Influence of Oral Supplementation of Vitamins A and E on the Effectiveness of Vitiligo Treatment

Abstract

Oxidative stress plays an important role in the development of vitiligo. The aim of our study was to assess the effect of oral vitamin supplementation with antioxidant activity on the effectiveness of the vitiligo treatment. The study group consisted of 46 patients suffering from nonsegmental vitiligo for over a year. Before and after the therapy, the clinical advancement of the disease (VASI) and impairment of quality of life (DLQI) were assessed in all patients, and the activities of selected antioxidant enzymes (SOD, CAT, and GPx), lipid peroxidation products (MDA), and vitamins A and E were determined. Each patient was randomly assigned to one of three therapeutic groups: FOTO (UVB therapy at 311 nm, 3x a week for 4 months), WIT (oral antioxidant supplementation-vitamin A + E at a dose of 5000 IU of retinol and 400 mg of tocopherol), and FOTO + WIT (combination therapy). After the treatment, an increase in all antioxidant enzymes and a decrease in the concentration of malondialdehyde in patients were noted, regardless of the therapeutic method used. The greatest improvement in the repigmentation of skin lesions was achieved in patients treated with combined therapy (VASI −6.95 ± 4.69, p < 0.01 , DLQI −1.90 ± 2.77, p = 0.011 ). The burden of patients with risk factors for oxidative stress turned out to be associated with a greater severity of the disease process, and a longer period of disease was positively correlated with a reduction in the quality of life in patients.

A systematic review of case series and clinical trials investigating systemic oral or injectable therapies for the treatment of vitiligo

“…Administering oral 8‐methoxypsoralen on three alternate days per week at a dose of 0.6 mg/kg body weight, in addition to standard treatment, did not show a statistically significant difference compared to standard therapy alone ( p = 0.052) 38 . In another study, the most significant improvement in the repigmentation of skin lesions was observed in patients who received a combined therapy of oral antioxidant supplementation (vitamin A + E) at a dose of 5000 IU of retinol and 400 mg of tocopherol, along with phototherapy 39 …”

“…37 Additionally, the combination of vitamin A and E has been associated with significant improvement in vitiligo lesions. 39 Vitamin E has been indicated for the treatment of various skin diseases, including Yellow nail syndrome, Subcorneal pustular dermatoses, Cutaneous amyloidosis, Atopic dermatitis, and Hailey-Hailey disease. 60 The treatment of vitiligo can also be added to this list of indications.…”

“…Significant improvements in vitiligo recovery have been observed with the combination of vitamin E, carotenoids, and P. emblica 37 . Additionally, the combination of vitamin A and E has been associated with significant improvement in vitiligo lesions 39 . Vitamin E has been indicated for the treatment of various skin diseases, including Yellow nail syndrome, Subcorneal pustular dermatoses, Cutaneous amyloidosis, Atopic dermatitis, and Hailey‐Hailey disease 60 .…”

“…38 In another study, the most significant improvement in the repigmentation of skin lesions was observed in patients who received a combined therapy of oral antioxidant supplementation (vitamin A + E) at a dose of 5000 IU of retinol and 400 mg of tocopherol, along with phototherapy. 39…”

Oxidative Stress and Potential Antioxidant Therapies in Vitiligo: A Narrative Review

“…Studies suggest that the combination of vitamin E with psoralen and ultraviolet A (PUVA) phototherapy may prevent oxidative disorders resulting from PUVA therapy, but did not improve clinical improvement of vitiligo lesions [ 91 ]. However, the combination of narrow-band ultraviolet B (NB-UVB) with oral supplementation of vitamin E may increase the efficacy of therapy [ 92 – 94 ].…”