Wednesday, November 9, 2011

Vitiligo and Zinc

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Vitiligo is a common depigmenting skin disorder characterized by acquired, idiopathic, progressive, circumscribed hypomelanosis of the skin, and hair. It is generally agreed that there is an absence of functional melanocytes in vitiligo skin and that this loss of histochemically recognizable melanocytes is the result of destruction.

Vitiligo is the most prevalent pigmentary disorder with an incidence rate between 0.1-2% showing multifactorial etiology and polygenic inheritance. The effects of vitiligo can be cosmetically and psychologically devastating, resulting in low self-esteem, poor body image, and difficulties in sexual relationships.

Because the disease is still not understood, there is a plethora of different treatments including topical corticosteroids, calcineurin inhibitors, vitamin-D derivatives, phototherapy (ultraviolet [UV] A, narrowband UVB), photochemotherapy (psoralen plus UVA [PUVA], psoralen with sunlight [PUVAsol]), surgical techniques, and combination of topical therapies and light treatment. These current treatments are largely unsatisfactory.

On the other hand, there are few controlled trials assessing efficacy of natural health products (e.g., vitamins, minerals, herbal medicines, and other supplements) for vitiligo, but those that have been published generally show weakly positive outcomes with few adverse reactions.

Zinc, as a trace element, has many vital functions in human. It is antiapoptotic factor and needed as a cofactor for antioxidant defense system. It plays an important role in the process of melanogenesis. It may be effective in prevention and treatment of vitiligo via some mechanism.

For the first time Nooshin Bagherani, Reza Yaghoobi and Mohammad Omidian from

the Department of Dermatology, Jundishapour University of Medical Sciences, Ahvaz, Iran has shown that topical corticosteroid in combination with oral zinc is more effective than topical steroid alone. Although this efficacy was not statistically significant in this study, it appears that more robust long-term randomized controlled trials with more patients, maybe with high doses of oral zinc are needed to fully establish the efficacy of oral zinc in management of vitiligo.

The authors investigated some probable protective mechanism for zinc in association with vitiligo in their scientific paper published in the November 2011 issue of the Indian Journal of Dermatology.

These mechanisms include:

  1. Zinc, via preventing apoptosis of melanocytes may be able to control vitiligo.
  2. Zinc can control vitiligo through inhibiting production of free radicals.
  3. Zinc may be effective in melanogenesis in vitiliginous lesions.
  4. Zinc may stimulate cell-mediated immunity against probable infective and other factors contributing in vitiligo development.
  5. Zinc has a role in the synthesis and release of á-melanocyte stimulating hormone.
  6. Zinc via Zinc á-2-glycoprotein (ZAG), a plasma glycoprotein, regulates melanin production by normal and malignant melanocytes.

Journal Reference:

Bagherani N,
Yaghoobi R, Omidian M. Hypothesis: Zinc can be effective in treatment of vitiligo. Indian J Dermatol 2011;56:480-4. CLICK HERE for the full text

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