The Use of Herbal Medicine in the Treatment of Vitiligo: An Updated Review

Abstract

Vitiligo is a chronic disease of unknown etiology that causes progressive cutaneous depigmentation. Current pharmacological treatments have limited success and present significant risks. Many efforts have been made in recent years to explore new anti-vitiligo therapeutic strategies, including herbal-based therapies. The objective of the present review is to provide an updated overview on the most frequently used medicinal plants in the treatment of vitiligo. A bibliographical search was carried out in scientific databases Pubmed, Scifinder, Scopus, Google Scholar, and Medline up to October 2021 using the descriptors vitiligo, herbal, medicinal plants, and alternative therapies. In our search, the highest number of published studies comprise plants commonly used in traditional herbal medicine, highlighting the usefulness of ethnopharmacology in the discovery of new therapeutic agents. The review outlines current understanding and provides an insight into the role of psoralens and khellin (photosensitizing agents obtained from plants such as Cullen corylifolium or Ammi visnaga). The paper also describes other traditional herbs such as Ginkgo biloba, Phlebodium aureum, Piper nigrum, Picrorhiza kurroa, and Baccharoides anthelmintica that can likewise act as potential therapeutical agents. Based on our findings, photosensitizing agents in combination with phototherapy, the association of oral Phebodium aureum with phototherapies as well as oral G. biloba in monotherapy showed greater scientific evidence as therapeutic options. The research results emphasize that further investigation in this area is merited. More long-term follow up clinical trials and higher quality randomized trials are needed.

A bibliometric and thematic analysis of the trends in the research on ginkgo biloba extract from 1985 to 2022

“…Despite GBE having a wide range of pharmacological effects, its clinical application is limited and controversial [ 37 , [109] , [110] , [111] , [112] ]. The first meta-analysis confirmed the efficacy and good tolerability of GBE was patients who suffered from dementia [ 111 ], then effects on tinnitus and dizziness were demonstrated [ 113 ], but showed no prevention of acute mountain sickness [ 114 ]; subsequently, GBE in mono-therapy showed greater scientific evidence as a therapeutic option for vitiligo [ 115 ]; then, Ji HJ et al reported GBE appears to improve neurological function and dependence compared with conventional therapy for ischemic stroke at different stages, however not ameliorate in recurrence rate for ischemic stroke patients [ 11 ]; Kuo CY summarized several conflicting studies exploring the neuroprotective effect of GBE in the clinical treatment of glaucoma, drawing the conclusion that whether GBE is effective in the treatment of glaucoma further large clinical trials still need to be justified [ 116 ]; Liang N et al reported GBE could help mild cognitive impairment patients to prevent progression into dementia and to improve the ability of daily living activities [ 117 ]; Xie et al showed GBE relieves dementia symptoms in early-stage Alzheimer's disease sufferers after high doses and long-term use of GBE from clinical studies [ 118 ]. Ahmad et al summary of randomized control trials determined that the combination of GBE and pharmaceuticals has far better effects than only allopathic treatment for dementia; they also report that consider different herbal remedies in combination with FDA approved drugs are effective and more promising than monotherapy in the treatment of Alzheimer's disease [ 119 ].…”

An extensive review on phenolic compounds and their potential estrogenic properties on skin physiology

“…Ginkgo biloba extract promotes repigmentation in vitiligo (Castillo et al, 2023). Carnosol from rosemary reduces inflammation markers in mice.…”