Vitiligo: Can dietary supplements repigment the skin?

Vitiligo is an autoimmune disease characterised by the appearance of white patches on the skin, which can be highly visible, particularly in individuals with darker skin. Although it does not pose a risk to physical health, it is important not to underestimate the psychological impact of this conspicuous dermatosis and not to view it as a mere aesthetic concern. At present, it is not possible to permanently cure vitiligo, but certain treatments can control outbreaks and repigment some areas. Alongside this, an increasing number of dietary supplements claiming to promote skin repigmentation are emerging, even though scientific studies on this subject are still tentative.

To date, numerous active ingredients have been studied for their antioxidant and immunomodulatory effects when taken orally, properties that could be beneficial in combating vitiligo. Indeed, it's worth noting that, while this skin condition is primarily mediated by the immune system, several environmental factors, such as oxidative stress, are considered to be triggers of the vitiligo. Therefore, the intake of antioxidant and immunomodulatory dietary supplements could prove to be relevant, provided they are not used as a substitute for treatments prescribed by the dermatologist, such as immunosuppressive creams, UVB phototherapy, or even dermocorticoids.

• Vitamins B12 and B9.

  Both vitamins B12 and B9 are involved in the biosynthesis of melanin, which has led several researchers to question their potential effect in managing vitiligo. However, while a six-month clinical study conducted on 100 patients showed improved skin repigmentation when combining UVB phototherapy with the intake of vitamins B12 and B9 compared to phototherapy alone, another study that applied the same protocol with 27 volunteers showed no significant difference between the groups.

  The results are mixed regarding the benefits of dietary supplements containing vitamins B12 and B9 for vitiligo.

• Vitamin D.

  Vitamin D is suspected to have anti-vitiligo potential as it may modulate the Wnt/ß-catenin signalling pathway in melanocytes subjected to oxidative stress. Furthermore, Vitamin D inhibits the accumulation of free radicals and cellular apoptosis in these cells. A study conducted with 15 children suffering from vitiligo showed that the combination of topical tacrolimus, an immunosuppressant, with oral intake of Vitamin D resulted in better skin repigmentation over six months than tacrolimus alone. Another randomised blind trial involving 48 women also studied the effect of Vitamin D supplementation over 5 months. An improvement in vitiligo lesions was observed in participants who received Vitamin D, unlike those who received the placebo.

  Vitamin D could potentially be a beneficial supplement in the fight against vitiligo, although further studies are still required.

• Vitamin E.

  The vitamin E is a well-known antioxidant, both in cosmetics and in the field of dietary supplements. A study conducted among 24 patients with vitiligo and divided into two groups revealed that after six months, 72.7% of participants who received 400 IU of vitamin E per day combined with UVB phototherapy showed excellent repigmentation, compared to 55.6% of those who only benefited from phototherapy. Subsequent studies have confirmed the benefit of combining UVB phototherapy with the intake of vitamin E, as it appears to enhance its effectiveness.

  In addition to UVB phototherapy, Vitamin E could potentially be a beneficial adjunct in the treatment of vitiligo.

• Extract of gingko.

  Beyond vitamins, certain plant extracts are considered potentially beneficial for vitiligo. This is particularly the case for ginkgo extract, which possesses antioxidant and immunomodulatory properties, notably by modifying the Nrf-2 pathway, which plays a protective role against oxidative stress. A blind study conducted over six months with 47 patients who received a daily dose of 120 mg of ginkgo extract or a placebo demonstrated the value of this dietary supplement. Indeed, nearly half of the volunteers who received the extract observed a halt in the progression of their vitiligo.

  Even though the study has shown promising results, further research is necessary to conclude on the benefits of ginkgo extract in cases of vitiligo.

• Extract of Phyllantus emblica combined with vitamin E and carotenoids.

  The fruit of P. emblica has also been studied in conjunction with carotenoids and vitamin E on 130 subjects. Half of the study participants received only conventional treatments, such as phototherapy or topical treatments. The other group received a conventional treatment with the combination of P. emblica, carotenoids and vitamin E. The study showed that after 6 months, a significantly higher number of participants from the supplemented group exhibited repigmentation of areas affected by vitiligo.

  The combination of an extract from P. emblica, vitamin E, and carotenoids could potentially enhance the effectiveness of conventional treatments, although more scientific evidence is still required.