Dietary supplements have a role in the integrative treatment of vitiligo, largely through antioxidant pathways and as an adjuvant to phototherapy, Ammar Ahmed, MD, associate professor of dermatology at Dell Medical School at the University of Texas, Austin, said at the annual Integrative Dermatology Symposium.
Data on the use of dietary supplements for vitiligo are scarce and of limited quality, but existing studies and current understanding of the pathogenesis of vitiligo have convinced Dr. Ahmed to recommend oral Ginkgo biloba, vitamin C, vitamin E, and alpha-lipoic acid – as well as vitamin D if levels are insufficient – for patients receiving phototherapy, and outside of phototherapy when patients express interest, he said.
Melanocyte stress and subsequent autoimmune destruction appear to be "key pathways at play in vitiligo," with melanocytes exhibiting increased susceptibility to physiologic stress, including a reduced capacity to manage exposure to reactive oxygen species. "It's more theory than proven science, but if oxidative damage is one of the key factors [affecting] melanocytes, can we ... reverse the damage to those melanocytes with antioxidants?" he said. "I don't know, but there's certainly some emerging evidence that we may."
There are no human data on the effectiveness of an antioxidant-rich diet for vitiligo, but given its theoretical basis of efficacy, it "seems reasonable to recommend," said Dr.
