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 Vitiligo Cures
...a clinically illustrated guide

Dr. R. Gnanasambandam, MD (hom)

Former president, Tamil Nadu Homoeopathy Medical Council, Government of Tamil Nadu
Governing body Member, Central Council for Research in Homoeopathy, Government of India
Former Nodal Officer, State Campaign for Mother and Child Care, Department of ISH&H
Member, Drug Technical Advisory Board, Department of AYUSH
Former Senate Member, Dr.MGR Medical University
Editor Homoeo Times

AKP Homoeopathic Clinical Research Center

Chennai
Vitiligo Cures

First Edition 2012

C Copyright reserved by the author

All rights reserved. No part of this book may be reproduced, stored in a

retrieval system or transmitted in any form or by any means; mechanical,
photocopying, recording or otherwise, without any prior written permission
from the author

Price Rs. 120/-

Published by
AKP Homoeopathic Clinical Research Center
# 6, Lloyds IInd Lane
Royapettah, Chennai - 600014
Phone: 044-28113300
www.homeomiracles.com
Email:[email protected]
Skype id : akphcrc

Disclaimer: The information presented in this work is in no way intended as medical advice and/or as a substitute
for the medical treatment. Nothing in this work is intended to self diagnose, or self treat, any illness/disease/health
condition. If the readers have any questions, or queries, concerning illness the author and publisher strongly
recommend them to seek the advice, or guidance from a professional Homoeopath.
 Foreword
Thiru. Naresh Gupta IAS (retd.)
Member, Central Administrative Tribunal, (Patna Branch)
Former, Chief Electrol Officer
Additional Chief Secreatary to Government of Tamil Nadu

This book is a guide for curing Vitilligo, a common skin disease.

It can cause of a lot of mental uneasiness due to the appearance of a
person afflicted by it getting affected and if there are patches visible to
others, the person feels very awkward even to meet others. However,
Homoeopathy has a solution to the seemingly incurable skin condition
known as Vitiligo. Unfortunately, knowledge about the efficacy of
Homoeopathy in curing diseases is inadequate. For certain diseases
including skin problems, Homoeopathy is very effective.

The author of this book, Dr. R. Gnanasambandam, has put in

considerable effort to set out the basics of skin, the cause of skin
problems, signs and symptoms and the cure. The treatment of the
subject is very simple. The pictures which are very clear and the FAQs
with their answers in the book make it easier to understand the subject
and would clarify all the doubts of the patients. The presentation
would be intelligible to even the common man. I am sure this will be
a very useful publication and a prelude to similar such publications
on other common diseases / afflictions.

Sd/-

[NARESH GUPTA]
 Preface
Few words ...
Vitiligo… a medically challenged disease everyone knows!
This devastating illness has a significant psychological impact on
patients which cannot be explained in terms. Clinically I have seen
many patients expressing their worries on discrimination.

I had been awarded in many occasions with regards, gratefulness

and gifts after our successful Homoeopathic treatment. I had a great
thirst for knowledge in understanding and treating the vitiligo
patients. I was driven with more interest on the ailment which made
me previously to write a Tamil book on Vitiligo with overwhelming
response.

This ultimately compelled me to host public awareness

programs and scientific papers in various seminars. Here I must
thank AKP Homoeopathic clinical Research center for hosting
many free awareness camps and publications for the development
of Homoeopathy

I think this book will give a deep understanding on vitiligo for

everyone; it could be an eye opener for the budding homoeopaths.
Indeed this book will be an instrument for better understanding for
the physicians of others systems of medicine.

My sincere thanks to Dr.K.Savitha for making her all efforts

to bring this book wonderfully. I also extend my thanks to
Dr.D.Manju Dr.Sherin Charles, Dr.Vineetha Anand, Mrs. Thansila
and Mr.Somasundram for giving a structure to this book.

I dedicate my entire works to my grandfather, a man of triumph,

whose soul is behind this success. I also dedicate to my beloved
parents; my Gurus, Officials, Medias, colleagues and staffs for their
continued support to me in serving the humanity by this wonderful
system of medicine.

Date : 25.6.2012 Dr. R. Gnanasambandam

Place : Chennai
 Contents
1. Curability of Vitiligo 1

2. Know your skin 3

3. Skin and complexion 7

4. White Patches on the Skin 11

5. How and why it occurs? 13

6. Clinical Types of Vitiligo 20

7. Signs and Symptoms 33

8. How to differentiate? 36

9. What are the Tests? 41

10. Diet Restrictions 43

11. How to Treat? 48

12. Clinical Evidences 52

13. Homoeopathy 70

14. Frequently asked questions 82

 1

Curability of Vitiligo
Vitiligo is a cosmetic disorder. Vitiligo is a relatively common skin
disease which does not give any physical disaster except the visual
perception. Many presume that it is contagious and afraid to touch,
contact or sit nearby the affected persons. Vitiligo never spread and
even if a person gets married a person with vitiligo it will not affect
him or her. The disfiguration is merely caused by the malfunctioning
of the pigment cells which gives colour to the skin and not by any
virus, bacteria, or a parasite.

Skin is a medium of expression of internal state of health, never

mind it’s white or black. Everybody wants to have only healthy skin
and the cosmetic perspective is also more on its way. There are lots
of skin ailments which disfigure and affect the appearance of an
individual.

When a skin is identified by small or large areas of white patches,

the victim’s mental health is also distressed by the society. The victims
are much humiliated to face the community. His family members and
his associates take much initiative to recover him and find a solution.
They sympathize more and often suggest various types of treatment
 2

and several systems of medicine. Many physicians find it difficult and

often refer to a specialist and senior physicians.

Many patients frustrated with different courses of treatment and

various types of medicines; applying the skin lotions and exposing
their skin on the sun to get acceleration of pigmentation. Many of them
are suggested for UV rays, PUVA therapy and finally transplantation
of skin and pigments also being tried.

Most of the patients took various types of treatment; finally in

frustration they state that “Vitiligo is an incurable skin condition”.
Many of them are afraid on the side effects of the drugs and say “Let
it go! When I go!” At least I must live healthy!”. Many of them are
annoyed with local applications and exposure to sun which could not
be possible at a long run. It does not mean that one cannot get rid of
white patches caused by vitiligo.

Homoeopathy could rescue this hypopigmentary disorder without

any side effects; in fact the therapy does not recommend any external
applications or exposure to sun. The tiny globules arouse the immune
system and allow the body to fight on its own natural way. It does
not mean that the lesion is very small or all over the body. When the
suitable homoeopathic medicine is prescribed, it could eliminate the
causes layer by layer and yields a wonderful recovery. Clinically lot of
patients had improved with evidence based studies.

Everyone is curious, how does it happen? What is the cause? Am

I wrong with my diet? How to recover? Which Medicine should I take?
Everyone should understand the basics of skin which could infer lot
of understanding of the vitiligo and also to choose the right way to
recover.
 3

...Know your skin

The skin not only gives us appearance and shape, it also serves
other important functions: Our skin is a wonderful structure, which
covers our body and protect from environment changes like heat and
cold. It also acts a barrier to infective agents such as bacteria and viruses.
Today cosmetic view of the skin is more among the community, in
accordance to the development of the civilization.

The wonderfully designed skin has two layers; what we see from
outside is called epidermis and beneath it Dermis can be seen.

The epidermis is a very thin layer measuring about 0.1mm , just a

thickness of a paper, however in the soles of the feet and the palms
of the hands it can be 1mm thick or more. The epidermis is made up
of five layers. The cells of these layers are called Keratocytes .The Cells
in the lower epidermis is basal cell layer which divide constantly and
continuously move up towards the surface layer forming other four
layers. The cells become flatten and almost look like fish scales; finally
they die and fake off. On an average it takes about 60 days for a
new layer to migrate to the surface and eventually worn off. Dead skin
cells sheds from the skin surface continuously. This is balanced by the
 4

Layers of the skin

dividing cells in the basal cell layer to produce a state of constant

renewal

The basal cell layer is provided with specialized cells like

pigment producing cells, Melanocytes which produce the Melanin.
The melanin is absorbed into the dividing cells uniformly to give
complexion of an individual.

The basal cell layer is also lined with immune cells “Langerhan
cells “which is also known as Dendrite cell

The dermis lies immediately underneath the epidermis and is

about four times thicker. It contains numerous specialized supporting
tissues as well as blood vessels, nerves, hair roots, sweat glands and
oil glands

Throughout the dermis the collagen and elastin which are made
up of protein gives it strength and flexibility. A reduction in these
 5

A detailed diagrammatic skin structure

proteins with age is normal and contributes to the more fragile skin of
elderly people. It is also responsible for wrinkling of the skin

The nerve endings sense pain, touch, pressure, and temperature.

Some areas of the skin contain more nerve endings than others. For
 6

instance the fingertips and toes contain many nerves and are extremely
sensitive to touch.

The sweat glands produce sweat in response to heat and stress; it

helps to cool the body. Specialized sweat glands in the armpits and the
genital region secrete a thick, oily sweat that produces a characteristic
body odor when the sweat is digested by the skin bacteria in those
areas.

The sebaceous glands secretes sebum into hair follicles. Sebum is

the oil that keeps the skin moist and soft and acts as a barrier against
foreign substances. This sebaceous gland is responsible for pimples
and dandruff

The hair follicles produce the various types of hair found

throughout the body. Hair not only contributes to a person’s
appearance but has a number of important physical roles, including
regulating body temperature, providing protection from injury, and
enhancing the sensation.

The blood vessels of the dermis provide nutrients to the skin and
help to regulate our body temperature. Heat makes the blood vessels
to enlarge, allowing large amounts of blood to circulate near the skin
surface, where the heat can be released. Cold makes the blood vessels
to narrow and retain the body’s heat.

Below the dermis lies a layer of fat that helps to insulate the
body from heat and cold, provides protective padding, and serves as
an energy storage area. The fat in living cell, called fat cells are held
together by fibrous tissue. The fat layer varies in thickness, from a
fraction of an inch on the eyelids to several inches on the abdomen
and buttocks in some people. All the components of the skin work
together in their designed mode to carry out its vital functions.
 7

Skin and complexion

She is fair and beautiful….! He is dark and handsome …!

Our eye perceives the complexion of a person at the moment of

seeing an individual irrespective of their gender. What is responsible
for this skin colour? Many of us do not know that the complexion
is contributed by Melanin pigments. The melanin pigments are
responsible for colour of the skin, hair and even the eyes.

A specialized cell called melanocyte which is present at the

bottom of the epidermal layer of the skin secretes the biological
pigment melanin. Melanocytes crafts the melanin and they pass it
to the neighboring keratinocytes in the epidermis. The melanocytes
have long and extensive processes that reach out and contact many
keratinocytes, to facilitate the pigment transfer. The melanocyte,
unlike the keratinoytes, life span is measured in years to decades. But
keratinocytes live for few days only.

We ingest the foods containing the protein which is converted

to aminoacid called “Tyrosine”. Each melanocyte secretes a special
enzyme Tyrosinase to synthesize this special protein, “Tyrosine” to
 8

DOPA, a chemical complex structure. This undergoes an oxidative

process to form into Dopaquinone to form the melanin pigments. They
aggregate as granules inside a tiny structure called melanosomes.
These packages are delivered to the basal cells and keratocytes by a
slender filament named as ‘Dendrites’

A schematic sketch showing the conversion of the protein Tyrosine to pigments

One melanocyte supplies about 36 keratinocytes with melanin

granules. These tiny packages of pigment sits over the nucleus, which
is the vital centre of every cell in the epidermis. Even though the
function of melanin is to yield complexion of skin, hair and eyes, its
key function is to protect it from the harmful rays of the sun.

The white skinned people are prone to be born with comparatively

less amount of melanocytes and more in dark skinned individuals.
The complexion of the skin is uniform throughout our life. Of course
in aged adult it could change due to hormonal indulgence and on
the process of aging. In tropical areas the uncovered parts could
give more darkening than the covered parts since the melanocytes
are stimulated more to protect from the sun. Sometimes the obvious
marks could fake an individual “I lost my original Colour”. In fact
the colour would return uniformly when they avoid sun exposure.
 9

Sun Rays or UV rays increases the melanin pigments by secreting MSH from brain

The sunrays or any Ultra Violet rays is exposed to the skin, a special
sense receptors are present in the keratocytes called photoreceptors.
They send information to the brain. The hypothalamus is the special
centre to recognize the necessity and order the Pituitary gland to
release more Melanocyte Stimulating hormone (MSH), which signals
the melanocytes to secrete more melanin. The sun exposed or UV rays
exposed areas become darker.

There are two types of melanin pigments the brownish black

‘Eumelanin’ and the reddish yellow ‘Pheomelanin’. Eumelanin
and pheomelanin presents in human hair also. People with light
complexioned skin mostly produce pheomelanin, while those with
dark colored skin mostly produce eumelanin.

Human skin colour is quite variable around the world. It

ranges from a very dark brown among some Africans, Australians,
and Melanesians to a near yellowish pink among some Northern
 10

The melanin pigments are secreted by Melanocytes to reach keratocytes, which

gives colour to the skin.

Europeans. There are no people who actually have true black, white,
red, or yellow skin. These are commonly used colour terms that do
not reflect biological reality.

Indians have an inherent desire to look fair-skinned, because the

fair complexion has gained respect. Not only women but men too are
aspiring for fair skin. Somehow, we have perpetuated the myth that
beauty and fairness are synonymous, which is not right and cosmetics
industry has captured our inherent desire for fair skin, by offering
cores of creams and lotions that promises to lighten our skin colour
which is not always reliable and no way permanent.
 11

White patches on the skin…

The white discoloration may occur in the body surface as a
small white colored almost milky patch which keeps on increasing
in varying size and shapes. The commonest sites are around lips, on
cheeks, legs, hands, fingers, chest or back, around the eyes and even
on the head. Few patients have these patches around or over the
joints like elbow, knee, finger tips, wrists, and palms.

A single dark hair may change to white initially and the body
hair, scalp hair usually appears as a localized patch of white hair.
Sometimes total involvement may occur with discoloured skin.
Eyebrows, pubic hair, and auxiliary hair, may turn white when the
lesion progresses.

Any changes in the skin colour definitely indicate that the

melonocyte beneath the affected part is disturbed and production
of melanin pigment is stopped due to various factors. A pigment
producing cell melanocyte could have been destroyed, or some
chemical synthesis in the production had been stopped, or stimulation
for the production of melanin is not enough to function. Even though
there are many causative factors explained, basically the pathology
falls under these three major categories.
 12

The skin is bleached to white when the production of melanin pigments are
stopped by melanosomes

When the melonocyte faces difficulty in production of melanin,

naturally the kerotocytes in the epidermis bleaches out to give white
discolouration on the skin. The clinical presentation of white patches
differs from one to another. The lesion may look milky white when
the melanin production is completely stopped; Rosy red when
there is much exposure to sun and spreading could be assessed by
the disappearance of line of demarcation. The lesions are called as
trichromic when the area of white patch and the peripheral healthy
skin if covered with dull, brown colour patches.
 13

How and why it occurs?

Is it due to an infection?

Am I anaemic? Any dietary errors? Any deficiency in food?

Is it Hereditary? My grandma had this!

I had an insect bite some years back. Is it because of that?

I think it could be due to intestinal worms!

When a white patch is noticed, every one digs their mind to

find out the cause. First and foremost we should understand that the
disease is not contagious and definitely a bacteria or virus or any living
parasite will not contribute this complaint and never be responsible
for vitiligo. The disturbance in the pigment cell, melanocyte causes
this disfiguration. Even though a number of disturbances could
affect the functioning of the melanocytes, three main basic causes are
indentified by Research studies.

• A Melanocyte may be destructed by Auto Immune reactions

• A Melanocyte may be disturbed chemically, by the nutrition and

by metabolism
 14

• A Melanocyte may not receive sufficient nervous stimulation for

functioning

Auto immune reactions

We know about immunity which protects our body on our
own. Our body is programmed, designed, to destroy anything that
is recognized as foreign body such as bacteria, virus, parasites and
many other foreign objects like metals or anything else which get
entry inside the body. This is a very critical survival mechanism. It

Structure of Melanocyte reactive auto-antibodies (IgG-anti-MC)

is as though we are programmed to reject foreigners, and the system

usually works remarkably well.

You would have commonly come across the blood testing for
white blood corpuscles for total and differential count. In differential
count you can note down the Lymphocytes. The white blood corpuscles
give immunity; specifically the lymphocytes are responsible for the
immune reactions.

B cell lymphocytes are derived from our bone marrow and T

cells migrate from thymus. When a pathogen enters our body the
 15

immediate immune reaction is offered by the T cell that is the ‘cell

mediated immunity’. In the cell mediated immunity the T cells bind
to the antigens and destroy the infected cells. Another type of immune
reaction is provided by the B cell which produces large number of
antibodies; they find the enemy cells and destroy them. The anti
bodies are known as immunoglobulins.

The studies about immunoglobulins also give high value in

detecting many diseases. For instance when a pathogen enters the
human body, the affected cell presents antigen as an alarming signal.
A specialized Lymphocte called T helper cell stimulates other T cells
to become more in number and they recognize all infected cells and
kill them. Similarly the B cells are also stimulated and they produce
Anti bodies which identify the antigens and destroy the cells. The
antibodies are the specific immunoglobulins which help us to detect
by investigations. For example the persons with asthma are ruled out
by increased IgE in blood and reciprocally by the increased number
in Eosinophil count and absolute Eosinophil.

But in some occasions instead of finding and destroying the

infected cell, the anti bodies attack the healthy tissue. This is something
like suicidal human bombs killing innocent people. This is an
exaggerated immune response which is medically termed as ‘Auto
Immunity’. These are called as auto immune disease. Rheumatoid
arthritis, Hashimoto’s Thyroiditis, Systemic Lupus Erythematosus
(SLE), Crohn’s Disease are the few examples of Auto immune disease.
Vitiligo is also considered as auto immune disease depending on the
etiology.

The research studies reveal that the detection of Melanocyte

reactive auto-antibodies (IgG-anti-MC) in vitiligo patients confirms
auto immune reaction which is a B cell reaction.
 16

Similarly the more number of T cells correlates with number

of melanocyte destruction which also confirms the auto immune
reaction. Mostly the Melanocyte reactive auto-antibodies and T cells
co operate with each other and destroy the melanocytes.

A strong association with autoimmune diseases is clinically

seen in many patients. Autoimmune thyroiditis is the most common
association in children with vitiligo. A research study had showed
that patients with nonsegmental vitiligo had thyroid alterations in
blood study. Vitiligo lesions are common in Pernicious Anemia,
Insulin-dependant Diabetes, Systemic Lupus Erythemetosus and
Alopecia areata patients.

Any infection, very commonly after typhoid and Jaundice had

clinically illustrated with these type of reaction. We should not think
only infection alone gives rise to auto immune reactions. Medical
science had identified a number of normal antigens as foreign
substance by the body

Normal chemicals of the body can become altered due to physical,

biological or chemical poisoning such as toxic metals, toxic chemicals
or infection. Then they may appear as if they are foreign chemicals
and the body starts destroying them.

Foreign chemicals that immunologically resemble or “look like”

normal body chemicals can be introduced into the body, usually in
vaccines. Then our body’s immune system starts reacting against the
foreign chemicals, which is a healthy response. However, the body
then overreacts and starts destroying normal chemicals also, because
the foreign chemicals in the vaccine or other foreign protein appear
very similar to some of the body’s normal chemicals.
 17

Few patients had given the history of insect bite which suspected
as a cause. Vitiligo patients are advised to avoid non vegetarian food
since they are likely to act as a foreign protein.

A significant association between familial nonsegmental type

vitiligo, the presence of HLA-B46 has been discovered.

Disturbance in the Cell Oxidation and Metabolism

We know that every cell in our body requires nutrition and

oxidation. A variant in metabolic process could also play an essential
role in the pathogenesis of vitiligo. This includes the deficiency in
nutrition, toxic chemicals, which disturbs the tyrosinase activity. A
melanocyte may be destructed or paralyzed in its function.

This makes suspicion on wide range of chemical use. Today’s fast

food, everything grown on fertilizers, plastics utensils etc falls under
this category. Dietary deficiency of Proteins; Copper and minerals is
a major factor for causing vitiligo. Use of some drugs, particularly
antibiotics may lead to appearance of vitiligo.

A gastro-intestinal disorder like Chronic Amoebiasis, chronic

Dyspepsia and Intestinal Worms may be additional factors. The skin
lesions such as psoriasis, eczema could affect the melanosynthesis,
which is seen in many chronically infected individuals.

Failure in nervous stimulation

Case studies reveal that patients affected with a nerve injury also
have vitiligo. This happens in, segmental type of vitiligo. Melanocyte
Stimulating Hormone (MSH) is secreted from pituitary gland, which
 18

controls the pigment cell function. The functions are controlled by the
Hypothalamus, so even mental stress could affect the functioning of
a melanocyte.

All the tissues are innervated by sympathetic neurons. The nerve

cell axon may be degenerated and thus missing the nerve growth
factor in vitiligo patient was analysed by research studies.

Basically melanocytes are disturbed either by auto immune

reactions or by failure in oxidization or lack of nervous stimulation.
Sometimes the changes could be single or all together combines to
attack the melanocyte functioning

Endocrine dysfunction and vitiligo

Vitiligo is frequent in association with endocrine disorders like

thyroid disorders, diabetes mellitus and Addison’s disease. Thyroid
gland may undergo inflammation causing Hashimoto’s thyroidistis
which is clinically produced along with vitiligo. It happens due to
auto immune reactions. The low secretions of thyroid hormones could
affect the oxidation process in cell which could affect the melanin
production.

Addison’s disease is another auto immune disease but rare. It is

caused by the insufficiency of adrenal secretion resulting in weight
loss, low blood pressure and fatigue. Vitiligo may be noticed in other
autoimmune diseases like Rheumatoid arthritis and alopecia areata too.

Diabetes mellitus could affect the cell function reciprocally and

the melanocyte may fail to produce pigments. This is the reason why
many diabetes patients produce white spots on their skin
 19

Hereditary in vitiligo
Vitiligo patients show multiple susceptibility and genetic
heterogeneity in some families. The inheritance of vitiligo may
involve genes associated with the biosynthesis of melanin, a response
to oxidative stress, and regulation of autoimmunity. Many scared
of predisposition of genetic factor, of course genetic traits takes its
course skipping some generations.

Human leukocyte antigens may be associated, but not in a

consistent manner as explained. For example, HLA-DR4 is increased
in blacks, HLA-B13 is increased in Moroccan Jews, and HLA-B35 is
increased in Yemenite Jews. An association with HLA-B13 is described
in the presence of antithyroid antibodies.

Everyone should be aware of the clinical varieties and types of

vitiligo, the changes and the causes for the devastating disease before
they choose any medication.

Post inflammatory
Melanocyte functioning can be changed subject to external
influences in some types. These types of lesions are localized to form
“Leucoderma”. Many of the patient’s skin do not resume its original
colour for a long time after burn or injury. It could be the effect of
destruction or transient dysfunction of the pigment cells. You could
have listened to some white patches in legs beneath the chapal strips,
inner wears and tight dresses which could have resulted from pressure
or chemical synthesis.

Common skin disease like Eczema, Psoriasis could injure the

melanocyte resulting failure in melanin production, which reflects
white spots on the skin
 20

Clinical types of vitiligo

Vitiligo is observed for thousands of years, all across the world. It
is a common distortion and approximately one out of every hundred
people suffers from this disorder. Earlier Vitiligo has long been
confused with leprosy. This term “Vitiligo” was identified and coined
by a Roman physician named Celsus. The prehistorical term Vitiligo
is believed to be derived from Latin word “Vitium” which mean
“calf”, the first part of the word, “VITI” means “Mark or Blemish”.
The suffix, “LIGO” is a common Latin ending meaning to “blind or
cause”.

A casual notice by the person himself or recognizing through

mirror or by others alarms will led to search a physician to rule out
the disease. Clinically the vitiligo patients present with different
type of white patches. A white discoloration may occur anywhere in
the body surface.

Clinically the White discolouration may occur in two types.

Some patients develop the white patches all over the body and it is
termed as Generalised vitiligo. In the localised patterns the lesions
 21

Presentation of Vitiligo

are confined to only one place and they never spread to the other
areas. Clinically generalized patterns are more common.

Localised patterns

Focal types

Focal types of lesions are seen as a single or along a course of

a nerve. Most commonly it is found in the face along the course of
 22

Localised patterns Focal type

The focal types are seen along the course of nerves.This picture illustrates the
involvement of trigeminal nerve

This picture illustrates the nervous stimulation failed along the course of Trigeminal Nerve
 23

Localised patterns Segmental types

The Segmental type of lesions restricted to one area and is found as one or
more patches matted together. Such lesions can be found around eyes, chin, chest,
thighs mostly in children

Around eyes Chin

Chest Thighs
 24

Localised patterns Mucosal types

These types are found in the junctional place of the inner mucous membrane to
the skin. Lips and genitals are more predisposed areas. Nipples, Navel, Eye Lashes,
Nostrils and anus also involved

Common in lips

Genitals also seen

25

Generalised patterns Acrofacial types

The lesions involves the extremities and face is, very common

The lesions involves face, hands and feet

 26

Generalised patterns Vitiligo vulgaris

A lesion may appear on back or chest then involves very rapidly to other
areas

Vulgaris type involving back

 27

Generalised patterns Mixed types

The vitiligo involves all parts to complete bleaching as in Vitiligo Universalis
. They may be presented as mixed with mucosal involvement

Complete depigmentation Picture showing nipple, navel, chest involvement

Armpit involved in this picture Nasolabial fold and other parts

 28

Congenital varieties Albinism

Albinism : The Picture shows eye involvement nystagmus.

Piebaldism

A punch of hair and the forehead skin is depigmented since birth

 29

Leucoderma
Leucoderma is named when the cause is external and factors affecting the
melanin synthesis

Eczema lesion showing depigmentation Burn injury causing depigmentation

Chapal mark showing hypopigmentation Inners causing discolouration

 30

trigeminal nerve. The lesion may involve left or right side of the
face.

Segmental types

The Segmental type of lesions are restricted to one area and

is found as one or more patches matted together. It occurs most
commonly in children. More than half of the patients with segmental
vitiligo have patches of white hair. These are usually seen around
eyes, chest and thighs.

Mucosal types

Mucosal varieties are confined to the muco cutaneous functional

places in our body like lips, anus, nasolabial folds, eyes, nipple and
genitals. These may remain as such for many years. Many patients
give their history in glans penis in case of male and labia in case of
females. These varieties are clinically almost stagnant , but later it
may turn to acrofacial types.

Generalized vitiligo

Acrofacial vitiligo

We see in a crowd with patients having lesions in fingers, toes

and the ventral part of the hands and feet with an involvement in
face. This Acrofacial clinical pattern is more common. In these types
of lesions usually the onset is gradual and spread slowly involving
other areas. They have a symmetrical distribution. For example if a
lesion appears in left fingers the right fingers will also be involved.
Fingers and toes, nail beds, palms and soles, lips discoluration had
been noticed clinically in this type
 31

Vitiligo Vulgaris
This clinical pattern scattered over the trunk or back or any
part with symmetrical distribution. Sometimes sudden appearance
of patches in the body and rapid spread could drive a patient more
panic.

Mixed types
Some patients present acrofacial and vulgaris vitiligo as a
combination. Sometimes the lesions further attributed with the
combination of mucosal types in which they can be noticed in ear
lobes, nostrils, nipples, genitals, navel and armpits. Sometimes skin
is completely bleached to mimic a type of albinism, medically termed
as Vitilgo universalis.

Body hairs of the affected parts may be depigmented. Vitiligo of

the scalp usually appears as a localized patch of white or gray hair, but
total depigmentation of all scalp hair may occur. Scalp involvement
is the most frequent, followed by involvement of the eyebrows, pubic
hair, and axillary hair, respectively.

Leucoderma
Leucoderma and vitiligo are the synonymous name; Leucoderma
is not a medical term, though it has come to mean any white/light
coloured skin patch. “Leuco” means white , the term “Derma” means
skin. In asian countries the term Leucoderma was used to denote
the white patches. The term is quite applicable for congenital birth
marks, the white discolouration after an injury or burns, pressure
and chemical trauma to the skin as in case of wearing tight dresses,
rubber foot wears , wearing gloves may opt the term.
 32

Congenital varieties
There are some pigmentary disorders noticed since birth, where
the pigment cells fail to develop genetically. Even though no hope in
the treatment lets know what it is!

Albinism
Other than the above clinical varieties we see some patients with
total loss of pigments since birth. This birth disorder results in blue
eyes, white skin and white hair. The eyes suffer from rapid movements
clinically known as a condition called Nystagmus and also other
retinal and vision problems. The skin is completely bleached from top
to bottom. They will be unable to withstand the sun exposure which
could turn pinkish rashes and even blisters on further indulgence.

Piebaldism
A punch of white hair with white skin beneath is seen in some
individuals since birth. This condition clinically termed as Piebaldism.
This genetic abnormality is due to mutation of genes which reveals
permanent loss of melanocytes in the affected area.
 33

Signs and Symptoms

The main sign of vitiligo is the pigment loss that produces
milky-white patches on our skin. The lesion is usually first noticed
as white patches on the skin. When the skin becomes very dull or
white the victim may ignore, thinking that could be some transient
skin discolouration due to fungus, chemicals or some injury. It will
be alarming when it spreads deep into the nearby area and starts
appearing in other parts. The patient would rush out for the medical
help.

It would be a surprise to everyone to note that there is no itching,

pain, burning like symptoms which are very common features of
many other skin diseases.

The diagnosis can be made easily pertaining to the most

predisposed areas like sun-exposed areas, including the hands, feet,
arms, face, and lips. Other common areas for white patches to appear
are the armpits and groin and around the mouth, eyes, nostrils, navel,
and genitals.

The appearance of clinical patterns also gives a clue on the types;

either it is focal, segmental, mucosal, acrofacial or vulgaris. The
 34

The lesion is trichromic. The skin is milky white in the middle, brown and then normal skin

This is marginal lesion with reddish, progressive at periphery

 35

lesions of trichromic appear in the middle with deep milky white

then a brownish area and the healthy unaffected skin. In the marginal
type of lesions the margins are progressive with reddish raised area
with mild irritation.

The key function of melanin is to protect the skin from sun

exposure. When the vitiligo patients are exposed more, the lesions
turns reddish and further exposure will lead to the formation of
blisters.
 36

How to differentiate?
We can differentiate well with the other ailments with its
characteristic milky-white spots on typical sites and symmetrical
distribution. The lesions are more easier to diagnose in dark
complexioned patients, the fair skinned may require tests. Woods
light examination is required to detect all the depigmented areas.

White patches always mimic other common skin ailments like

Pityriasis alba, Tinea versicolor, Pityriasis vulgaris, Leprosy, Systemic
lupus erythematosus, Hypopigmentation in psoriasis or Allergic
dermatitis.

Pityriasis Alba
Tinea Alba is most frequently seen in children. It is the chronic
skin disorder that affects some children usually between the ages of
6 to 12. This rash is characterized by patches of lighter skin mainly
on the face, although the neck, upper chest, and arms are sometimes
involved. The borders of the rash are not clearly visible. The light
coloured patch seems to blend gradually into normal appearing skin.
Sometimes the rash is covered by very fine skin flakes resembling a
light dust.
37

Lesions of Tinea Alba with flaking

Lesions of Tinea Versicolor with flaking

 38

The lesions of SLE with raised reddish eruptions in the margins

Leprosy patches with ill defined margins

 39

The cause of pityriasis alba is not clear, but worm infestations had
been observed in many patients. Pityriasis alba can also be confused
with vitiligo. Pityriasis alba can be distinguished from vitiligo by the
border of the rash. The rash of vitiligo has a very distinct border with
a sharp line between the normal and light coloured skin.

Tinea Versicolor
This is also medically termed as Pityriasis versicolor, Tinea
flava, Achromia parasitica and Dermatomycosis furfuracea. This is
a common skin condition caused by infection of the dead outer layer
of skin cells with a yeast fungus, Pityrosporum orbiculare which is
also known as Malassezia furfur. Every human being has yeast living
on the surface of their skin. In hot and humid climates, yeast tends to
grow more quickly.

Young adults are the most affected. This causes spots or patches
that have either reduced or increased pigmentation - they may be
pale and white, brown or even salmon pink. There are often no other
symptoms although sometimes the spots are a little dry and flaky.

The upper trunk, arms and neck are the commonest sites.
Lesions are sharply demarcated and have fine scaling. The covered
areas become white in colour and the sun exposed spots are darker in
colour. A vitiligo patch can be differentiated from the presence of fine
scales and spots with different colours

SLE
The systemic lupus erythematosus skin lesions are rare incident,
the progressive lesions with presence of other symptoms like low grade
fever, joint pains, extreme tiredness would give key understanding
of the disease. This auto immune disease can be better detected by
 40

its atypical distribution and with tests like immunofluorescence and

other serologic studies are positive.

Post-inflammatory hypomelanosis
The skin lesion presents the depigmented spots as a sequel of
inflammation in eczema or psoriasis lesions. An eczematous lesion
presents its features with severe itching lesions mostly in legs. A
psoriatic lesion is typically presented as silvery scales with red
indurations.

Leprosy
We have to distinguish leprosy, as the name and the nature of
lesion always alarm the patients with more anxiety. In southern states
of India, the vitiligo is labelled as “Venkustam” giving more intimacy
to the leprosy. This could be the main reason for many persons blind
belief that vitiligo is contagious. Certainly vitiligo is not caused by
any infection it is only an internal disease.

We must know something on the key features of leprosy. It

is caused by bacteria called Mycobaterium leprae. It is clinically
presented as Lepromatous leprosy and Tuberculoid types. Even
though the lepromatous types give typical disfiguration to face
like lion and more degenerative changes in the fingers and toes the
spreading is limited, where as the tuberculosis variety gives more the
discoloured spots on thighs, legs, upper arms and hands

The lesions are more in one part unlike the vitiligo with the
characteristic features of numbness with typical brownish white
spots. Further it can be attributed by examining the thickening of
Ulnar Nerve and also ear lobe thickening. The affected part can be
sensed testing with a thread and a pin.
 41

What are the tests?

“Doctor! Any specific test should be done? “

Usually most of the patients put this query to every physician

Wood lamp Test

However the naked eye examination gives the details, sometimes
physical aids are needed to confirm the vitiligo patches and rule out
the other skin lesions. Woods lamp test helps to detect various fungal
infections like, Tinea versicolor, Tinea Alba, Tinea capitis. It also
helps to detect the bacterial infections, Hypo and hyperpigmentary
disorders. It has its value in detecting the vitiligo in fair skinned
victims

Biopsy
Skin biopsy is needed to study the undergoing pathological
changes in a particular affected part and who wishes for immediate
transplantation. It is the most confirmatory test than others.

The skin smear may be needed to rule out suspicious leprosy

which could be positive for the Acid Fast bacilli. KOH solution
application also helpful to detect fungal infections.
 42

Blood Tests
Even though specific tests are available currently to rule out the
immunological reactions in auto immune reaction and the familial
trait by a study of immunoglobulins anti nuclear anti bodies HLA-
DR4 HLA-B13, HLA-B35 and HLA-B13 is described in the presence
of antithyroid antibodies.

Melanocyte reactive auto-antibodies (IgG-anti-MC) in blood

serum shall be detected. Clinically no use since the condition is mostly
involved as an immune reactions, but we have to rule out the other
auto immune disease for better prognosis of the patient

Many patients present vitiligo with Diabetes mellitus and

Thyroid disorders which require periodical screening.

A routine test for blood gives out the picture of blood on the
details of Total and differential count of white blood corpuscles which
could give valuable information of basic immunology.

Haemoglobin gives valuable information on different types of

anaemia in association with comparative study in peripheral blood
smear for Red Blood corpuscles and White blood corpuscles

Motion Test
A motion test may be needed to rule out worm infestations and
amoebiasis
 43

Diet Restrictions
“Should I restrict my Diet?”

“What to eat and not to eat?”

This could be the final question after every consultation on every

illness. Vitiligo also calls for the special attention towards the diet and
regimen to expedite a cure. A blind advice on diet is not admissible, it
should have scientific understanding. Therefore everyone should be
aware of the cellular changes, its nutritive process, causative factors
and the obstacles for recovery.

We come across that the nutritive and oxidative process involves

protein, minerals and vitamins. The research studies state the Vitamin
C prohibits melanin synthesis. Even though Vitamin C is essential for
our healthy living a moderate control over the citric food helps. An
understanding on food that should be added more in diet is always
better for fast recovery.

Next common cause is auto immune which is even the normal

proteins are recognized by the cells as the foreign proteins. So a non
vegetarian food could be a culprit irrespective of its several sources
44
45
 46

Many perceives wrongly on allergic foods, which is not, it has no

value and restriction is also unscientific.

“If I restricted with all food then what to eat?

A curious leading question would have ended many

consultations.

“Diet restrictions are very simple and moderate and live happily
as vegetarian” the answer.

Avoid
Pickles, Lemon, Orange, Gooseberries, Grapes are rich in vitamin
C, so a moderate control is needed. Tomato and Tamarind are very
essential items in cooking, which can be moderately allowed.

All non vegetarian foods, Egg, Chicken, Meat, Fish, Dry Fish shall
be avoided to restrict the auto immune reactions. The animal proteins
always misinterpreted by the immune cells as foreign substance

Even though milk and dairy products cannot be avoided, fresh

always better. Fresh milk, Fresh curd, Butter milk can be included in
the diet moderately.

Add
We can add more Carrots, Papaya, Beet roots, Radish; Green
leaves Gingily, Jaggery which could promote more pigmentation

Melanin synthesis is enhanced by sun exposure; a moderate

exposure is always good. Many patients are raising a leading question
“what Soap I can use? “ Vitiligo is neither contagious nor caused by
allergy. So these is no restrictions on the soap use.
 47

Diet for Homoeopathy

Every system holds some dietary restrictions exclusive to their
system additional to a particular disease. Patients usually ask a
question is there any precautions for homoeopathy. Homoeopathic
medicines are small sugar pellets, which had been asked to chew.
Since the medicines are dynamic, the action is expected from nerve
routes from the tongue. Even it could through respiration only a
mere amount reaches the stomach. We advised the patients to take
on clean tongue and avoid eating anything before and after 10-20
minutes of taking medicine.

Earlier days Coffee, Tea, Onion, Garlic are advised to restrict but
clinically patients had been even in coffee toddlers.
 48

How to treat?
The change in appearance caused by vitiligo can affect a person’s
emotional and psychological well-being and may cause them to alter
their lifestyle becoming less active in social activities. Many people
experience emotional stress when the vitiligo develops on visible
areas of the body. Many patients find the quick way to camouflage
vitiligo until treatment returns pigment.

They are fussed with treatments in the main stream of medicine

on which system of treatment will be opting for their complaints.
The modern medicine will be the first choice. Patients will seek the
help of a dermatologist to take their advice and treatment. They will
be advised for Oral therapy with steroids, topical applications with
exposure to sunlight. Photochemotheraphy (PUVA) is a combination
of Psoralens with Ultra violet rays is commonly adopted. When the
lesions are small, more embarrassing or compellations on the event of
marriage surgical measures are adopted. Melanocyte transplantation
or skin grafts are done depending on the intensity of the lesions.

When the patients experience toxicity ultimately move to

the alternative systems of medicine. They choose Homoeopathy,
 49

Ayurveda, Siddha, and Unani. Some prefer acupuncture or Chinese

medicines.

Ayurveda and Siddha treat with herbominerals on physiological

dose, studying the body and soul. Topical applications with exposure
to sunlight are advised in most of the cases with strict diet and regimen.
They consider the vada, pita, kaba in relation with fire, water and air
for the constitutional approach.

Homoeopathic concept differs from other systems on medicinal

administration. The physiological, material doses increase the blood
concentration level; penetrate the melanocytes to secrete melanin
forcibly. The action falls down when the dose is stopped, but
Homoeopathic medicines are administrated in more minuteness and
dynamic form and action also long lasting.

If you find the causative factors for vitiligo are dynamic. An auto
immune response is seen most of the cases the unexplained changes
 50

are disease producing powers. It can not be explained more firmly

in every individual. Another thing the genetic trait also starts when
the immune system is lowered

The vitiligo lesions cannot be treated on the name of the diagnosis

alone. It needs total study of the patient on physical and mental
health additionally. The total study of the patient at the physical
and mental level and the pathogical background gives a collective
treatment to the individual and the action is also centrifugal which
could eliminate the unknown causes what ever puts together for an
argument sake

When homoeopathic medicine is administered in a vitiligo patient

it arouse the immune system to fight it on its own. The medicinal
force reacts with the existing disease force in the body to eliminate the
causative factors gradually and restore the function of a melanocyte

The action is like immunization which is used in modern

medicine as preventive and curative for infections, but the action
is more dynamic. When a tiny globule is administered to chew, the
action is expected from the nerve endings in the tongue rather than
the absorption through the Gastro intestinal tract.

The nervous system arouse the immune system to recognize its

malfunction and thus a natural way of cure is expected with minute
dose without any side effects. Eventhough the action is unbelievable
to the materialistically accustomed customs every one surprises after
the result.

We can co-relate with snake bite poisoning . When the poison is

more than the lethal dose it will kill the patient. When it is moderate it
 51

could praralyse the victim, but when the same poision is admistered
to a horse in minimal dose for long times, the serum of that horse is
being used to treat the snake bite poisoning as we seen in “Antivenin”
preparations in modern medicine.

Next advantage is no external applications and instructions to

exposé the lesions in sunlight. The most advantage of Homoeopathy
is free from side effects even it is continued to life time, because of its
minuteness in dosage.

The clinical results are wonderful in treating many varieties

of vitiligo patients. Mostly the patients with frustration after trying
all sorts of medicines and as a last chance of treatment choose
homoeopathy.

The results are indivisdualistic depend on a skill of a physician

to understand the inner pathology of an individual in relation to the
vitiligo, physical and mental level observations. Simply we can say
that the patient is treated rather than to say the vitiligo is treated.

A remedy that which is successful in one case, may not give

result in another case because the disease tendency is presented in
different types. Homoeopathy pioneers in the treatment of vitilgo, the
curability is more pronounced with clinical evidences.
 52

Clinical evidences
Vitiligo is known as incurable in the public and scientific purviews,
but clinically lot of patients had improved, cured and observed in
many patients without any recurrence after the treatment. The
clinical evidences support our study. Even though I had come across
many patients with improvement and cure, I would like to illustrate
some memorable success stories for better understanding on how a
vitiligo case study differs from others and the mode of approach of
homoeopathy with different causative factors

An insight
When I was a medical student at Government Homoeopathy
Medical College at Kilpauk Chennai, I came across a patient with vitiligo
all over the body. Myself and with my friends Dr.P.Mukundan and
Dr.A.Kamaraj were standing in front of the Outpatient department,
we saw that man, who looked like a foreigner. After few months
we were surprised to see the patient with remarkable recovery, only
palms and soles remained with white patches. We had discussion
with him and he told that he had the lesions since ten years and were
better only after the homoeopathic treatment.
 53

We were curious to know the case details. We approached

Dr.S.Sembulingam, the internee in duty; he told Prof. Dr.K.P.R.S.Sathana
Pandian had treated the case with Lycopodium 30C. We contacted
him and he taught us how to treat the case and his clinical experience
in the treatment of vitiligo.

This was a great visual evidence for homoeopathy that we gained

more confidence in the homoeopathic system and there we had laid
the foundation stone for the today’s excellence.

We know that vitiligo is labeled in Drugs and Magic remedies

Act as incurable disease, despite of the understanding of the universe;
the homoeopathic remedies had penetrated on the curative part of an
incurable disease.

The fame and name of Homoeopathy is known since it has

benefited many chronic illness, dread downed diseases were
successfully treated when they opted homoeopathic system of
medicine as final choice. The founder is so particular in treating the
chronic disease by total understanding of the disease pathology as
Psora, Sycosis and Syphilis which is todays understanding of cell
pathology as sensitization, proliferation and degeneration. This
understanding not only helped in treating Vitiligo but also the other
chronic illness too.

First Experience
After my studies I started my initial days of practice at my native
Avalpoondurai, in 1983. I had an opportunity to treat a boy aged
14 years who had white patchy discolouration in his left and right
fingers. He had burns while lighting the crackers to celebrate diwali.
 54

The wound heeled but the skin was depigmented. I considered the
causative factor as chemical injury and prescribed the medicine
Arsenicum Album 1M. Surprisingly the patient improved with four
months and totally the lesions turned to normal skin.

The medicine Arsenicum album is a poison everyone knows and

it could produce cholera like symptoms, vomiting and diarrhea. If
it is consumed for long time it could produce a pigmentary change
which was scientifically accepted. The documentary evidences say
that a particular area of west Bengal was affected with discolouration
in palms.

I was quite surprised how the most diluted potency 1M in

which the material part is nothing but the potentised inert energy
had brought such a cure. This will be a best understanding how the
immune system is stimulated dynamically and made the body to
fight on its own for recovery of the lesions. This personally made
me to understand that a medicine which is capable of producing
the pigmentary changes could be used to cure pigmentary disorder
which is the basic concept of Homoeopathy.

I personally gained confidence to handle the vitiligo patients

and more interested to continue, learn and dedicate to the system by
serving the humanity. I have seen all clinical patterns in my practice,
the acrofacial, Vulgaris and mucosal types are very common in clinical
practice. A handful of cases on focal patterns, segmental patterns also
treated successfully. Leucoderma of chemical origin had responded
very nicely. The post inflammatory depigmentation with allied skin
disease like eczema, Psoriasis and other unnamed varieties were quite
successfully treated along with it. Of course no remedial measures
 55

can not be expected in congenital pigmentary disorders like albinism

and piebaldism

Clinical evidences on Acrofacial types

Case-1
A girl aged eleven years consulted me for white discolouration
of the skin all over her body since one year. She had discolouration
on her face, scalp, chest back and legs. The lesions first started from
the toes on both sides and extended everywhere. The multiple lesions
were pure white, trichromic. She had one sided headache with
nausea, which was worse on sun exposure. She was vaccinated for
all communicable diseases. She gave the past history of prolonged
fever. Initially she tried Siddha Medicine, then allopathic treatment.
She used both the external applications and oral drugs. She is very
calm by nature. Never opens her mouth, gloomy, worries about her
illness, studious.

A drug was prescribed by understanding the inner changes in

relation with her physical characteristic features it recovered her with
almost 95% cure and she is still on treatment.

Case-2
A female aged 45 years presented with white discolouration of
skin since three years. The white lesion appeared first in the right
fingers and then extended over fore arms, chest, abdomen and
legs. The lesions were larger in size the periphery is continuing the
hypopigmented patches and the lesions were larger in some of the
places. Had been hospitalized for Typhus fever for fifteen days.
Underwent radiation for suspected carcinoma of mammary gland
five years back.
 56

Initially tried with modern medicine, oral and topical applications

but not benefited. Blisters appeared on the applied parts. She
tried siddha treatment for one year, treated with oral and topical
applications with exposure to sun light in the morning. With all these
she was not recovered.

The patient was prescribed with a homoeopathic similimum by

understanding the miasmatic background of the disease. She had
typhoid, which could have emitted toxins, which later could have
produced the auto immune reactions. Radiation for Ca is an attributed
factor. The psoric manifestations of the cell had quickly shown with
destruction of melanocytes, an understanding of pseudo psora, which
later entered syphilitic in the chronic course of the disease.

Understanding the inner reactions in relation to her physical and

mental attitude, the prescribed medicine brought her about 80% cure,
still continuing the medication.

Clinical Evidences on Vitiligo Vulgaris

Case-3
A middle-aged lady consulted me for her white discoloration all
over the body. She is a Muslim. Her complaints started 10 years back.
She was moderate in complexion, mild yielding and fastidious. She
got married to a professional and has two children, lives happily in
a joint family. She was quite desperate with her illness. The white
discolouration has started at the back and extended rapidly all over
the body with in a period of one year.

The lesions were trichromic with sharp margins leaving a

brownish part and milky white areas. The patches had started as a
 57

Case - 1
 58

Case - 2
 59

Case - 3
 60

pinhead and extended to join with other patch and there by large
areas of white coloured skin brought her an embarrassment to move
in to the social gatherings. Her past history shows that there is no
hereditary trait. She had suffered from Malaria at her puberty and
undergone treatment for anaemia. No acute illnesses like typhoid or
jaundice. She had loose stools most frequently and the investigations
revealed that amoebic cysts were present. She had been vaccinated
against Tuberculosis and also received the triple antigen for Diphtheria,
Pertusis and Tetanus. She was administered with Polio drops in
childhood. Initially she took allopathic medicines, and then tried all
sorts of alternative systems. Her final choice was Homoeopathy.

There are two things which appeared in my mind for the selection
of remedy, one is malaria and other is vaccination which could have
manifested the auto immune reactions in her body. Surprisingly the
dynamic homoeopathic remedy had given her fast relief for her long
running sufferings. Now she is enjoying her days happily with her
daughter at Dubai.

Case-4
A fifty seven years old male presented white discoloration all
over the body since 5 years. Initially started on dorsum of the left leg,
then scattered all over the body involving lips, face, scalp, fore arm,
legs, thighs and back . The skin was depigmented about 95%. Initially
he tried all systems of medicines and external applications and finally
opted homoeopathic treatment.

The lesions were trichromic involving total depigmentation and

with clean edges with a line of desquamation. Additionally he had
cold and catarrh and dyspeptic symptoms like eructation; burning in
61

Case - 4
 62

Case - 4
 63

the epigastrium.

He had occasional fever and abdominal colic. Never had been

hospitalized or no history of surgical intervention. He gave the
history of honey bee bite few years back. Had vaccination for small
pox and chicken pox.

None from paternal and maternal side affected with any

pigmentary disorder. His maternal cousin had allergic bronchitis. The
white discolouration with symmetrical distribution, nature of spots
with trichromic presentation involving mucocutaneous junctions
gives the simple diagnosis of Vitiligo. He is free from hereditary
trait and the possible causes like Gastro Intestinal Disorders, worm
infestations, impaired endocrine pathology are absent in this case.
There is a history of insect bite in the past and also vaccination history
for communicable diseases.

Understanding the inner pathology and immune reactions in his

body a homoeopathic similimum brought an excellent result

Clinical evidences on mucosal type.

Case-5
A 12 years old school boy was found with white discolouration of
lips since 4 years. He was very poor and his parents were not interested
to take care and treat him. The boy was residing in my neighbour
house. I called him and the case study revealed that it was acquired
without genetic trait as we expect in their mucosal varieties.

I examined his mouth to rule out other pathologies. The

depigmentation had extended to inner parts of the mouth.
Understanding the inner pathology and the homoeopathic approach
 64

Case - 5
 65

Case - 6
 66

the prescription brought him alright after two years treatment on free
of cost.

Clinical evidence on segmental type

Case-6
A 7 years old boy consulted me for white discolouration of the
skin in chin and legs. No similar history in their family. The causative
factor was not clear. He was calm, studious and had more sweat in
palms and soles. The symptom leaded a remedy which cured the
case.

Hereditary as a cause
Case-7
A 17 years old girl had white discolouration since four years. She
had the lesions in face, chest, thighs and around the nipples. They
tried all system of medicines and at last they opted homoeopathic
treatment as referred by a post master in their village. Her case study
illustrated that her grandmother from maternal side had developed
vitiligo when she was sixty years old and passed away. She was thin
built, medium in complexion and she is sensitive, shy, anxious and
fearful. The totality of symptoms according to the way of homoeopathic
study, revealed her as Arsenicum Album

After four months her mother started digging me with questions.

“Doctor! No improvement!” I consoled her “Please wait”. After two
months she developed dark pigmentation in the middle of the lesions
in face, later other areas also started improving. After two years, only
the discolored patch around the nipples was remained. Her mother
asked me “Shall she get married? I answered “Sure!” Now the patient
 67

Case - 7
 68

Case - 8
 69

had completely recovered from her complaints.

The genes which had the disease strain were carried out from
her maternal grandma and had exhibited its virulence when her
immune system was lowered in fighting against the disease force.
The material doses and sun exposure not helped, indeed the tiny dose
aroused the immune system to remove the strain from her body. So
the melanocytes retrieved the normal functions to give her the true
skin.

Thyroid dysfunction as a cause

Case-8
A 35 years old lady came with multifaceted complaints. She had
white discolouration on the cheek since three years. She additionally
had hypothyroidism and pain in joints. The understanding on
inner homoeopathic pathlogy of this case is the causative factor
hypothyroidism which inferred with metabolism of the cells. The
sensitivity of the melanocyte also disturbed which had presented
with white discolouration. Understanding all the problems together
a drug was selected and prescribed to the patient. After a year the
lesions disappeared and the parameters of thyroid were normal. Joint
pain was also better.
 70

Homoeopathy
Today many kinds of systems are available in the main stream of
medicine. Modern medicine pioneers in the field pertaining to their
efficiency in tackling the emergencies and its surgical interventions.
Homoeopathy is being practiced all over the world and considered as
second to modern medicine. Among the Indian system of Medicines
Ayurveda, Siddha and unani are practised in India. Many countries
like china own their traditional system of medicine.

The curative approach differs from system to system. Specific

disease approach is formulated in modern medicine. Medicines are
prescribed on the name of the disease. Most of the alternative systems
hold holistic approach which studies the body, mind and soul. Every
system has its own merits.

Many think that the Homoeopathy is Indian system of Medicine.

The real fact is that the Homoeopathy system is discovered by a
modern medicine physician, Dr.C.F.Samuel Hahnemann in Germany.
He discovered Homoeopathy system to treat the humanity without
side effects.
71
72
 73

He inspired the principle of Similmum which advocates the

medicine which is capable of producing the similar symptoms of
the disease. This can be easily explained for better understanding.
Today we learn about immunization, to tackle every infectious agent
of bacterial and viral origins vaccines are administered as the way
of prevention. When the same causative agents are administered in
vaccines and attenuated antigens it arouses the immunity.

Similarly medicines which have the tendency to produce the

similar symptoms of a disease can be prescribed successfully to arouse
the immunity and to induce the body to fight on its own.

Another wonderful understanding in Homoeopathy is

administration of tiny doses by potentisation. He realized that the
material doses may be necessary to tackle acute situations; but in
chronic ailments it could produce toxicity to the tissue to develop
drug induced diseases.

Everyone would be surprised to see how this small tiny globule

will act on our body! For instance, we know what will happen if a
snake bites us, when the poison is more it will kill, when the poison
is moderate it could paralyses the organ, but when it is in small dose
act as a medicine. Just think about the preparation of “Antivenin” the
Anti snake venom used for the treatment of snake bites. The Antivenin
is prepared from horse blood serum. A horse is injected with a small
amount of snake poison regularly to raise the immunity. When a
considerable result is attained the horse serum is administered as a
medicine to save the life of a snakebite patient.

Similarly minute doses always act as a stimulus and arouse the

immunity gradually to eradicate a disease. Dr. Hahnemann, father
 74

of homoeopathy inspired that many chronic diseases are the result

of invisible, dynamic disease producing power, which needs to be
tackled only by dynamic medicines. He contributed the method of
potentisation by diluting the medicine stage by stage and by inducing
the inert power of medicines. The genius of Homoeopathy lies in
potentisation

We cannot prescribe the medicines blindly in the name of disease

as the other systems adopt. The case study involves disease aspects
with physical and mental characteristic features of a patient. We can
say that Homoeopathy treat the patient, rather than a disease. The
real treatment lies with the study of the whole person. Of course while
case taking, many patients thinks that the questions are irrelevant to
their disease. But the questions are to infer the complete picture of the
individual.

Any changes in the organ, tissues, cells it would have some

alterations in the particular area with the pathological changes,
then changes in the body fluid. So scientifically such changes can
be detected by scientific parameters such as blood test, Urine test,
X-ray and imaging studies like USG, MRI. There are biochemical
changes that can be observed through the alteration in the blood,
lymph etc.

Another route is the nervous system which carries to the

immune system to arouse and by the serological studies, their imprint
can be studied. Similarly the endocrine system is also involved
in disseminating the message to the nervous system which gives
enormous feedback theories in medical text book. The hypothalamus,
the center for emotions gives rise to changes in emotions, will and
 75

behavior of a patient. It gives orders to the pituitary gland for better

functioning.

Generally we believe that the medicines are reaching our

stomach, absorbed, mixed in blood and reach the respective centers
to counteract, but homoeopathic medicines action is different.
When a sweet pill or a dilution is put on the tongue the medicine
stimulates the nerve endings in the tongue and the medicinal force
is disseminated to the body as a dynamic power. This is the reason
that Homoeopathic Medicines have been asked to chew it. Only a
moderate quantity reaches the stomach and the action is also expected
from respiratory system during gaseous exchange.

The clinical applicability is wide range; we cannot point out in

the name of disease. Finally we can say that Homoeopathy is a safe,
simple, effective scientific system of medicine.

Homoeopathic Medicines are prepared from herbs always?

The most Homoeopathic medicines are derived from plants,
but also from minerals or animal sources. Some of the medicines are
highly poisonous in their original, undiluted form and the patients
who learn that they are being given medicines derived from such
sources sometimes feel apprehensive, but the homoeopathic method
of preparation yields such extremely high dilutions that there is no
danger at all.

How the medicines are prepared?

The method of preparing the medicines is the process of diluting
the medicinal substance and inducing its inert healing power by
the method of potentisation. We know Nux Vomica is a poisonous
 76

nut. If it is administered in raw, material dose it could kill a person.

Homeopathically we use this as a wonderful medicine for several
complaints in the diluted form. Let us know how it is prepared. A
small grain part of Nux vomica is mixed with 100 parts of alcohol to
make the mother tincture. This is almost not toxic when administered
to the patients. But it is not practically used. The one part of the mother
tincture is diluted with 99 parts of alcohol to make the second potency
by potentisation. Then again the second potency is added with 99
parts of alcohol. So the process will continue as 3C, 4C… 30C…200C
and 1M and 10 M. You might have noticed these in a homoeopathic
prescription. When potency is raised it does not mean that it has
more medicines in quantity, it denotes the strength where the inert
medicinal properties are inherited to the alcohol by potentisation.
The potentised medicines has a power to stimulate the body like a
atomic power

Is there any restriction in taking Homoeopathic Medicines?

The medicines are allowed to dissolve in the mouth. Unlike the
allopathic medicines, which make your blood levels in quantity. Our
medicines are absorbed through the nerve endings of the tongue,
inhalation and small portion by absorption from the alimentary tract.
All potency medicines are advised to take on a clean tongue before
food. I usually advise my patients to avoid taking anything before
and after ten minutes.

Should we avoid taking coffee while taking Homoeopathic

Medicines?
There is a general belief that Coffee and Tea should be avoided,
but there is no good evidence that these substances really interfere
 77

with cure. Moreover there is a belief bitterguard, onion and strong

odours should be avoided. Clinically I had observed nothing interferes
the cure as such. It is therefore probably enough to avoid tea or coffee
for 10 or 20 minutes before and after taking the medicines

What type of diseases can be cured?

We have “pill for every ill”. Even though we treat acute disease,
public choose our system mostly for chronic ailments only that too as
as a last choice of treatment after trying all sorts of medicines. People
choose our system when they fail to achieve the benefit from other
systems of medicine. Our medicines prove the cure well enough in
many incurable diseases such as Asthma, Cancer, Myasthenia gravis,
Parkinson’s disease, Migraine and so on. It is clinically proved in
most cases. It is a surprise to our medical fraternity as we could cure
tumors with internal medicine. We treat psychosomatic disorders
also, ranging from anxiety to depression. It suits well for the children
in bringing immunity to many ailments such as cold, cough, sore
throat and other incurables ailments.

“I heard that homoeopathy medicines will aggravate the existing

disease and then cures!” Is it true?
It is seen in allergic conditions where the disease undergoes
suppressions by immunomodulators. For example in the treatment of
eczema which goes for suppression by topical and oral steroids. After
some time it may give rise to Dust Allergy or Asthma . Reciprocally
an Asthma patient on suppression could emit eczema. In such
conditions intensification of old symptoms could give more oozing in
the eczema . It could be a good sign of improvement in Homoeopathy
which shows the medicine had fitted well to the disease symptoms
 78

and cures in few months. Homoeopathic aggravation is very rare and

if the potency is administered correctly there will not be any suffering
of the patient . The cure is always gentle.

Who are qualified to treat? Like Allopathy do Homoeopathy have

Medical Colleges?
Institutionally trained Homoeopathic medical practitioners
are qualified to treat the patients. Indian government has enacted
an Act to protect the rights of a registered Homoeopathic medical
practitioner under Central Council Act 1973. State Councils or Boards
are formed under the respective state governments. They maintain a
register for the registry of the Qualified Homoeopaths who obtained
the prescribed qualifications.

There are 186 Homoeopathic medical colleges in India. The

curriculum is based on the same syllabus as an allopathic medical
college in relation to subjects, years of study etc. Now post graduation
is also available in many colleges.

How do you examine a case? Do you use the equipments like

stethoscope and B.P. apparatus etc.,?
Yes! We use all medical equipments for examination of a patient.
Normally we start with a routine medical history to arrive at a
diagnosis of a disease then gears up to study the constitution of the
patient. Constitution means the physical and mental build up of a
patient.

We look more into their peculiar physical and mental symptoms

together with the pathological state of a disease to individualise each
and every sick person to select a remedy. Here the emphasis is on those
 79

features, which distinguish one particular patient from others with

the same conventional diagnosis. Well two patients, both suffering
from rheumatoid arthritis; might receive different homoeopathic
prescriptions. We don’t prescribe on disease names! Homoeopathy
case taking is similar to fishing.

Are laboratory investigations necessary for a Homoeopath?

Yes, Investigations are absolutely necessary to diagnose a disease.
Even though we don’t give much importance to the common disease
symptoms we require to know the prognosis of a disease.

Diagnosis is common to all systems of medicine. Some

homoeopaths do not rely on investigations; they simply observe the
symptomatalogy alone. But it is dangerous, for instance, a patient
suffering from kidney stone, it rolls inside the pelvis according to the
gravity of urine and its movement gives pain. Here the pain cannot
be taken as a vague symptom. We cannot justify the size of the stone
during or after treatment. Therefore, investigations are must in most
of the incurable diseases. Do you advice surgery to your patients?

Yes, we are not against surgery. In our medical curriculum we

are not trained to identify and classify the case which appears to be
in need of surgery. Many of the so-called surgical cases can very
well be cured by Homoeopathic remedies, eg., Polycystic ovaries,
Chocolate cysts of the ovaries, Fibroids of the uterus, Cysts in various
other organs of the body, Chronic Tonsilitis, Sinusitis, Subacute
appendicitis, Renal calculi, Cholelithiasis etc.

At the same time we are trained to identify the patients for whom
surgery can only be helpful eg. Perforated peptic ulcer, Respiratory
 80

obstruction which need tracheostomy, Acute Appendicitis,

Strangulated Hernia etc.

While taking homoeopathic treatment if one happened to take

an allopathic medicine what happens? Will there be any adverse
reaction?
There is no good evidence that Allopathic drugs interfere with
Homoeopathic medicines. In any case, it is always undesirable to
stop conventional treatment without the approval of the concerned
physician. Sometimes patients healing power requires sometime for
stimulation until then you have to continue the drug and gradually
you can drop the allopathic drugs. There are no dangerous interactions
between homoeopathic medicines and modern drugs; because the
allopathic medicines are in material quantity where as homoeopathic
medicines are in diluted and dynamic doses. There could not be a
chemical reaction even if the patient happened to take the medicines
simultaneously such as in diabetes and hypertension.

Do you advice on diet to your patients?

Yes definitely! Diets are obstacle for recovery of a disease. They
are the maintaining causes of a disease. A person suffering from
jaundice has to follow a fat-free diet. Similarly in all diseases, such
as sweets in diabetes, salt in hypertension. Some homoeopaths as I
said before, believe that strong perfumes, spices, coffee and tea will
antidote a Homoeopathic medicinal action, but it is ill proved.

Everybody knows that Homoeopathic Medicines do not have

side effects. Now a days there is general fear of kidney failure.
What you say about that?
When a medicine is administered in material dose it may damage
 81

the kidneys. The material dose with short duration can be tolerated
by the kidneys. But if it is administered in heavy dosage for longer
duration then there is some possible complication. Moreover there
are many diseases that naturally damage the kidney. For example
Hypertension and Diabetes are very common.

Homoeopathy medicines never predispose such action because

of minimum and most diluted dynamic form. Our system is the safest
system for treating kidney failure also.
 82

Frequently Asked Questions

1. I want know whether the vitiligo spread to others? My
husband has white skin in the fingers, toes and genitals. Will
it affect me?
Vitiligo is not contagious at all. It neither caused by a bacteria,
virus, nor by fungus. Vitiligo is caused by the malfunctioning of
pigment cells, Melanocyte which fails to secrete the melanin pigments.
The skin turns white wherever it lacks the pigment. Many people
have misconception that it is contagious particularly with partners.
It never spreads even if they have intercourse

2. My daughter is 11 years old. Recently her lower lips colour

changed mild pinkish, sometimes looks almost white. She
is medium in complexion. She feels embarrassed when any
body asks for it and advices her for treatment. I had examined
her all parts of the body and told no changes in the skin
colour. I am quite afraid about her future, will it spread? Is
it curable?
This variety is mucosal type of vitiligo lesions. It usually self
limited and remain as such for long time. But it could turn to acrofacial
 83

type involving the fingers, soles, palms, navel, and genitals. Some
persons have the tendency to develop frequent mouth ulcers called
apthae and some dyspeptic complaints, such cases improve very
rapidly with homoeopathic medicines. If the lesions are true type
don’t be panic Homoeopathic remedies cured many cases.

3. I am 45 years. I have vitiligo since 20 years. First I had a

small patch on my left shoulder and almost within a year
all of my body turned white. I took allopathy, siddha and
ayurvedic treatment. I tried all oils, ointments, PUVA, few
turned back and then returned white. I was frustrated in
taking treatment. I have a doubt! If I take homoeopathy will
any thing go worse in my body? Any adverse effects will
happen?
Physiological doses always give a forcible stimulation to the
melanocytes. When the doses are more then the toxicity may give
adverse effects. The melanocytes which are in a paralyzed state
may give few patches to show their forcible stimulation. Second
thing that the vitiligo is a dynamic disease producing power; it
always reacts better to a dynamic medicines whatever the system
treats. Homoeopathic medicines are prepared to such minuteness,
potentized to inert the medicinal power to tackle the disease. If the
abnormality is absorbed it will work, otherwise it will safely go away
from the body without harming anything. It will not have any side
effects even if it is continued to their life time.

4. I am 52 years old. I attained menopause three years back.

Now I have small pin sized white spots in my forearm and
hands. Is it curable?
 84

This dysfunction of melanocytes occurs in some persons due to

hormonal indulgence. During menopause women undergoes lot of
changes in hormonal secretions, which could change the oxidative
function. It could be corrected with basic study. These kind of white
spots also occurred in some individuals after blood transfusion which
could be evolved due to auto immune reactions.

5. I heard that homoeopathy would aggravate the disease and

cure after. Whether my existing lesions will spread more?
No homoeopathic aggravation is seen in allergic reactions,
Vitiligo is a progressive disorder. The skin which appears as white
shows total dysfunction of the melanocytes. If the patient receives
a trauma that healing part remains white for long time. This shows
that already the dysfunction of melanocytes had initiated. Generally
the lesions respond very quickly if the indicated remedy fits well to
the patient, but in some cases the progressiveness is due to existing
disease force only and not by the medicinal force. Generally the old
lesions gets better and by reverse order of appearance is a good sign
for improvement.

6. How long it takes to recover. Public says that Homoeopathy

is slow acting!
The cure depends on the individual. We do not treat vitiligo in
the name of the disease; we treat the patient as whole to raise his
immune process to fight with the disease force. The result will be quick
depending upon the sensitization, reversible pathology in the body.
The response is similar to a small lesion and letions all over the body
is the same. Few patients had given response with in three months.
Some patients had responded after two years. We can not assure with
 85

time bounded treatment. A homoeopathic physician should apply his

mind on the vital changes, study them correctly to prescribe the most
suitable remedy for radical cure and give fast relief to the patients

7. I have vitiligo since three years in my lips, wrist and legs; I

took all types of treatment. I applied oils and stood in sunlight
for one hour every day. I found few patches turned back
and again it is white now. Is there any external ointments in
Homoeopathy?
We do not advocate any external therapy. We trust the dynamic
action of the drugs only to make the body to fight on its own. Usually
sun exposure could stimulate melanocyte to a certain degree by it
is transient action. Local applications, Ultra violet rays also render
the same to a patient. The reliability depends only that the immune
system action to nulliate the causative factors

8. I am having vitiligo since 10 years. If I get married will it

affect my kids? Shall we prevent it?
The genetics always differs from one generation to other
generation. It depends upon the genes that disease code inserted. It
may or may not. For example a fair lady married to a dark man gives
birth to fair or dark child. The dark may give birth to a fair child. The
disease genes are always submissive in generations to generations.

So a medicine which is possible to rectify the genetic code will be

suitable. We cannot say blindly that Homoeopathy could do wonders
or others do a lot.More research is needed, however in the present
state; the Homoeopathy has reached in treating the body on dynamic
plane.
 86

9. Why non vegetarian food is restricted for vitiligo patients?

Non Vegetarian foods are recognized by our body as foreign
proteins. Meat, Chicken, Egg Dry Fish , Pork or any kind could give
auto immune reactions rather than a vegetable origin. It is just like
blood transfusion!. When blood group is not matched the victim may
face grave consequences. Even after good cross matching I have seen
some patients with tiny white spots all over the body which could be
due to auto immune reactions . Clinically the vitiligo patients are less
in vegetarians, especially among Brahmins. Vitiligo patients can live
happily as vegetarians!

10. Would stress could cause vitiligo?

Stress will not be the basic cause, but could be an aggravating
factor. In our brain hypothalamus is the center for our emotions. It
usually picks up the information from the skin as a feed back and
order the pituitary gland to secrete more melanocyte stimulating
hormone. Similarly our emotions could modify the function of the
pituitary. Counseling is more important to over come such worries.
Homoeopathic prescription always based on such expression for
better prescription to a patient.

11. I have vitiligo over face, chest, fingers and toes. I am much
embarrassed in attending a function or meeting. Shall I put
some cosmetic camouflage to cover the spots ?
The discolourations could make low self esteem and feeling of
inferiority. There are make up materials available to match one’s skin
colour. These cosmetic camouflage can be used occasionally to attend
the functions, but prolonged use could sensitise the keratocytes and
 87

melanocytes affecting chemically. Natural colour like Henna, turmeric

can be used safely

12. I am pregnant and carrying since three months , I have

white skin and continuing Homoeopathic treatment. Shall I
continue during pregnancy?
Certainly! Homoeopathic Medicines do not have any adverse
effect since it treat your immune system not the disease. In fact other
allied illness can be tackled without your knowledge. The medicines
are more diluted and administered in dynamic form so it will not
have any side effects at all.

13. I am having a small white spot in my chest . I am getting

married soon. Shall I take homoeopathic medicine for
immediate recovery or shall I go for skin grafting? Which is
advisable.
We cannot predict the time limit in an individual since
the medicines are applied to arouse your immune system . The
susceptibility varies to individual to individual . Since the lesion is
single you prefer surgical aids, but if there are more lesions always
better to rely on medicines

14. I have the vitiligo patches all over the body. About 95%
covered with white skin. Is there any medication available
for complete bleaching. I heard great singer Michael Jackson
had bleaching.
Skin bleaching treatment are available only in modern medicine.
The chemical could affect the melanocytes functioning and make
the dark skin to white. Consult a dermatologist
 88

15. Why sour things are restricted in diet for vitiligo patients?
Sour foods are rich in Vitamin C, it interferes with oxidation
process in melanocyte by affecting the formation of tyrosinase. So
all citric acid foods to be restricted to minimum. So vitiligo patient is
advised to avoid all sour foods like lemon, orange, pickles, grapes.
However it is needed minimally to compensate the requirement of
vitamin C

16. How much time needed to cure a vitiligo patient?

This universal question will be expected every patient at the end
of the consultation. We cannot challenge or fix time limit for cure. If
the symptoms of the patient match the remedy the cure will be fast.
There are patients who responded within a period of three months
with normal pigmentation. I have seen one vitiligo patient showed
improvement only after two years. Generally the patients with dark
skin responded quickly than a fair skinned patients. Some patients used
to ask me to increase the dose to expedite cure as in modern medicine
by believing the material effect of medicines. Homoeopathically we
cannot do like that since the medicines are dynamic. The selection of
potency and medicine totally depends on the skill of a homoeopath.

17. I am having vitiligo since 3 years over my lips, forearm and

legs. I have tried PUVA therapy; some spots came and then
disappeared. I applied oil and showed to the sun every day
morning for one hour. Few spots recovered but vanished
again after few months. Shall I apply the oil and take
homoeopathy medicines together!
UV Rays, sun exposure and external oils would stimulate the
 89

keratocyte photoreceptors to stimulate the melanocytes by activating

the pituitary gland through the hypothalamus stimulation. It would
be beneficial to understand whether the melanocytes completely
destructed or functional disturbed, but it cannot yield permanent
result. Here we should stimulate our body immune system for
sustained effect and make our body to fight on its own. Homoeopaths
apply the medicines to arouse the body’s immunity. This is the reason
a Homoeopath takes more time in case taking to understand his mind
body in relation to the disease. We do not advocate any external
applications for Vitiligo.
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