This little understood disease causes progressive loss of normal pigment (melanin) in variously sized and shaped, white, smooth, sharply defined patches.

Above all, it has long been linked to hypochlorhydria, or hydrochloric acid deficiency in the stomach. Although it is common to associate hyperacidity with heartburn and gastric discomfort, hypoacidity is a much more common cause of such distress. Low stomach acid, linked with such diverse conditions as diabetes and underactive thyroid, is quite a common problem, causing poor protein digestion and chronic malabsorption of most minerals and some vitamins. These deficiencies seem to contribute to the loss of pigment.

Drinking milk can aggravate the condition. It takes so much hydrochloric acid to acidify milk that little is left for other components of the meal. This can result in an incomplete breakdown of the nutritional components (Nebraska Med J, 1931; 16:25-26; Lancet, 1971; i:1331-4).

My own experience is that a large number of vitiligo sufferers have low or even absent hydrochloric acid production in their stomachs. This can be accurately tested (with a Heidelberg pH capsule gastric analysis, for instance). About 45 per cent may stop the condition from progressing or often even reverse it once the hydrochloric levels in their stomachs is corrected.

The herb Angelica atropurpuraea is used to help vitiligo (Am J Hom Mat Med, 1856, 1: 272). However, since it can induce photosensitivity, you must be wary of sun exposure while taking it, restricting exposure to no more than half an hour per day.

In homeopathy, there are no specific homoeopathic remedies for vitiligo, but success may be achieved with the long term use of such remedies as Arsenicum album, Ferrum phosphoricum, Nitricum acidum or Zincum phosphoricum, (F M Dearborn, Diseases of the Skin, New York: William Radde, 1913).

In Ayurvedic Medicine, for over 3000 years, Psoralea coryliforia combined with natural sunlight has been used successfully to treat vitiligo (Pharmacol Ther, 1987; 34: 75-97).

In aromatherapy, bergamot oil is applied to the white skin patches and then exposed to sunlight. Although this has been described as an uncertain method of treatment, I have personally seen several successful cases. Do not use bergamot indiscriminately, and never neat, but always under professional advice.

Supplementation with paraamino benzoic acid (PABA) has on occasion caused vitiligo (J Am Academ Dermatol, 1983; 9: 770). However, nutritional supplementation with copper may be beneficial as it activates tyrosinase, which is necessary for the production of melatonin. Low levels of melatonin can result in vitiligo (Clin Chim Acta, 1972; 37: 207-11).

One highly successful treatment in Egyptian medicine concerns Ammi majus, also known as bishopsweed. A tincture of the herb is painted on the depigmented areas, which are then exposed to the sun for, at most, a half hour. At the same time, powdered Ammi majus seeds are also given internally, 4-6g per day. This is said to have remarkable sucess in restoring pigmentation (R F Weiss, Herbal Medicine, A B Arcanum, Gothenburg, 1988; Fortschritt der Medizin, 1976; 94(29):1595). Nevertheless, WDDTY panellist Melvyn Werbach has unearthed one study demonstrating that applying the herb topically is ineffective, suggesting that taking the herb orally is what actually works (Botanical Influences on Illness, Third Line Press, Tarzana, Ca, 1994).

Harald Gaier is a registered naturopath, homoeopath and osteopath.