Psychosocial Trauma – Leucoderma

LEUCODERMA HAS been testing patience of both Hmoeopaths and patients due to its distant healing. I call lueoderma, psychosocial trauma and an emotional-shock having a lasting effect for the sufferer. In Indian society, it has psychosocial effect and people look down upon the sufferer. It is not cared for much in Europe and America since their white skin does not reflect dominance. ‘Phulberi’ in Hindi and ‘Safed khusht’ in Ayurved, is a worry for parents, despair for relatives and inferiority complex for the sufferer. It does not kill the body but the spirits. In ‘Arthava veda’, it is a disorder of Vata, Pita and Kuff’. In Allopathy, both toxic and tropho-neurotic theories have been invoked to explain its phenomenon. Application of ultra violet rays, arc-light baths and surgery are some of the suggestive treatments. In Homoeopathy, it is due to miasmatic dyscrasi
Leucoderma changes the color of skin to white but does not alter its texture. Skin has roughly two layers. Layer of vascular connective tissues called corium and external covering of epithelium called epidermis or cuticle. Epidermis consists of five layers. The third from within outwards layer contains the pigments (melanin), which imparts color to the skin. Melanin is formed in cells called melanocyte carries the melanosomes to epidermal kerotocyes, which further transport the same to epidermal surface. Besides imparting color to the skin, melanin protects the skin from rays of sun. Skin does not change its color only due to lack of melanin. Ithas emotional and physiological impacts. We become white with fear, red with anger and blue with cold. Such conditions can be attributed to blood vessels of skin and yellowish ring of skin tissues. It has nothing to do with melanin.
When melanin is totally absent in the body, it is called Amelanosis. A child born with such absence is called Albino. Vitiligo and leucoderma are same. Leucoderma is broader outlook consisting of vitiligo and albinism. In India, vitiligo is common. It is an acquired disease characterized by progressive disappearance of normal pigmentation in course of time. It has an erratic map-like spread, defined by white smooth patches. It is of three types, mucosal, focal (limited area) and generalized (allover).
Hereditary miasmatic condition IS responsible for leucoderma. Syphilis is the miasm, which flares it up owing to diet or environmental exciting reasons. Physical trauma like injury, sunburn, constant friction, use of inferior cosmetics and psychological trauma like shocks, death and anxieties are precipitating causes. Tight ring, bangles, friction from persistent tight wearing of cloth string around waist use of inferior ‘Iip sticks’ and vermilion (Sindoor) flares it up. Excessive smoking and chewing tobacco also precipitates it, when on or around lips. It is common in India in the age group of 10 to35 years. However no age, sex or race is immune to it. It is not infectious or contagious disease.
The typical lesion of leucoderma has white chalk color with a’ shine. At places within it, brown tan exists. If the site is covered by hair, they turn gray. Family history is responsible in about thirty five percent of cases, according to a study. The white patches of skin are more visible in summer and less during winter. This is due to tanning of normal skin during summer. The process of whitening of skin is very slow taking years. The ptches have map-like demarcation of white and normal skin color. In advance cases, even dark (normal) skin appears abnormal. Complete loss of pigmentation is a rare phenomenon. The sites of vitiligo are back of hands, finger mail joints, neck, scalp and genital regions but it can be anywhere on the body. The general health is not affected.
At times chaloasma is confused with leucoderma. Chloasma has yellowish or brown patches and not exactly white. It is better to examine the patches in abundant natural light than checking under bulb light. Chloasma has concave lines of lighter surface surrounding pigmented areas whereas leuco-derma shows convex lines of whiter surface surrounded by hypertrophical pigments. Chloasma skin is firstly thickened and trophied. It may have light brown, yellow brown, or fawn color patches. Face is common location for it. Neck, back, arms and chest are also favorite locations. White spots appearing in random on the faces of growing children are not confusing since they are very light in color and in the sunlight they will not be visible. These pateches are due to worms most of the times. For the beginner-homoeopaths, it is better to send the patients to skin specialist for confirming the disease.
Prognosis is favorable and relief is possible in Homoeopathy. It has a distant healing, Both doctor and the patient require plenty of patience. Initial improvement may take months or years but once the pigmentation starts, the progress is rapid. Leucoderma has related manifestations like Psoriasis, Addison’s disease, Typhoid, Alopecia areata, Goiter, hyperthyroidism and Diabetes Mellitus etc. If any of these diseases are combined with leu- coderma, it is difficult to get any relief.
Like all diseases, leucoderma is systemic disorder. It is either inhabited or acquired miasmatic dyscrasia. Psora, Sycosis and Syphilis miasms may be responsible, either Once this is done, the treatment become! easy. The precipitating factors should also kept in mind. Causes like effects of vaccinations, Allopathic drugs, use of inferior quality cosmetics and injuries should be taken care of but totality of symptoms is primary method to find a remedy. Treatment has to be changed according to changed symptoms. No local applications are required on white spots but staining the white skin can be done to infuse confidence in the patient; It is only coloring just like dyeing gray hair. Disease remain intact. The staining may be weak solution of Iodine or Walnut juice. In Rajasthan, I have seen villagers using one-year-old mustard oil taken from mango pickles jar. Application of grinded seeds of ‘Babchi’ (Psoralia) mixed with cow milk is also a good coloring agent. Another coloring agent is juice of Brinjal (Cutting the brinjals and rubbing them on the spots). Sun tanning is needed after these
The selected remedy should be given in 200 potency initially. Going in for higher potency is a matter of decision after considering changes in. the silvery color of pigmentation, smooth skin to rough skin, fading 0sharpness of edge-lines, feeling of well being improvement in appetite and sleep, good drainage and overall satisfaction. If two or more said changes are observed, it is time to go in for higher potency. If a new depigmented area develops on the skin and it does not  increase rapidly, there is nothing to worry, Wait and watch is the best policy here with placebo intact for the patient. Use of LM potencies is said to be free of aggravations. No comments on the results since I have not used these. Here are few guidelines for the beginners:
· Try to find out the miasmatic background of the patient.
·   Ask for a photograph of white spots (any one prominent area). Without it, you cannot identify the changes.
·   Limb-wise remedies as per Kent’s repertory (Arms-Ars. Wrists – Mere sol and so on)
or lower limbs (Legs-Alum, Ars, Calc etc) or particular one part of the body does not work always. Repertory can lead you to a-remedy provided it has coinciding symptoms of patient in Materia Medica.
·  Family history like tuberculosis, vitiligo etc can be clue to find miasmatic remedy.
Emotional status should be taken into serious consideration. This includes anger, anxiety, cruelty, carelessness, fears like that of dogs, animals, ghosts, crowds
and darkness etc.
·  Constitutional aspect is also needed. Obesity (CC, NM, AUR) leanness (ARS,
NM, PHOS, SUL ere), dark or fair complexion, desires, aversions, menses etc. also help.
·  The most important is selecting remedy based upon all other symptoms of the body except the white spots.
Whilee medies, sometimes we commit blunders. I cite here a case of a twelve-year-old girl who had leucoderma on her feet. The reason stated was wearing and friction of ‘hawai chapal’ and some allopathic injections given to treat very high fever. Those were ‘V’ shaped diffused white spots. The skin specialist diagnosed it as leucoderma and she was on allopathic medicines since four months. The spots had further increased. I tried many medicines (Arnica, Thuja etc.) basing upon the causation but without any response. After two months of treatment, I referred her to a. senior homoeopath. He advised me to select a remedy basing upon present symptoms and not causation only. She had frequent bouts of painless diarrhea, craving for cold milk, distention of bowels and other symptoms of Acid phos. Needless to say that all the spots were cleared within a month although Acid phos. has no such skin symptoms. One learns from experience. Selection of remedies like Dulcamara, Rhus developed my own concepts about causation and failed. At present I am having eight cases of vitiligo in our charitable. clinic. They have partial removal and fading of white spots but none has recovered fully after years of treatment. One must understand that leucoderma is a challenge for the doctor. If the patient has patience, definite cure is possible but the irony is that most of the patients divert to other therapies when they get fed up with longer medication. Only those who cannot afford costly treatment of allopathy stick to homoeopathy and eventually gain. Here are views of some scholars of homoeopathy on use of remedies for your information. R.B. Bishamber Das advises use of Tuberculinum
200 as an intercurrent remedy and Arsenic sulf flavoum for daily use. If ASF failed, he used Hydrocotyle. N. C. Ghosh used Azadirecta and ASF as per above procedure. TP. Chatterjee advised Thuja and Syphilinum as basic medicines with ASP. He also cautioned that amoebiasis and internal parasitic infection, if any, must be removed before commencing treatment. B.S. Bhandari recommends Natrium mur 3x internally and its
powder rubbing externally. Sidharthlankar recommends Argentum met. 1 M and Arsenic alb. 1M with ASF 3x. Also Drosera and Selenium, if symptoms agree. P.S. Khokarhas cured his patients by mixture of Hydrocotyle 3x (1 part), Echinacea 3x (1 part), ASF 2x (1 parts), Gynocordia 2x (1 part) and Psoralia Q (4 parts). One drop of mixture should be taken four times a day. Those who believe in polypharmacy can try this mixture. ‘Vitiligo is difficult to cure permanently, Patient should be told about limitation of Homoeopathy in advance’, says Farokh J. Master. Coming to Arsenic-sulf-flavum, it is said to be specific. I have my doubts that it may not work at all if given as specific. It can be given when there are symptoms like difficult respiration, pain behind the ear, sensation of needle-pricks accompanying leucoderma. I have not seen any patient having the above symptoms with leucoderma and hence not used ASF. Kent says, ‘ ASF is one of our deepest remedies for Psora and syphilis, especially in old broken constitutions. Anxiety, confusion, over-consciousness and general despair make this remedy useful for vitiligo.’
In Ayurvedic system of medicine, ‘Nishidh Aahar’ or taking two dis-similar foods together create many diseases (including leuocoderma). For example salt and sugar in equal quantity, honey and water or milk in equal quantity, milk and fish or milk and meat and pigeon meat by itself are said to be vitiligo-producing agents. Taking combinations like milk-curd, milk-brinjals, milk-wine, milk-urad dal and milk-muli may precipitate or produce this disease. During treatment, it is better to avoid all types of non-vegetarian food and buffalo milk. Milk contains citric acid and it is said to obstruct production of melanin. Hahnemann says in ‘ Chronic Diseases’ that all dishes containing vinegar or citric acid are injurious for chronic diseases. He further says that moderation in all things, even in harmless ones, is the chief duty of patients suffering from chronic diseases.
Homoeopaths should take case of leucoderma as a challenge. The strange thing about leocoderma patients is that they will not reveal any other symptoms of the body till you dig them out through your art of questioning. The dread of leucoderma itself is so mindblowing that patient prefer to declare healthy and fit except their leucoderma. A good deal depends upon arriving at totality of symptoms.