Vitiligo (Safed Daag) or Leucoderma is a non-infectious disorder of skin; where white lesions (patches) are formed. Vitiligo is caused by stoppage of melanin (color pigment) formation by melanin producing cell, melanocyte; as a result depigmented macules are formed. These macules may vary in size and shape and can be located in any part of body even on mucus membrane of lips and genitals. 

The common areas affected are face, hand, feet, axillae, groins and trunk. The areas which are subjected to friction and trauma are usually involved and anywhere in skin white depigmented scar is formed. 

Vitiligo can also be precipitated due to these causative factors: 

1. Persistant pressure of string of underwear or in a person who wear tight string of underwear 
2. Use of plastic slippers (over dorsa of feet), plastic bindi and rubber gloves 
3. Use of rubber brassieres. 

In Ayurveda all the skin ailments are usually described under the head “Kusth”.  Vitiligo in Ayurveda classical text is described as “Svitra” or “Shveta Kusth”.  While classifying Kusth in its 18 main types ancient Ayurvedic erudite had omitted Vitiligo due to its non infectious nature. 

The lesion of Vitiligo is painless and remains sensory unlike leprosy. Except the cosmetic defect Vitiligo is an absolutely harmless disease. 

Treatment: There is a common myth about the Vitiligo that it cannot be cured but contrary to this; remarkable repigmentation can be achieved in every patient and its spread can be arrested provided that patient follows dietary restrictions and take appropriate treatment for prescribed duration. A proper assessment of known causative factor of Vitiligo; such as plastic slippers; gloves; and other plastic materials; pressure or traumas is very mandatory and if any such factor is the cause, instruct the patient to discard them. T

The Ayurvedic concept regarding the treatment of Vitiligo is comprehensive.  Both Sodhan (Purifications) and Saman Chikitsa is being advocated for the treatment.  

Sodhan is chiefly performed with liquid extract of Kakoudambur (Ficus Hispida) with sugar lump. 

Saman Chikitsa is mainly composed of: 

A. Kastha Aushadhi (Herbal drugs )
B. Ras Aushadhi (Herbo-mineral drugs) 

A. In group of Kastha Aushadhi there are mainly 2 types of drugs: 

1. Photo Sensitizing Drugs
2. Blood purifiers 

1) Photo sensitizing drugs: It includes Psoralea corylifolia (Bavachi) Ammi Majus (Aatri lal) Semicarpus anacardium (Marking nut) and Ficus hispida (Kakoudambur). These Drugs are used locally as well as systemically with sun exposure. Sun exposure is usually advised after 3 hours of oral administration; and 45 minutes of local application of the medicines at least for 10 minutes. These drugs are given once a day during daytime only because without sun exposure these drugs cannot initiate repigmentation. 

2) Blood Purifiers : As Svitra (Vitiligo) is a disease of Rakta Vikrati (Auto immune disorder) therefore blood purifying drugs like Curcuma longa; Eclipta alba; Tinospora Cordifolia; Hemidascus indicus; Acacia catechu; Acaranthes aspera are used to redress the blood morbidity. 

B. Ras Aushadhi (Herbo-mineral drugs): It includes chiefly Ras Manikya, Taal Sindur, Sameer Pannag Ras, and Talkeshwar Ras. These drugs act like an Immuno Supressant and usually used in those patient where spread of disease is very fast to arrest the spread of disease. Tamra Bhasm; Kashish Bhasm; are also used to initiate repigmentation. After initiation of repigmentation; treatment must be continued till the desired complete repigmentation of all the lesions is achieved. But some stubborn lesions especially of mucosal surface of palms and fingers tips; sometimes respond very poorly or incomplete. These residual repigmented area can be subjected to camouflage. For this Paste made from Mehndi (Henna) leaves is applied to affected area or lotion made from root of Plumbago Zeylenica in absolute alcohol is painted over skin. This impart natural colour which last for two or four days.     

Image (c) Gettyimages.com