Botanicals in Dermatology: An Evidence-based Review

Juliane Reuter; Irmgard Merfort; Christoph M. Schempp

Disclosures

Am J Clin Dermatol. 2010;11(4):247-267. 

In This Article

6. Vitiligo

Treatment of vitiligo by UV exposure combined with oral or topical application of photosensitizing plant extracts goes back to ancient times, 1200–2000 BC, when A. majus was used in Egypt and Psoralea corylifolia in India for photochemotherapy.[120] Modern oral methoxsalen PUVA therapy of vitiligo seems to be inferior to standard narrowband UVB therapy,[121] which nevertheless is not fully satisfactory. However, the combination of narrowband UVB therapy with oral administration of CPF (P. aureum or P. leucotomos) extract 250 mg significantly increased repigmentation on neck and hand areas in comparison with placebo plus narrowband UVB, as was recently shown in a randomized, double-blind trial with 50 patients treated twice weekly for 25–26 weeks.[122] The difference was less pronounced on the trunk and extremities[122] [LOE-A]. Another clinical observation of 74 vitiligo patients investigated the therapeutic efficacy of Xiaobai mixture in comparison with a control group treated with PUVA. The therapeutic effect of Xiaobai mixture was better than that of PUVA.[123] Unfortunately, the ingredients of Xiaobai mixture and the LOE are not clear since the full text of this study is only available in Chinese. A recent review of natural health product treatment for vitiligo criticizes the quality of studies performed with plant materials but acknowledges that phenylalanine in combination with phototherapy and oral Ginkgo biloba are promising.[124]

Oral administration of an extract of gingko (G. biloba) 40 mg three times daily over a 6-month period was effective in a double-blind, placebo-controlled trial in 52 patients with limited, slowly spreading vitiligo[125] [LOE-A]. Ginkgo significantly induced cessation of active progression, and 10 of 38 patients compared with 2 of 22 patients in the placebo group showed marked to complete repigmentation. However, no information about a long-term follow-up was available. Antioxidant and immunomodulatory properties of ginkgo may be the underlying mechanisms. Since ginkgo is the most prescribed botanical medicine, this treatment appears to be safe.

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