Complementary and Alternative Medicine for Vitiligo

We are in an era of modern medicine that is defined by rapid change. Scientists are accumulating and analyzing scores of genomic data, however, the majority of data being accumulated on vitiligo has not been appropriately archived or systemized for analysis (Alikhan et al, 2011; Spritz, 2011). The pathogenensis of vitiligo is multifactorial, and includes three main factors: genetic, immunological, and environmental. Clinically, environmental factors are important in the development of vitiligo. Trauma, eczema, chemical agents, and fragility of keratinocytes play a role in development of vitiligo, so treatment decisions should be made taking these factors into account (Alikhan et al, 2011; Lee et al, 2005). Historically, vitiligo was deemed to respond relatively poorly to treatment with a high recurrence rate, therefore, there is at times a reluctance to advise treatment. Recently, various treatment modalities have been introduced, and treatment options and outcomes have been improving. Excimer laser, phototherapy, epidermal grafts, and lifestyle modification have improved the results of treatment and quality of lives of patients with vitiligo (Felsten et al, 2011). South Korea is a country (approximately 1/7th the size of Texas) with excellent modern medical facilities for the treatment of vitiligo. There are 130 practices where eximer lasers are commonly used and more than 70 practices can provide surgical management (epidermal grafts). Nevertheless, many patients seek alternative medical options, including oriental medicines and folk remedies for treatment of their vitiligo. Dermatologists should have an objective point of view on how to use and combine complementary and alternative medicine (CAM) with modern medicine. This chapter will review the various complementary and alternative medicines and evaluate their efficacy and safety to validate their reliability.