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  5. How To Treat Hypopigmentation With Ayurveda?

Is your skin losing colour in patches? Skin hypopigmentation can spread rapidly if not treated on time.

Repigmentation is a difficult process if the condition reaches a progressive stage. However, the ancient science of Ayurveda cites the use of certain powerful herbal remedies that can stimulate melanin production by holistically treating the underlying medical condition.

Read on to know more about the types, causes and best treatment options available to cure hypopigmented patches on the skin.

Our Ayurvedic Doctor Speaks

“Autoimmune hypothyroidism - Hashimotos’s thyroiditis may also cause white patches on skin.”

-Dr. Zeel Gandhi, Chief Ayurvedic Doctor at Vedix.

What Is Meant By Skin Hypopigmentation?

Your skin derives its natural tone from a pigment called melanin which is synthesized by special cells known as melanocytes. However, some skin conditions, inflammation, infection, injuries and certain medications may affect melanogenesis, causing low melanin production and discolouration of your skin. This is known as hypopigmentation [1].

Hypopigmentation occurs when melanocytes in your skin lose their ability to produce enough melanin or there is a reduction in the number of melanocytes. This may affect the whole body or can be limited to specific skin areas giving you lighter or white coloured patches. The size and number of the patches depend on the condition causing hypopigmentation.

According to Ayurveda, amongst the three Doshas or bodily humours that govern our body functions, Bhrajaka Pitta Dosha (a sub-type of Pitta dosha) determines the production of melanin. When an imbalanced Bhrajaka Pitta vitiates the ‘Medho dhatu’ (fat tissue) resulting in low melanin synthesis and patches of hypopigmented skin. Hypopigmentation is classified as a Kushta or skin disease and is referred to as ‘Shwetakushta’.

What Do Hypopigmented Patches Look Like?

Hypopigmented spots are patches on your skin that are lighter than your original skin colour. They can occur in any part of your body. Hypopigmentation can affect anyone, however, it's common among people with dark skin tone.

Does Hypopigmentation Go Away?

Hypopigmentation resulting from inflammation may disappear on its own. Ayurvedic treatments and home remedies can speed up the healing process and restore your natural skin tone. However, conditions like Vitiligo may be difficult to treat.

What Are The Causes Of Hypopigmentation?

medical Illustration of the symptoms of vitiligo

1. Inflammation

When your skin suffers an injury, the immune system triggers a healing process that involves inflammation. This can result in melanocyte damage at the site of the wound causing hypopigmented patches.

2. Immune Dysfunctions

Hypopigmentation can be caused by certain autoimmune diseases where an overactive immune system attacks healthy body cells. Vitiligo and hypopigmented sarcoidosis are the most common examples of hypopigmentation from an autoimmune disorder. 

“Autoimmune hypothyroidism - Hashimotos’s thyroiditis may also cause white patche son skin

3. Age

There is a general reduction of melanocytes as your skin ages. After the age of 40, research shows a 10 to 20 per cent decrease in melanin-producing cells per decade, thus increasing the chances of developing hypopigmentation.

4. Infections

Certain viral, bacterial and fungal infections of the skin can affect melanosis resulting in skin damage and the occurrence of hypopigmented macules. Some examples include pityriasis versicolor, progressive macular hypomelanosis (PMH), leprosy.

“Helminthic infections may also cause Hypomelnosis on the face in children” says Dr. Zeel.

5. Nutrition Deficiency

Deficiencies in Vitamin B12, iron, copper and protein can affect your skin’s production of melanin. Kwashiorkor, a condition that occurs from severe deficiency of protein, can cause hypopigmented patches in different parts of the body.

“Calcium, Vitamin D and Vitamin E deficiency often causes white patches on skin.” she adds.

6. Skin Lightening Creams And Skin Resurfacing Procedures

The constant preference for lighter complexion amongst certain races has driven people of various cultures to take extreme measures to lighten their skin tone. This includes the usage of skin lightening creams that contain harmful substances such as steroids, hydroquinone, mercury and other toxic ingredients. In a recent study, many such creams were found to induce vitiligo and hypopigmented patches among the users [2]. Active ingredients in such products incapacitated the melanocytes causing localised hypopigmentation.

Skin resurfacing procedures like chemical peels, laser therapies and dermabrasions are often followed by hypopigmentation as a common side effect.

7. Arsenic Exposure

Constant exposure to arsenic from water and other sources can be highly damaging to human skin. It can result in hyperkeratosis, hypopigmentation and an increased chance of developing skin cancer.

8. Medication

Medication induced hypopigmentation occurs due to dilution of already created melanin or inhibition of tyrosinase (an enzyme required to produce pigment melanin). The following list of drugs are known for causing pigment disorders in patients:

  • Drugs for treating various types of cancer ( lung cancer, melanoma, leukaemia) are often known for inducing hypopigmentation and vitiligo in patients. It may begin gradually with localised hypopigmented patches and become more generalised with prolonged use.
  • Blood clotting medicines containing Tranexamic acid, used for treating menstruation disorders decrease the synthesis of prostaglandins. This in turn affects the production of melanin from the amino acid tyrosine.
  • The drug Chloroquine, which is often used to treat malaria, has been found to cause hypopigmentation and worsen the conditions of Vitiligo.

9. Genetic Influence

Genes are often a determining cause for hypopigmentation skin disorders. One is most likely to suffer from hypopigmentation if someone in the family has a history of it.

10. Pituitary Failure

The condition of Hypopituitarism, which involves decreased production of pituitary hormones can have various dermatological manifestations such as hypopigmentation.

Types Of Hypopigmentation

When classified under a broader category, Hypopigmentation is of 2 types - Congenital and Acquired. Listed below are some of the most common types of hypopigmentations that fall under these 2 broader categories.

A. Congenital Hypopigmentation

1. Albinism

One of the most known congenital hypopigmentation disorders is albinism. In this condition, there is either a complete or partial absence of the pigment melanin. It occurs when your body inherits a special type of gene which affects the production or distribution of melanin. With an absence of melanin, people with albinism are at a greater risk of skin damage from sun exposure and skin cancer.

2. Vitiligo

woman with vitiligo skin problem on face

An auto-immune disease that has a strong genetic influence. Though the exact cause of Vitiligo [3] is still under research, scientists believe that the body’s immune system attacks healthy melanocytes causing either a decrease in their number or a reduction in their ability to produce enough melanin. Vitiligo is more common in people who have a family history of the condition. Patients with Vitiligo have hypopigmented patches on their faces, hands, necks and the folds of their skin.

3. Congenital Piebaldism

Piebaldism [4] is a genetic disorder affecting the development of melanocytes. It is characterised by a white forelock and/ or other multiple hypopigmented patches all over the body. The affected areas have a complete absence of melanocytes.

4. Angelman Syndrome

The angelman syndrome

People with Angelman Syndrome [5] have a pleasing personality and tend to laugh and smile a lot. It is a genetic disorder that causes disability in speech and development. According to research, tyrosinase inactivity causing skin hypopigmentation is one of the characteristics of this condition.

5. Waardenburg Syndrome

A genetic condition that causes alterations in skin, eye and hair colour. Along with hypopigmentation, people diagnosed with the Waardenburg syndrome may also face partial loss of hearing.

6. Menkes Syndrome

In Menkes Syndrome, a genetic mutation affects the distribution of copper in the body. Copper deficiency leads to weakened muscles, delayed growth and nervous system disorders. Menkes syndrome also causes a deficiency in the enzyme Tyrosinase, which results in skin hypopigmentation.

B. Acquired Hypopigmentation

1. Post-Inflammatory Hypopigmentation

scar on man hand skin after accident

Post inflammatory hypopigmentation [6] is a classic example of acquired hypopigmentation. It occurs from inflammation caused by skin tissue damage, topical medication or dermatological treatment or injury (burns, wounds). Due to the inflammation, melanocytes in the area suffer damage, leading to hypopigmented patches.

Post inflammatory hypopigmentation often recovers quickly with minor treatment if the condition causing it ceases to exist. The most common skin diseases that result in post inflammatory hypopigmentation are:

2. Leprosy

A chronic bacterial infection caused by the Mycobacterium leprae bacteria affects the nerves, skin, eyes and nose. It is characterized by hypopigmented patches and numbness in the affected areas. Leprosy if detected early can be cured within a few months of treatment.

3. Pityriasis Alba

A condition that causes red, scaly patches to occur on the skin. Once these lesions heal they leave behind hypopigmented patches. Pityriasis alba often occurs along with eczema and may get aggravated with sun exposure.

4. Pityriasis Versicolor

Pityriasis Versicolor is a fungal infection of the skin caused by an overgrowth of Malassezia yeast. The fungal growth causes light, flaky, hypopigmented patches on the chest and back. The condition is not contagious and can be cured within a month with treatment.

5. Halo Nevus

This skin condition is characterised by a mole with a hypopigmented ring (halo) around it. It is quite common in children and adults. Such moles have a 4-step development process after which they fade on their own. Though its exact cause is unknown, the body’s immune system perceives the mole as a threat and attacks the pigment producing cells in it. This is also responsible for the lighting of the surrounding area.

Halo nevus is usually benign but it is advisable to check your mole for abnormal growth and protect it from sun exposure.

6. Idiopathic Guttate Hypomelanosis

Several factors such as a decrease in melanin, age, sun exposure, influence the occurrence of Idiopathic Guttate Hypomelanosis. It is characterised by small hypopigmented spots on the skin. People with a lighter complexion are more prone to developing this condition.

7. Lichen Sclerosus

It's an uncommon condition of the skin that causes thin, hypopigmented patches. Lichen sclerosus commonly affects the genitals. The affected areas tend to be itchy, red and painful and often require treatment.

8. Chemical Leukoderma

man's hand covered with white vitiligo spots

Chemical leukoderma or contact hypopigmentation is a condition caused by the loss of skin pigment due to exposure to certain chemicals. These chemicals include aromatic derivatives of phenols, catechols.

In India, leukoderma from constant use of bindis has become a rising dermatological problem. Other substances causing pigment disorders are rubber shoes, wallets, low cost hair dyes, alta etc. The affected areas in chemical leukoderma have hypopigmented patches of varying sizes depending on the causative factor.

Unlike Albinism, people with Vitiligo are not born with hypopigmentation. The condition may begin to show up in a young person before they reach 20. It can also emerge later as the person grows old.

How Do You Get Rid Of Hypopigmentation

A. Home Remedies

The best way to treat your hypopigmentation is to detect what is causing it. If your hypopigmentation is occurring from an infection, antimicrobial home remedies are likely to resolve your issue. For chronic inflammatory skin diseases like eczema, psoriasis, it is advisable to first treat the condition to heal your post-inflammatory hypopigmented macules.

The home remedies listed below will protect your skin, prevent aggravation of the condition, increase its immunity and help regain its original colour.

1. Oatmeal Exfoliation

Gentle exfoliation may help remove patchy hypopigmented macules and increase your skin’s cell turnover rate. Oatmeal being anti-inflammatory and anti-bacterial helps your skin fight inflammatory conditions and infections causing hypopigmented patches.

How To Use

Grind colloidal oatmeal and add lukewarm water to form a coarse paste. Gently exfoliate the hypopigmented patches and wash them off after 10 minutes.

2. Aloe Vera

Use aloe vera as a moisturizer and sunblock for your skin hypopigmentation. Aloe vera reduces skin irritation, fights bacterial infections, keeps the affected areas hydrated and protects them from harmful UV ray exposure.

How To Use

Apply freshly extracted aloe vera gel on the hypopigmented patches. Aloe vera is light and can be left on the skin for long hours.

3. Mineral Infused Water

Using herb infused water that is heated in Copper or Iron vessels are known to reduce vitiligo patches. Storing your drinking water in copper vessels may also be helpful.

How To Use

Take 10 to 15 basil leaves. Put it in water and heat it in a copper or iron vessel. Cool and strain the water and use it regularly to reduce hypopigmentation of the skin.

B. Ayurvedic Treatments

1. Ayurvedic Herbs

A. Bakuchi

The Ayurvedic herb Bakuchi has been used to treat skin hypopigmentation and Vitiligo for ages. It is well known for its amazing skin healing abilities and gradually reduces hypopigmentation spots on the skin.

B. Haritaki

Haritaki is an ancient remedy for treating various skin diseases. It is frequently used to treat hypopigmentation spots and patches. Being an antioxidant, it fights free radical damage to melanocytes. Haritaki also helps reduce anxiety in patients suffering from hypopigmentation.

C. Manjistha

Manjistha is frequently used in various Ayurvedic medicines to cure several skin diseases including hypopigmentation. It helps rejuvenate hypopigmented skin and return it to its original colour.

D. Guduchi

Guduchi is one of the best treatments for hypopigmentation caused by autoimmune diseases. It is known to strengthen your immune system and destroy melanocytes.

E. Ginger

Ginger is often used for treating minor skin hypopigmentation. Its anti-inflammatory properties are also effective against infections and post-inflammatory hypopigmentation.

F. Khadira

If hypopigmentation is detected in the early stages, using Khadira daily can prevent its progress. Khadira works like magic on the hypopigmented macules and reduces their appearance on your skin.

2. Panchakarma Therapy

As per Ayurvedic belief, skin diseases including hypopigmentation, are to a certain extent caused and aggravated by the accumulation of harmful Ama toxins in the body. The Panchakarma Therapy which is an amalgamation of 5 detoxifying procedures, removes such toxins from your body. It also enhances your body’s ability to absorb medication and nutrition thus aiding the natural healing process. The 5 procedures involved in treating hypopigmentation are:

A. Virechana - Detoxifying through the use of purgatives.

B. Nasyam - This involves purging through the nasal cavity.

C. Vamana - Medicated vomiting.

D. Basti - Enema with the use of Ayurvedic medicine.

E. Snehavasti - Enema with medicated oils.

3. Ayurvedic Diet For Hypopigmentation

Diet is an important part of any Ayurvedic treatment. The right foods help balance your Doshas, heal and detoxify your system.

A. Drink lots of water and keep yourself hydrated.

B. Avoid foods that have a sour taste, meat, fish, sweets and also foods that are rich in phenols.

C. Consume bitter foods like neem, bitter gourd, moringa.

D. Green leafy vegetables such as kale, lettuce are often cited as good for people with hypopigmentation.

Vedix Tip: Applying a paste of mustard seeds or mustard oil on the hypopigmented patches can prevent progression of the condition and help in regeneration of melanocytes.

C. Essential Oils

Abhyanga or herbal massage is an important part of the hypopigmentation treatment in Ayurveda. The below listed essential oils have shown promising results in preventing certain hypopigmentation conditions.

1. Thyme Oil

A rich source of antioxidant compounds, Thyme Oil has been often used along with other medication to treat skin hypopigmentation. It is also anti-inflammatory, antibacterial and antifungal, thus allowing it to treat various conditions that may cause hypopigmented patches on the skin.

2. Myrrh Oil

The amazing wound healing properties of Myrrh Oil make it an apt hypopigmentation remedy. Its antioxidant properties and anti-microbial abilities help it fight infections and aid cell regeneration in hypopigmentation patients.

3. Neroli Oil

Neroli oil is packed with skin benefitting natural compounds which have anti-inflammatory, antimicrobial and antioxidant properties. It soothes skin irritations caused by infections and helps in rejuvenating hypopigmentation affected skin.

D. Medical Treatments

phototherapy dermatosis -treatment of skin diseases

1. Phototherapy With Narrowband UVB

In this treatment, skin areas affected by hypopigmentation are exposed to narrow UVB wavelengths [7] for a specific time. The exposure to ultraviolet light prevents immune dysfunctions thus treating hypopigmentation caused by autoimmune diseases.

2. Afamelanotide Implant

New research shows the efficacy of using Afamelanotide along with narrowband UVB phototherapy in treating hypopigmentation, especially Vitiligo. Afamelanotide is an analog of a-MSH (a hormone that stimulates melanocyte formation). It is administered as a subcutaneous implant and often used along with narrow band UVB phototherapy as a combination therapy to treat skin hypopigmentation.

3. Psoralen And UVA Light (PUVA)

Psoralen is a medicine that sensitizes your skin to light and enhances the effect of phototherapy. Psoralen is available in pill and ointment forms. After taking or applying Psoralen on the skin the hypopigmented patches on the skin are exposed to UV light for a set period of time.

4. Skin Grafting

Skin grafting for hypopigmentation is highly effective when treating minor discoloured patches like the ones caused by leukoderma. According to patient reports most treated with skin graft achieved successful repigmentation.

5. Laser Therapy

Minor hypopigmented patches may be treated with laser therapies. However, laser therapy for hypopigmentation is often used in combination with other treatments or topical medicines.

E. Other Topical Medications

1. Topical Corticosteroids

Topical corticosteroids are known to prevent the spread of hypopigmentation due to their anti-inflammatory properties. They can even help stimulate melanocyte growth and repigmentation. However, topical steroids have side effects such as skin thinning, stretch marks, if used as a long term treatment.

2. Topical Calcineurin Inhibitors

Topical calcineurin inhibitors come in cream and ointment forms. These medications prevent the immune system from attacking healthy melanocytes thus reducing the progression of hypopigmentation. Topical calcineurin inhibitors are often prescribed to treat hypopigmentation in sensitive areas. This kind of medicine is comparatively safe for long term use.

3. Calcipotriene

Calcipotriene is a known medication used to treat psoriasis. It is a synthetically produced derivative of Vitamin D. Often used along with other therapies, Calcipotriene may be effective in regenerating pigment in skin areas affected with hypopigmentation.

F. Post-Inflammatory Hypopigmentation Treatment

Post-inflammatory hypopigmentation from minor injuries usually resolve on their own within a few weeks without treatment. However, if a larger skin area is affected, topical steroids, skin grafting and photo therapies will be useful.

How To Prevent Hypopigmentation?

1. People prone to hypopigmentation from inflammatory skin conditions such as eczema, psoriasis, must take necessary precautions to avoid flare-ups.

2. Treat infections and injuries promptly to prevent long periods of inflammation.

3. For hypopigmentation from chemical leukoderma avoid objects and chemicals your skin is allergic to.

4. For congenital hypopigmentation conditions like albinism, prevention is not possible. Hence, one must protect the hypopigmented patches from direct sunlight. With the absence of melanin, such spots are more vulnerable to skin damage from sun exposure. This may also increase chances of skin cancer.

Hypopigmentation Vs Vitiligo

The major difference between hypopigmentation and Vitiligo is that hypopigmentation is an umbrella term used to define all conditions of pigment loss. Vitiligo is a specific congenital condition that causes loss of skin pigment. To put it simply, Vitiligo is a hypopigmentation condition but all hypopigmentation conditions are not Vitiligo. Vitiligo treatments may also differ from other hypopigmentation condition treatments.

The best way to know whether your hypopigmentation is Vitiligo or not is through a Wood’s Lamp test. In case of Vitiligo, when the Wood’s Lamp, a UVA light, is held close to the affected skin, the hypopigmented patches show up as fluorescent white making it easy to diagnose. However, a skin biopsy is a more sure way of detecting the type of hypopigmentation your skin is affected with.

Frequently Asked Question About Hypopigmentation

1. Is Hypopigmentation Permanent?

Congenital hypopigmentation disorders such as albinism are permanent. However, cases of acquired hypopigmentation such as post-inflammatory hypopigmentation, hypopigmentation from fungal or bacterial infections are curable with treatment.

2. How long does it take for hypopigmentation to go away?

How long it will take for your hypopigmentation to go is entirely dependent on what is causing it. Minor post-inflammatory hypopigmentation usually disappears in a few weeks time. For infections or chemical exposures causing hypopigmentation, the patches are likely to heal once the condition is treated or exposure is prevented. Other acquired conditions of hypopigmentation may take months or even a year to completely heal with regular treatment.

3. Can hypopigmentation lead to complications?

Hypopigmentation is benign and often harmless. Keep your affected areas safe from direct sun exposure as the lack of melanin protection may result in skin damage. However it is advisable to consult your doctor if the cause of your hypopigmentation is unknown to avoid risk of complications.

The Last Word

Hypopigmentation as a condition is harmless and can be curable if its cause is diagnosed correctly and timely. With the advancement of Ayurvedic and contemporary medical science, repigmentation is becoming more successful in a majority of cases. However, there is no overnight solution to the condition. Skin hypopigmentation needs patience and constant treatment to heal completely. Thus, maintain an Ayurveda recommended diet and skincare to keep your Doshas balanced and ensure complete healing.

Know Your Dosha Now

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