of hydrogen peroxide in blood and skin. These levels can be brought down by use of topical pseudocatalase cream and thus restoring color.
However when this treatment was administered to Asian population, part of the population did not respond to the treatment. It was thought that lack of response could be due to dietary intake of turmeric.
To investigate it further the hydrogen peroxide levels in skin of normal as well as vitiligo patients after application of topical curcumin was observed.
Elevated levels were seen in both groups but more in the case of vitiligo patients due to lack of catalase enzyme to break hydrogen peroxide down.
15 Asian patients with acute vitiligo and who consumed turmeric daily were treated with pseudocatalase cream twice daily and no improvement was seen after 6 months.
8 patients were then advised to avoid turmeric in diet and to continue the treatment. Significant improvement was seen in 2 months and after 6 months 6 out of 8 patients showed complete repigmentation.
Though this study suggests that turmeric can promote oxidative stress in vitiligo, it is essential to note that this study is limited to Asian patients.
Asian countries like India consume around 60-100mg of curcumin per day while it is proven that daily consumption up to 8 g is safe.
Curcumin is famous for its antioxidant activities. Yet under certain conditions like anaerobic environment, presence of transition metals, high concentrations etc curcumin can act as a pro-oxidant.
Concentration dependant antioxidant and pro-oxidant activity of curcumin on red blood cells has been studied.
At low concentration curcumin prevented depletion of glutathione (a natural antioxidant) while at high concentrations, glutathione levels decreased rapidly.
This could be a valid explanation for turmeric’s unusual reaction in Asian vitiligo patients as Asians are known to consume high amounts of turmeric daily.
More research is required to be focused on this new finding to find other possible causes.
Practical use of Turmeric in Vitiligo
Topical application of turmeric in vitiligo is recommended in different forms with different herbs but two practical home remedies are:
Grind equal quantities of turmeric root and sesame seeds together and add water to make a paste. Regular application of this paste improves repigmentation.
Oral administration of turmeric for vitiligo has not been proposed by any research article.
Though dietary intake of turmeric has not yet reported any adverse effects.
One of the findings even suggests that dietary intake of turmeric can hamper the treatment of vitiligo, but this is with respect to a specific population of particular ethnicity.
Nevertheless taking turmeric orally has significant health benefits and thus us highly recommended.
You can also look at some amazing turmeric recipes here>
You can easily take around 1 tsp of turmeric daily without any issues, though always start slow if you are new to it.
It is important to include fats and black pepper in your diet while taking turmeric as it helps in its absorption which otherwise is low.
Read detailed article on improving turmeric absorption here>
Caution is to be exercised while consuming turmeric supplements due to presence of substances which enhance its absorption in the body and one could be allergic to them.
Also drug interactions or overdose could cause harmful effects.
Certain conditions in which turmeric supplements should be avoided or taken only as per prescription are:
- Pregnancy & Lactation
- Gall stones & bile passage obstructions
- Diabetes if already consuming blood thinning medications
- Prior to surgical procedures
- Consumption of blood thinning agents or antacids
Vitiligo affects less than 1% of the world population but in certain populations of specific race it can affect 2-16% of the individuals.
It is a difficult disease to treat and despite of the research and latest developments no foolproof cure has emerged.
Ayurveda, Indian traditional medicine and Indian religious texts suggest the use of turmeric in aiding repigmentation of vitiligo patches but this has been supported by limited scientific researches as of now.