Skin Problems: Vitiligo and Smoking
Vitiligo commonly called as ‘leucoderma’ is a condition in which there is a development of milky-white patches on the skin. Those with vitiligo and their families are treated differently in society leading to low self-esteem, and even serious depression. Hence, it is a life changing to those who have it even though it is not physically incapacitating.
skin called melanocytes, die. The cause of this still remains elusive to scientists. Multiple factors such as genetics, a faulty immune system which attacks its own cells (auto-immunity), and increased free radical-induced damage (oxidative stress) may be causative.
Cigarette smoking is proven to have deleterious effects on nearly all systems of the human body. Along with nicotine, smoker’s inhale 7000 other chemicals in cigarette smoke which reduce health in general and have long-term damaging effects.
Even second-hand and third-hand smoke can be injurious to health. The most damaging compounds in tobacco smoke include tar, carbon monoxide, cyanide, toxic metals (lead, arsenic and cadmium) and free radicals. Smoking is known to increase oxidative stress and deplete stores of glutathione a natural antioxidant in the body. One of the important causes of cell death in vitiligo is accumulation of free radicals like hydrogen peroxide and other reactive oxygen species (ROS).
The cyanide in smoke also prevents the activation of vitamin B-12 (cyanocobalamin) to its active form rendering it useless. Vitamin B-12 deficiency is associated with slow repigmentation in vitiligo. Hence, smoking can accelerate the progression of disease or hamper the repigmentation process.
Hence it recommended that vitiligo patients who smoke should cut back and eventually stop smoking. In addition it may also be beneficial to avoid second and third-hand smoke. Methods that have been found to be effective are individual and group counselling and medications including nicotine replacement therapy and varenicline.
Vitamin B-12 in its active forms (methycobalamin and adenosylcobalamin) can be supplemented. N-acetyl cysteine supplements can build up the body’s stores of glutathione. Following a rainbow diet which incorporates fresh fruits and vegetables of different colours provides a variety of antioxidants like carotenes, anthocyanins and flavonoids which help quench free radicals. Carotenes also protect the skin from the damaging effects of ultraviolet rays of the sun. Exercise and calming techniques like meditation and yoga can help reduce the stress associated with both vitiligo and smoking cessation.
*Data Courtesy: Dr. Rickson Pereira, M.D. (Dermatology, Venereology & Leprosy), F.C.P.S. (Dermatology & Venereology) D.D.V (CPS), M.B.B.S, Consulting Dermatologist, Dr. Minal’s Dermatherapie Centre.
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