SKIN – Leucoderma
“Give me a blue sky, brown mountain, silver falls and green around, Nothing more I want,” is a popular saying. Nature is always wondered and admired at for its colourful beauty, the colour being the main attraction. The attraction in colour is the reason for huge sales of fairness creams. But the whiteness offered by skin disease – leucoderma – is often depressing for all the sufferers.
Skin is a protective covering for our body. It protects our body from heat or cold, external germs, toxins, etc. Melanin is the colouring pigment of our body. It is mostly black in colour. Sometimes it may be brown or creamy yellow in colour. Melanocytes are the cells responsible for the formation of melanin pigment. It is present in the basal layer of the epidermis and the first layer of the dermis, i.e. melanin is present in two layers. Generally, the colour of the skin acts as a shield for rays which enter the body, i.e. colour acts like a dark film in a car which restricts UV rays.
UV rays from sunlight penetrate the epidermis as well as the dermis. This UV penetration makes melanocytes produce more melanin as a natural defence or protective mechanism. More pigmentation makes skin more opaque to prevent the body from harmful effects of UV rays. So, black skin protects us from the harmful effects of UV rays like a black umbrella. The black umbrella is the best anti UV rays shield, better than any other coloured, beach or rain umbrella. Likewise, in white skin people (even for leucoderma patients), hot sun UV rays penetrate more, putting them at risk for sunburn, skin cancer, etc.
Leucoderma is a miserable acquired skin disorder, making skin white due to loss of the melanin pigment. It is a non-contagious disease. It is otherwise termed as vitiligo. This progressive, cutaneous discolouration or depigmentation of the skin disturbs the sufferer cosmetically more and rarely functionally i.e. they feel ashamed to face the public.
You notice whiteness of the skin while healing of a wound takes place. This indicates that melanin pigment is not yet formed and occurrence of black spots indicate the beginning of pigmentation. But if there is any dysfunction in the production of melanin, due to functional or hormonal or structural problem, whiteness (by losing colour i.e. becoming colourless) appears in the affected spots.
Leucoderma is mostly restricted to the epidermis layer. Herethe , skin function is otherwise normal with texture, hair growth, thermostat functions and sweat. Congenital absence of melanin pigment is called albinism. In this albinism the pigment is entirely absent in both layers of skin, hair and eyes. Also albinism has no treatment at all, since it occurs due to complete absence of melanocyte cells to get induced for the production of melanin pigment.
Incidences and risk personalities – The occurrence of leucoderma is more markedly noted in the dark people of the tropical countries. It can occur in any age group (infants to old age), sex and races. Females are more commonly affected than males. The most commonly affected areas are face, neck, back, wrist, hand, groin, genitals, armpits, etc. i.e. dark places, places where folds occur or where friction takes place. It can co-exist in many cases of endocrinal disorders especially with pituitary, thyroid & adrenals.
Till now, researchers have not identified any causative factor for leucoderma. Generally leucoderma can be seen in older people. As skin loses its texture and other things due to ageing or the natural degenerative process, it may happen to become devoid of melanin also, like the graying of hair due to loss of melanin in the hair. Many doctors or patients correlate the occurrence of leucoderma with the other complaints which occur simultaneously during of the start-up of the complaint, i.e. they often correlate with diabetes, jaundice, typhoid fever, measles, etc. But nothing has been proved. It can also be commonly seen in friction spots like knees or elbow. It can also be familial i.e. hereditary factor also has some role in the prevalence of leucoderma. Being emotionally upset may also precipitate or aggravate the complaint in certain circumstances. Some suspect sin, lack of sun exposure, infection, etc., to be the reason for the problem. All these are risk factors only, but the real cause is still obscure or unknown.
Leucoderma appears as odd, harmless, white spots or patches disturbing the appearance of the sufferer. Mostly, no other symptoms can be noted except whiteness of the skin. The whiteness usually starts as a small discoloured white or pale or brown spot which spreads and becomes whiter day by day and becomes milky white in the course of time. The occurrence may be in a single spot or multiple spots. Hair on the spot will also become white. The hypopigmented or white skin is usually margined by hyperpigmented demarcations. The person’s health is no way affected except for leading to depression. Usually, it spreads very slowly, but sometimes it may also be very fast to appear all over the body. Also many a time it may remain the same for a prolonged period without spreading, even without treatment. It may cause itching sometimes, due to exposure to the sun or coming in contact with chemicals, which shows easy friability and susceptibility of the skin. Leucoderma sometimes appears pale, sometimes red and some other times, milky white.
Diagnosis and investigation – Diagnosing the patient with leucoderma is very easy and simple. Everyone can easily identify the disease as leucoderma or vitiligo with its characteristic whiteness of the skin. No other special investigations are necessary for diagnosing the complaints. Also, since leucoderma is restricted to the epidermis, there won’t be any change in blood or urine. Biopsy can reveal the absence of pigments. Fungal infections can resemble vitiligo patches. So, in doubtful cases, it has to be ruled out with biopsy and culture. Also, sensation over the leucoderma is normal, compared to other discolouration diseases.
Prevention of spread
- Check for any infective focus, worms, chemical contacts, etc. if noted, they should be treated or eliminated
- Start treatment early
- Take medicines regularly in the early days itself, so that complete cure can be achieved
- Don’t worry about leucoderma, since effective treatment can arrest the course of the disease and cure it
- Use umbrella when out in the hot sun
- Track all your eatables and habits to streamline all the irritants or chemicals or sun exposure to arrest the spread of the disease
- Avoid working or roaming in the sun
- Avoid fast foods, citrus fruits, coffee, tea, cold drinks, alcohol, beer, non-veg, egg, etc., since it can cause spread of the disease
- Avoid multiple drugs or drug cocktails
- Avoid chemical soaps
General treatment – There is no scheduled, conservative treatments at all. Even then, every doctor aims at improving the cosmetic problem by improving the functioning of the skin. With rudimentary knowledge, everyone speaks more, but none of the available internal or external medicines claims guarantee for solid cure. No single therapy for leucoderma produces good results in all patients. Treatment course and medicines always vary and are unpredictable. Usually, treatment is a long process which may take months or years.
As doctors prescribe, people go for internal medicines, external applications, radiation therapy, photosensitivity therapy, depigmentation therapy with bleachers and surgery. All have their own side-effects and limitations. Patients should be aware of the risks of drugs or procedures before undergoing treatment. In spite of it, being eager to wipe off all the white spots, many of the sufferers apply a variety of external applications, including steroid, psoralen, dyes, etc. Steroids may be helpful in repigmenting the skin. But side-effects and continuous use is not acceptable. Drugs used for production of melanin also cannot be continued in the long run, since they can damage the liver (hepatotoxic nature). In cases that have a bad attack of leucoderma and in failed cases, to avoid ugliness, some prefer and attempt permanent depigmentation with bleaching agents.
Surgical options – Skin grafting, melanocyte transplantations and tattooing. All these procedures are costly and painful.
Complications – Normally, there won’t be complications, even if left untreated, except that it will spread more. But if maltreated, complication can arise from drugs. Since there is no 100 per cent guarantee or sure cure in any system of medicine, people often go on with drug cocktails from various systems of medicines and doctors. This mode of treatment often brings drug effects or side-effects. Likewise, people often go for external application, dyeing, bleaching, etc., which make the skin more sensitive and cause infection or boils.
Everyone knows that being in the hot sun make one’s skin darker. In the case of leucoderma patients, it will be more, i.e., extreme darkening of the skin and sunburn. Excess exposure to the sn even for treatment purpose, may cause blisters, ageing of the skin, wrinkling and extreme darkness of the skin. Also, if they had previously tolerated the sun (while having a sunbath), it may become intolerable when they suffer from leucoderma. Itching red rash or blisters may develop due to polymorphic light reaction of the sun. Everyone should be careful about this as sunlight is a leading cause for skin cancer.
Leucoderma can reflect in the mind, causing psychological fears, emotional upset, shame, and socio-behaviourial changes by trying to avoid being in the public, attitude of others who insult by avoiding contact. These changes restrict their social behaviour and communications. There may also be fear of ugliness, fear of hereditary (infecting the generation), contagiousness, other diseases, cancer, etc.
A single spot has more chance of cure, i.e., 100 per cent, than multiple spots which have less success rate or many failures. No one can deny the Homeopathy effect in arresting or controlling leucoderma. In most of the cases, Homeopathy treatment can improve the condition. It works and cures superbly like a miracle in the early stages of leucoderma. Even then, Homeopathy or the Homeopath cannot promise a sure cure in all the cases. Leucoderma, if left untreated, goes on spreading. So, at least treatment should be followed for arresting the spread. Good results often follow when leucoderma is of recent onset, in children or youth, dark people, sun exposed areas & in non-friction spots.
Homeopathy treats patients, not the disease, for betterment or cure. Also Homeopathy treats leucoderma as a general complaint rather than a local skin problem. So, Homeopathydoes not believe in external applications. The treatment can also give good improvement in cases of white patches after burns or contact with chemicals. The duration and success of treatment depends on the duration, extent of the patches, and patient’s susceptibility. During the course of treatment, in white spots, there appear black dots or spots as the process of repigmentation which later merge together or coalesce to mask the diseased whiteness. The patches often turn dark and then finally fade to normal colour during treatment.
Homeopathy treatment can reward marvellous, dramatic and effective cure during the initial stages of leucoderma. Homeopathic medicines commonly used for treatment of this condition are Acid nit, Antim-crud, Apis mel, Ars alb, Ars sulf flavum, Borax, Ferrum ars, Hydrocotyle, Kali ars, Kali bich, Kali carb, Lachesis, Lycopodium, Medorrhinum, Nat mur, Opium, Psorinum, Pulsatilla, Silicea, Sulphur, Thuja, Tuberculinum, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.
Dr. S. Chidambaranathan, BHMS, MD (Homeo)
24 E. New Mahalipatti Road
Tel: +91-452-233-8833 | +91-984-319-1011 (Mob)
(Disclaimer - The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)