Are there successful vitiligo treatments? Yes, there are but “there are currently no treatments for vitiligo that effectively promote complete repigmentation with long-lasting effects while preventing recurrence.”
Vitiligo is caused by 2 main things: a trigger event and the autoimmune response to that event.
- The trigger event induces a stress response in the skin and body. Such trigger events are known to be:
- sunshine exposure
- skin cuts and abrasions
- phenolic chemicals exposure
- unknown trigger events
- The autoimmune system responds to the stressful trigger event by attacking the cells that create pigment.
The current successful treatments for vitiligo do not deal with the underlying factors that cause vitiligo, these treatments address the symptoms of vitiligo, skin depigmentation. Without intervention of some kind, the patches of depigmented skin generally expand and spread. Over time a person can lose all pigment. Current vitiligo treatments include:
Topical treatments for vitiligo include:
- corticosteroids, calcineurin inhibitors, and vitamin D analogues
Phototherapy treatments for vitiligo include:
- narrowband UVB (NB-UVB)
- psoralen
- UVA (PUVA)
Topical treatments for vitiligo
- corticosteroids, calcineurin inhibitors, and vitamin D analogues
- Topical prostaglandin analogues
- Immunosuppressive drugs like Elidel
Oral and systemic treatments
- Oral corticosteroids
- Minocycline, an antibiotic
- Oral statins
- Janus kinase (JAK) inhibitors
- Afamelanotide
Oral vitamins and supplements:
- Vitamin B12
- folic acid
- vitamin C
vitamin E - L-phenylalanine
- khellin
- polypodium leucotomos
- Ginkgo biloba
- alpha lipoic acid
- zinc
Procedural treatments for vitiligo
- CO 2 lasers
- laser-assisted dermabrasion
- autologous punch
- suction blister grafts
- split thickness grafts
- needling
The vitiligo treatments that almost worked for me:
I was introduced to several successful vitiligo treatments by two dermatologists for my vitiligo. The treatments I was prescribed was Narrow Band UVB Phototherapy for my vitiligo along with Elidel. UVB phototherapy is a standard treatment for many skin ailments such as vitiligo, psoriasis and eczema. Repigmentation did happen for me. The treatment worked, and worked fairly quickly. It took 6 months for me to realize that problem with this treatment.
Initial trips to the doctors office for treatments were very quick. A few mins, in and out. But the treatment needs to be longer and longer each week and it kinda snow balled pretty quickly. After 9 months, treatments of phototherapy were taking 1.5 hours 3 times a week when I included drive time. It was cutting into my work and weekend schedule. It was also cost me and my insurance quite a bit of money. I was paying about $300-$400 per month for these treatments. My insurance? About 5 times that amount.
So between the time and the money, I had to evaluate whether the progress I had seen was enough to keep going and would it be enough to make vitiligo go away permanently?
I got a second opinion to consider my options. The second dermatologist I went to was incredible. He wanted to know all my questions up front. Gave me lots of time to ask any type of question, my concerns about side-effects, my curiosity about the function of certain drugs and then answered all my concerns with commanding authority. He explained what the scientific community knows about vitiligo – it’s an autoimmune disorder, it’s progressive and there is no cure. I already knew these things but I didn’t know about the side effects of the treatments. The treatments then, and now all have side-effects with long term use, and for some treatments with short-term use. For Elidel, The FDA required the drug manufacturer to place a black label on elidel because of the side effects that warned people of the risk. My first doctor did not warn me about these risks. The second doctor recommended I make an informed choice about long term use of medical treatments for vitiligo. He did not recommend further treatments for vitiligo because of the long term use side-effects. I decided to go another way, because of the time and money investment and the risks associated with long term use, which would be required for my case.
While many dermatologists online and during office visits downplay the rates of side-effects, the reality is that long-term use studies related to vitiligo treatments are not available.
Phototherapy side-effects include:
- Melanoma – Cancer
- Skin aging
- Melanoma
- Headaches and nausea (with PUVA treatment)
- Sunburn
- Cataracts from insufficient eye wear during treatment
The Problem With Vitiligo Treatments
Hmmm. Let’s consider this for a minute. You have a skin condition, rooted in a faulty immune system response to stress and the medical treatments for vitiligo only go skin deep. They don’t stop vitiligo from coming back at anytime, anywhere on the body. Additionally all these treatments have side-effects, including cancer.
For Elidel the second treatment prescribed for my vitiligo, here is what the label of the drug reports, as found on the FDA.gov website:
WARNING
Long-term Safety of Topical Calcineurin Inhibitors (Elidel) Has Not Been Established
Although a causal relationship has not been established, rare cases of malignancy (e.g., skin and lymphoma) have been reported in patients treated with topical calcineurin inhibitors, including ELIDEL Cream.
Therefore:
Continuous long-term use of topical calcineurin inhibitors, including ELIDEL Cream, in any age group should be avoided, and application limited to areas of involvement with atopic dermatitis.
ELIDEL Cream is not indicated for use in children less than 2 years of age.
…ELIDEL Cream should not be used in immunocompromised adults and children
…The safety of ELIDEL Cream has not been established beyond one year of non-continuous use.
What is the most important information a patient should know about ELIDEL Cream?
The safety of using ELIDEL Cream for a long period of time is not known. A very small number of people who have used ELIDEL Cream have had cancer (for example, skin or lymphoma). However, a link with ELIDEL Cream use has not been shown.
Because of this concern:
A patient should not use ELIDEL Cream continuously for a long time.
ELIDEL Cream should be used only on areas of skin that have eczema.
ELIDEL Cream is not for use on a child under 2 years old.
I’d like to highlight one key point:
…ELIDEL Cream should not be used in immunocompromised adults and children
If you have vitiligo, your immune system is not working right. Your immune system is behaving in a compromising manner by killing healthy cells in your skin that produce pigment. And Elidel was prescribed for vitiligo, without understanding the core pharmacological function, as made perfectly clear on the label, and for a chronic skin condition, a skin condition that will likely return post-treatment for many people.
With an increased chance of deadly disease like cancer and you can have some of your pigment back temporarily.
That does not appeal to me anymore. Also, the idea that the treatment sessions for Narrow Band UVB Phototherapy for vitiligo are short is false. They are short in the beginning. As the treatment progresses as it must, the sessions get longer. I was at the point where I was getting treatments 3 times a week and sessions we lasting 50 minuets per session. 4 hours out of my week for a more normal skin pigment and an increased chance of getting skin cancer.
How do we define success when it comes to vitiligo treatments. Normal skin pigmentation? Is that it? If the answer is yes, normal skin pigment is all we are after regardless of the side effects, then there are successful vitiligo treatments through the medical system.
I think we ought to ask ourselves about the price of being normal or beautiful. Are we willing accept a potentially shorter life in order to have a standardized skin tone? I am not willing.
More cancer risk? Two treatments were prescribed that increased my risk of cancer. No warnings. They just sold me. Over the course of those months in treatment I cost my insurance company tens of thousands of dollars. What if I get cancer 20-30 years from now? How much will that cost an insurance company? Is this a wise course of action?
You get treatment for a disease that is not at all life threatening and your chance of getting a deadly disease increases.
What is normal skin pigmentation worth? And can we get rid of vitiligo without deadly treatments?
Is there another way? Yes there is.
A holistic approached to chronic disease more and more became the obvious best route for me to deal with vitiligo. Vitiligo represents a very serious problem in the body that is progressive. With vitiligo The immune system is malfunctioning, attacking healthy cells. It’s generally progressive in nature, so it keeps spreading. And, there is a good chance that vitiligo will be accompanied by another autoimmune disease. How good? A 25% percent chance. 1 in 4 people with vitiligo will develop another autoimmune disease. Multiple autoimmune disorders.
Not medical vitiligo treatment deals with the potential for multiple autoimmune disorders.
So how do we approach vitiligo in the context of our lives, our dreams and our health, long term? What’s a sustainable approach to taking care of our whole self to reverse vitiligo naturally?
The first place began was to consider how I dealt with stress. I looked to understand the sources of my own stress such as my emotions, choices at work, and dietary choices, daily habits, life goals, spiritual life and social inputs.
Here is what I found: a holistic approach to life that incorporates maximum health, purpose and reality about where we are now, can make vitiligo vanish from our worries & vanish from my skin.
The odd thing is that a successful vitiligo treatment is not about vitiligo, it’s about your life and your health. What do you want? How do you want to deal with stress as it shows up? Do you look to the root causes? Do you consider the long-term? Do you think about side-effects?
Successful vitiligo treatment for me has 0 side-effects. A holistic approach is the only approach that actually deals with the underlying issues fully.
I explain more about my own approach and how it can help you on my webinar. You can sign up to watch it here:
“THE 5 STEPS TO STOP HIDING AND START HEALING VITILIGO!”
Sources:
Miriam Vitiligo Mira says
For my vitiligo treatment I use a medication called Tacrolimus which is similar to the Pimecrolimus you mentioned in your article and I begun bleeding in both my eyes. You can see the pictures on my blog.
I therefore, had to ask myself the same question you asked, “What is normal pigmentation worth?” and it definitely was not worth blindness.
I therefore stopped the conventional treatments and I was cured after attending a healing service though I have been applying some essential oils to the affected areas.
Ramona says
What do you mean by “healing service”?
Does that actually work??
vivian says
what is healing service, pls give us some details please….
sujata says
please let me know about that natural healing.Does it really work?
Rajinder Kaur says
Can you tell me what is natural healing? What do you have to do?
Ann says
My 5 year old and husband have Vitiligo. My hubs started showing it about 8 years ago and our 5 y.o. last year. It’s progressed so much in one year and I feel so helpless. She is okay with it and I’ve become okay too. I just truly hope she continues to be so positive. I’m so happy that you shared your experience with these treatments – I’ve been looking into them, and get very skewed remarks.
Keith says
Hey Ann,
Thanks for stopping by!
I am glad you found my experience helpful.
Have you considered exploring if your husband and child have any food allergies? Getting tested would be a place to start in my mind. I have found the changes to my health substantial.
I bet that your child’s positive attitude is because of the job you are doing as a parent. Bravo! Keep up the good work. The sense of confidence comes from the knowledge of your love. That is a gift!
Have you read the emilys vitiligo story?
Here is the link: http://vitiligo.50webs.com/
Saw your website: looks like you are having fun as an expat.
Best,
Keith
Ann says
I have not looked into food allergies… Is their a connection? Ironically, the hubs has an allergy test in a few weeks, I will have to ask about the food thing. Maybe I’ll get our 5 y.o. an appt. too. This is all so new to us. Of course, I’ve read about it, and we’ve excepted it, but I honestly don’t know where to start.
Thank you for sharing Emily’s story… I have it book marked and hope to read it today.
I’m not sure what the doctors are doing in the States… But here, in Germany, I’ve been told by our pediatrician and dermatologist that there is nothing that can be done. You just have to accept it. Not the answer, or compassion, I was hoping to hear.
I’m looking forward to reading your story and becoming a more active member of the Vitiligo community. Again, thank you for putting yourself out there!!
Keith says
Hey Ann,
For me the connection between food allergies and vitiligo is this: vitiligo is a disease and the problem is unknown so its best to understand as much as possible about each individuals body. If someone is allergic to gluten, like may, might there be a connection between inflammation caused by that gluten intolerance and the inflammation that is vitiligo? Autoimmune is not well understood by the medical establishment and it seems as though the alternative medicine practitioners have better options. I guess is depends on your willingness to explore health in a broader perspective. There is not much science that is helpful for people like us looking to deal with vitiligo.
My goal is to be as healthy as possible, be as well nourished as possible and stay clear of treatments that may have long term side effects.
I saw a dermatologist that teachers at the Stanford School Of Medicine that told me the same thing as the doctors you talked to. There is no cure, there are treatments, yet those treatments all come with side effects that may or may not be show stoppers for you. Each person needs to make an informed choice. As a disease that is cosmetically damaging only, it does not get much research dollars.
So glad to have you as a member of the global vitiligo community. It is always great to hear from someone that is struggling with the realities of this disorder and life. Feel free to email me with any questions or please comment here on the site. Many people come back to the site just for the comments! Thanks for being here.
Best,
Keith
Wazi says
My 4 yrs old daughter is having vitiligo.First i had consulted one doctor and he suggested streoids and execare cream.We had applied same cream and streoids for 4 months but there is no improvement.Then we consulted some other doctor and this doctor suggested phototherapy UVB and Pimecrolimus cream.My daughter had three times UVB in a week .I could see some improvement .Do phototherapy UVB has any side effects?.
layla says
Hey Keith!
i been reading about your website and its pretty good, i have vitiligo around my mouth,and i been seeing around 7 dermatologist,the keep saying that i should,start using Elidel cream, but i did some search and there is plenty side effects,is elidel can cause spot spreading?Can u give me some advise pls.
Tnx.
ANAND says
I was having a white patch on my right eye side since past four months.I am using a homeopathy cream Ammi Visnaga since two months.The 80% patch area has been covered with bit black marks(hypermelanan) .
But another patch at my right chin (the place where the jaw bone ends) which was only a faded sketch two months back ,became visible developed..
Then I went for allopathy medicine treatment.There they took some blood tests and then confirmed the case as Virtiligo.They refered a cream Tacrolimus and a sunscreen Suncros and asked me to undergo phototherapy with two times a week.
The doctor is saying that the sitting will recover the patch in three months.
However by going through your comments I am quite in doubt wheather to start the phottherapy i.e.PUV B exposure to be continued for three months.
Please help me and suggest honestly wheather I should undergo Phototherapy or NOT.
Please help.
Priyanka says
does tht homeopathy cream Ammi Visnaga work? m looking for the cure for my 7 year old sister , we have reffered a lot of doctors ut nothing is working , pleaserevert back !
Radha says
I have vitiligo nd it is spreadin all over my body after I went for PUVA treatment at albert luthuli hospital. If anyone knows of a cure please let me knw. Thanks nd GOD bless
Sophia says
Hi,
My 12 year old son just started a white patch around his eye. I took him to the doctor and we were told he’s got vitiligo. After a lot of research and based on people’s experience I was recommended to get him ginkgo biloba tablet 120mg from Walmart . I am very optimistic about using it. Hope it work for you too. But first you have to not stress yourself about it, get good sleep. Start a healthy diet with green vegetables. Get vitamin b12, vitamin C and vitamin D. You will improve by the grace of God ?
Ken Tsak says
I have had Vitilago for about 10 years , I have heard nothing new from doctors , when I get a flare up IE : Face or hands I use pro topic cream a inhibitor twice a day a sunsceen and a UVA-UVB hand held wuan , I try and get sun on the areas and over a period of a month or so the spots dissipate and disappear Vitilago is a auto emmune issue and I also take Synthroid to handle my thyroid condition, yes the two do go hand in hand , if you suffer from this chances are your vitamin D and B12 levels are low get bloodwork done and stay away from the 3 times a week UVB narrow band crap it’s just not worth the cancer risk , KENNY
KD says
Hey Kenny,
Not sure you will see this since you posted this a while back but let me know if you can, where I can get a UVB wand that isn’t 800 dollars in the US. I want to try UVB treatments but I am uninsured and the costs are way out of my league. Any information on cheaper costs for UVB lamps would help but all the searches I have done reveals high prices in the US and not sure about quality units outside of US. If you see this, let me know.
Yhanks
Ken Tsak says
Note one other option is the psorholyn not sure of the spelling You apply to the spots and get sun on those areas , however care with how much sun should be considered KT
Keith says
Thanks ken!
tarun says
Folks, drink lot of water and eat healthy all the time. make sure do not eat lot of sour food, like yogurt. minimize meat intake and do not eat salty food with milk. it helps. send me emails, and i try to reply in timely manner.
thanks,
tarun
Keith says
Thanks for the advice buddy!
Rich A. says
Hello,
I was reading your food advise and wondered if you have any more? My 8 year old daughter developed vitiligo on her neck and wile she was 4.
Thank you for any help you can offer
Chad says
I am going to try the home narrowband UVB treatment with a portable light unit. Can you tell me the directions for your treatment? How many times a week? Length? When and how to increase?
I know there are risks associated with it. I appreciate your input.
Thanks
Keith says
Cant offer medical advice but I can tell you what I went through.
I had treatments of increasing time lengths. Started with seconds, ended up around 50 min sessions, over a 8 month period, if I recall correctly.
All the best!
Keith
Kelly says
My 13 yr old daughter has been getting photo therapy treatments for vitilago for almost a year now and she is only up to a little over 4 minutes a session. There is no way that you could get up to 50 mins a treatment!!! That is not even possible. She is on a very high dose too and only up to 4 mins. Please quit misleading and scaring people.
Kristyn says
I was just diagnosed with Vitiligo. I have it on my pelvic area, chest and just got a new spot on my wrist. I was just prescribed today, to start Elidel. I did my research after my biopsy so I was prepared for the diagnoses and read about the B12 defeiciency and when I asked my doctor she told me that the interent is alot of nonsense and that she wasn’t going to order bloodwork. Reading about Elidel is making me very apprehensive about trying it. Should I just try to take B12 and Folic acid supplements without her knowing before I try the cream to see if it helps first? I have read they go hand in hand. I am a young girl with young kids and the last thing I need is to be on something that might take me away from them. I don’t like my spots but they don’t bother me or my hubby that much so is the risk really worth it? Idk. Any input would be appreciated. Thanks.
Kristyn says
Also, I started getting these white spots three months after taking a hormone Aygestin and they got worse the longer I was on it and stopped growing so quickly after I got off it. Coincidence? Anyone else?
Keith says
Don’t know anything about this.
All the best Kristyn!
Keith says
Hey Kristy,
Good to hear you have a good attitude about all this. That is the best medicine for sure.
Here is the short story on the docs: They don’t know jack about auto-immune disease. Do your research. Supplements are great to try out. I have experienced re-pigmentation as much as when I was in treatment for vitiligo through changing diet and supplements.
Are you allergic to some foods? Find out. Don’t let this be a mystery for too long. Maybe gluten is a real problem for you as it is for so many people with vitiligo. Maybe you dont do dairy so well. I don’t do medical treatment for this. Its not worth it to me, but maybe it is for you.
Let me know how things progress!
Best,
Keith
duchess says
i hav’nt experience any horrible side affects i’ve been going for a week now , but when does the stuff start happening , im going to ask my doc , because i did’nt know it causes cancer , and death ,
tonya says
Thank you for your comments. We have 7 year old twins, both with Vitiligo although one rather extreme. I am looking for all and any more concrete answers to help her and am definitely not interested in swabbing her with chemical creams, etc. I was tossing around phototherapy but now I am not so sure. We have celiac (auto-immune) in the family and want to find out if there are other more natural connections to help her….
Betty Jo says
I too have vitiligo. Probably have had it for at least 5 years but this year it really came out. I hear all your concerns about the light treatment and cancer but going through the Mayo Clinic for my treatment, I must let you know that the cancer threat is not from the lights as they are really monitored. The cancer threat is if you do nothing to the vitiligo. Without treatment, you have no melanin in your skin and this is when you are really at risk for cancer. Before starting treatment, my skin would turn red and get tons of little bumps all over. I thought it was a rash as it itched terrible but found it was a sunburn and any time I would go outside without 50 sunscreen it would happen. Once I began the treatment, the Doctors told me that I would need to use sunscreen of 30 or more even to ride in my car because there is nothing protecting the skin from the UVA and UVB rays of the sun. They told me that if I did not, I would have a chance of getting skin cancer. Once the color comes back to my skin, I would not need to worry as much. I cannot spend the rest of my life with long sleeves in the 100 degree heat, long pants, hat, etc. I am going through the treatment and will get the maintenance unit for my home once I have completed the treatment in the clinic. Currently I am at 43 seconds and the color is returning. I know the time will go up but that small amount of time out of each day is nothing compared to the prison I live in without the treatment. The chances are far greater for cancer without the treatment then with the controlled environment with expert phototherapists doing their job.
Uvb says
Betty Jo I just love your post!
Puja says
Hi Betty,
I loved reading your post as much as I did the rest. This is an old post and I was wondering if you would be willing to share your experience this far with the home unit. Are you also using Elidel or another topical cream? Also, what is the order in which you use these? (You apply elidel and then the sunscreen on the days of phototherapy or the other way round?)
Thanks so much! I recently started therapy at mayo as well and planning to buy home myself. Kind of freaked out after reading about the cancer stuff. But I do see improvement already so being optimistic.
Sue says
Betty Jo,
Curious as to how your progress is going? Did you purchase home unit?
Also, what medications are you using on your body?
Esther says
I have had vitiligo since I was 8 years old, I am now twenty. It started off with just a little patch but now covers most of my body. I have found that staying out of the sun creates less of a contrast so its not so obvious. I cant help but feel Im missing out on things because of it though. When I was younger I loved swimming, now im too self conscious. Same with holidays with my friends, beach and pools and hot weather isnt idea. Living in Wales doesnt bring too much trouble with hot sunny weather so its easy enough to keep covered but I would love it if anyone had any advice that they know of? Iv been recommended vitamin supplements before which iv tried. Also someone suggested snow mushrooms, but havnt been able to get hold of any. My mum nan and sister all have hypothiroid problems so maybe its linked to that? After tests my thyroids are fine apparently though.
Thanks
Esther
Nancy says
A horrifying story? My dermatologist years ago prescribed elidel for me. I asked about safety using it on my face. His response was that it was perfectly safe…he was using it for a little boy who had vitiligo on his genitals. That poor child!
I have found most doctors don’t have a clue about the mechanism of action or potential resultant risks of most medications they prescribe. They get the five minute schpeel from the pharmaceutical rep and a suitcase full of samples that they pass around to everyone they see with that corresponding health condition. Frightening.
grace says
I recently got the handheld narrow band uvb LMP. I have been living with vitiligo for over 5 years and I have researched many different treatment options. This one seems to be the safest with minimal risk of cancer. It also sounds like the best way to treat the depigmented areas with better results than other treatments.I agree with Betty Jo , the cancer risk is higher with depigmented skin exposed to the sun.
Cindy says
I have had Vitligo for about 2 years now, it just showed up one morning under my arms and couple spots on my knee , and private area. One small spot under my breast and a few spots on my upper thighs. It was stable not spreading for about a year and then I noticed a couple spots spreading down my side, arms and hands..It is very upsetting! My dermatologist gave me Protopic to use and after 3 months it did nothing! So all he said was” Well, nothing else we can do bedsides laser treatment” ..I was so upset because I cant afford that..So I ignored it , used lots of cover up fake tan lotions etc..I started doing more research about gluten free diets etc.. I also bought Novitil gel and started tanning at the local tanning booth 3 times a week, I STARTED REPIGMENTING!! My spot under my breast is almost cleared and a few spots on my thigh..one spot on my arm is completely gone..my private area is all pink and no longer white, clearing up daily. I quit tanning because it started looking so bad and bought a NBUVB lamp off eBay. .started back at it today, I have a feeling this will take years and be a ongoing treatment plan for new spots.. But I have no more itching, no more spreading after gluten free and cut a lot of dairy products, tons of vitamins and no more birth control, since I heard it can cause more harm to my already thyroid disease.. I hope this helps, and be calm..Vitligo sucks!!!
Clarence says
hey guys! I am a 16 year old student from the Philippines and I just want to share my story. Last year, I was diagnosed with vitiligo.. I was so devastated to find out. My dermatologist prescribed me topical medications but unfortunately, it didn’t work. Aftee how many nonths of researching, I found out that there is a PROBABILITY that Vitamin B deficiency is the cause of auto immune disorders. So, this month, I am going to buy supplements to test if it is true. Research on that guys! I hope it will help you/me! Godspeed!
Clarence says
I suggest taking a vitamin-B complex containing 100 milligrams of each of the major B vitamins and at least 400 micrograms of folic acid daily; 1,000 micrograms of vitamin B12 daily, and 2,000 milligrams of vitamin C twice daily. AND MOST IMPORTANTLY, STAY UNDER THE SUN. THAT’S RIGHT. IT HELPS THE REPIGMENTATION WORK FASTER! RESEARCH SUGGESTS.
benj says
Hi Clarence,
I’m also here in the Philippines and I also have vitiligo, may I know hows your dermatologist?
Thanks,
Bhaskar says
http://www.sciencedaily.com/releases/2013/02/130227150908.htm
I really really hope, pray and wish that this works and will be in the market soon.
Aki says
Hi Bhaskar,
well if u r really looking for some cure then u mite wanna see this
http://www.bharatdefencekavach.com/News_940$1$53-DRDO-Lab–finds-cure-for-Leucoderma.html
Indian defence research lab DRDO has find Some med for vitiligo
I tried it too but it went terribly wrong for me…Due to extra sensitive skin..
But i have seen people getting cured with this med with my own eyes. when i went to the doc..
But plz do read about it & consult ur doc first ..
All the best & tc 🙂
Teri, Dover, Pa says
Hi Keith and Vit sufferers,
I’ve never posted before…but you all seem so real.
I have Vitiligo on my forehead, in my hair, front and back of my neck, shoulders, forearms, hands, chest, underarms, groin, thighs, shins, ankles, toes. It feels like everywhere. I am trying many things and I have some repigmentation on my forehead, forearms and shins. 9 months ago I started a gluten free diet after being diagnosed with gluten sensitivity through enterolabs. I recommend this testing. They test your stool which is sent through the mail and you don’t go through your local doctor. There’s still more food sensitivity tests I want to have done through Enterolabs when I have the money. I also thought a hair test would be good to try to test for heavy metals. Then I started to follow The Perfect Health diet/Dr Jaminet…which is gluten free. This teaches to stay away from all grains but white rice and all legumes. I take St Johns Wort which is a natural psoralin to increase pigment, Gingko Biloba which has helped some others in trials, A multivitamin and a hair, skin and nail vitamin, melatonin, folic acid, and L-Phenalalinine which has helped some people in studies. I recently started a copper supplement and Vitamin D3 and am waiting to receive K2 to start that too. I have Hashimotos Thyroid disease and take Levothyroxine. I had psoriasis in the past for which I have Lydex ointment in case it flares up. I recently started Elidel and Protopid which I also used years ago but gave up. I thought I’d try again with the natural sun. I just recently obtained a hand held NB-UVB wand that I ordered from Ebay for about $85. This was the first wand that I found that was affordable, shipped from NY, and uses the same Philips light bulbs as the more expensive wands. I use coconut oil as a deodorant and mixed in my St Ives mineral lotion. I figured the mineral lotion has some of the same minerals as the Dead Sea which has repigmented others. The coconut oil has a natural SPF of 4-7 to reduce burning outside without all the sunscreen chemicals. It also reduces peeling after getting alittle too much sun. And it contains vitamins too.
I haven’t given up yet.fighting this autoimmune disease. Various of my family members have other autoimmune diseases. I feel the need to carry on so that if I find out how to manage this monster, it may help my children in the future. It’s comforting to hear of the frustrations of others in our journey and what has helped others, or not. Vitiligo feels like an isolating disease and its helpful to hear from others who suffer similarly. Thanks for your website Keith 🙂
lynn says
hey guys.i have vitiligo on the neck and im using UVB Narrow band for one and half years now but there is no improvement.im worried too much exposure to the light might affect me.please advice
Donna says
I have had vitiligo for 10 years now (hands and fingertips) and I just started treatment with the XTRAC laser. I saw repigmentation on the 2nd session and I am now up to my 8th session. The area over my eybrows are almost completely filled in and the white areas on my cheeks are about 50% repigmented.
The pigmentation is coming back much darker then my natural skin color and the tech keeps assuring me it will fade to my normal color. I still do not have any repigmentation on my hands and they have to keep increasing the strength of the laser but it has kept white patches from spreading. I am hopeful this treatment will work and I will be totally repigmented by the end of the summer.
Shabeena says
Hello, please help.. Please provide me some contact details.. i am suffering form vitiligo from last 1 and half year. Please help….. i m early waiting for ur reply..
Ramu says
I was suffering vitiligo from more than 3 years the first i noticed at 2nd year i started allopathy treatment(B12-Floric acid tablets with Pimecrolimus Cream) which showed good results after using 9 months i noticed the patched again spreading.I thinked to move to Aurveda Treatment using since last one year 90% no spreading the Aurveda Treatment was suggested to use for 8 years by Doctor
Krishna says
Plz suggest these medicines
Ardilah Mohamed says
Good day i have been sufferingwith vitaligo for about 21 years now and i can honestly say i have tried everything about three years ago a friend of mine went to Egypt and brought me a powder medication i used it and within two weeks my knees had been cleared then my arm then my hand it got finished and i have tried ever since to get a new packet and i phoned the man he said it’s given out free in Egypt and due to the language challengeshe said they do not distribute out to South Africa. I am planning to go to Egypt in December of 2013 to find out how i can get hold of this medication. Since using it the patcheshave not reopened. If anyone knows anything about this medication please let me know.
qu says
hi did you find out the name of the powder in Egypt?
unknown says
if you have the address and phone number, could you please give it to me.
ted says
Hello there,
Mr. Ardila. Can you please give some more detail on the mysterious “powder medication” you mentioned in your post? How did it look/ taste/smell etc.? How long did you take it? Did the vitililigo come back? Did you expose to the sun? Give some more detail. I am spending my summer vacation in Egypt nowadays. I can help if you can be more elaborate.
Regards,
Ted
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ehhahu says
is this one?
asialavit says
Helloha !
Diagnosed with Vitiligo about three months ago and has spread fast and furious ( neck lips and fingers). My dermatologist advised on laser treatment together with 2 topical creams Advantan and Tacrovate. Last week I went in for a laser- uvb treatment. Anybody ever heard of that ? Anyway I have done three sessions. the sessions themselves are painful ,seems the neck area is very sensitive and there is a sharp pain when laser hits the treated areas Should this be happening? Also got painful blisters especially in the neck making each session a nightmare. Is this normal even though there are slight signs of repigmentation.
asialavit
Dan says
Asialavit,
I have been using XTRAC laser for about 10 months now. I have vitiligo on my lips, fingers, elbow, legs, knees and armpits, including lesions I have had for about 30 years. I also cycle Protopic and steroid that my doctor has prescribed. Finally, I take multiple vitamins that a leading dermatologist for vitiligo in California has recommended. I am almost done pigmenting in my armpits, elbow, knees and legs. The lips and fingers are stubborn. I was offered micro-grafting as an option for those hard to treat areas but I’m not open to surgical options at this point. Besides, if I wanted surgery, I might as well get micropigmentation. For me, the best treatment has been accepting that God has made me different, trusting Him in whatever happens and accepting whatever the results of my treatment. As you may be aware, stress and worry can worsen vitiligo. We have no control over the progression of the disease or the results of any treatment. Resting in Him while utilizing the treatments that are available to me has been the best path for me.
If you are getting blisters, your doctor is probably being too aggressive with the dosage. In my experience, you don’t need to burn to get pigment. It may be good to get a slight pink, but getting blisters can delay the progress. My doctor increases the dosage every second treatment and has been more conservative than aggressive in increasing the dosage. It is a long process, and there is no point in getting blisters that can spread the lesions. Have the doctor be more conservative, especially in the face and neck area that should respond extremely well to excismer laser even without being that aggressive. Also, see if your doctor will prescribe Protopic to supplement your light treatment. Those I have seen treated with both Protopic and excismer laser for the face and the neck area have had almost 100% repigmentation. Good luck and trust in God in all things.
Kathryn says
Ardilah – it might be worth you getting lots of the mysterious packets from Egypt and selling them to us!
tina says
How do you get rid of it? please help me
Jenny says
Hello, my husband (scandinavian) was diagnosed with vitiligo 2 months ago (face). He was prescribed elidel and after 6 weeks use it has repigmented completely. We were not warned of the side effects and unsure if it will return (fingers crossed. we have now changed our diet and eating/living as healthy as we can:-)
What I would like to add is two things 1. He has a b12 deficiency and will now get a b12 shot quarterly. 2. Prior to the vitiligo he was taking supplements (for skin and a respiratory problem) Both of these natural remedies had something called Astragalus (sp?) as their main ingredient. If you are taking it STOP!! This boosts the immune system to fight the melanocytes -effectively killing them off faster and compounding the vitiligo. I hope this info helps at least one person. Good luck to all of you out there you are doing an amazing job!
Mehtap says
Hi, my daughter(15) is prescribed elidel , but i am worried about side effects also wondering if it will work, could you tell me if your husband face is still clear? Thanks
Theresa says
I have my first dermatologist appointment for a consultation for light therapy treatment for my vitiligo and I am very nervous can anyone tell me what to expect?! I want more than anything to have results from this therapy and I am just so nervous that it won’t work for me, any words of wisdom would be greatly appreciated!!
Jaimin says
Hi,
I also have vitiligo on my face ( lips corner & and my nose) and all finger tips
I have stared uvb-narroband 311 nm last 8 months
my nose area covered 90 % normal and rest 10% is also similar to normal skin
but cornor of my lips and right to left not cure only heal 5%
I have vitiligo in 10 finger but now days improvement is too good and 2 finger tips 99% cure and rest is very positive
I advice do not waste your money in hospital or any other place
I do it in my home for one month
philips PL uvb-narroband 311 nm
Indian Price in only 2200/- and any Pl attachment only cost 250/-
first month only 3 min per session ( 3 days in Week )
and increase it upto 6 min. per session
My blessing to you for come out from this
Rroy says
Hi Jaimin .
Thanks for your advice on the light therapy .
Since its been a year for you of using the therapy could you tell me if it has worked for you or not ?
Do we need to consult a doctor before we start with the treatment ?
I have it on my legs and hope for a solution from you guys .
Thank you so much
harsha says
Hi am suffering with virtilogo past 5months ……hw can it curable
Kuldeep says
Patanjali jao. Aur baba ramdev ki treatment shuru karo. Koe b milk product, fish, chicken, garam masale, garam cheeje,khata avoid karo.
cindy says
I have had vitiligo for almost twenty years . I feel no need to except this disease so very often google for any new treatment or information. I found that in Germany there is a treatment using pseudocatalase cream and narrowband UVB light. Some of their findings are: melanocytes are still present in long-standing vitiligo 25 years plus, all generate and accumulate hydrogen peroxide in the epidermis, cannot remove it due to low levels of catalase, glutathione peroxide,and thioredoxin reductase, have difficulty maintaining calcium balance in the skin. Vitiligo can be diagnosed based on ability to metabolize amino acid L-phenylalanine. Clinical evaluation for a large patient group does not support the autoimmune hypothesis. These studies were done in Germany by Professor Karin Schallreuter MD. There are people in this country studying this disease, but unfortunately don’t have funding. That is what happens when the medical industry is based on the bottom line which results in expensive treatments that don’t work rather than a cure.
Shellee Jean says
I’m not sure what you just said, but I think you are saying that the German’s study shows that even after 25 years vitiligo patients still have bottom layer cells that generate color. Do the Germans think that vitiligo is caused by hydrogen peroxide in the upper levels of the skin due to a calcium deficiency? I’m relieved that they don’t support the autoimmune theory. I’ve been trying to understand how I could have autoimmune or suffered from food allergies all these years. I would never use a topical cream that is linked to skin cancer, that’s just asking for trouble. I think there has to be an issue with the body’s system and the white spots are a result of the issue, I just haven’t heard anything that makes since to me, but I’m intrigued by the German study. I know that I did not get the white spots until I moved to a climate that is humid and virtually no sun all winter long and I had cut out carbs, but took lots of vitamins. I have used hair dye for many years and worried that the peroxide in the hair color could be an issue. Maybe it’s different for everyone. I’m more confused then ever.
Dulce says
It is an auto immune disease in as far as your body also having one or two other auto immune diseases ( i.e., diabetes or thyroid disease etc. ). One study after another has proven certain facts:
1. Tyrosinase is the main enzyme used in melanogenisis
2. Melanogenisis is the beginning of the melanin process
3.,Melanocytes are the cells that produce pigment
4. Melanocytes then transfer the pigment to another cell called Keratinocytes
5. There are 10% melanocytes in the skin while there are 90% keratinocytes
6. Thyroid disease ( of which there are many ) is implicated in vitiligo
7. The most recent development is that, vitiligo has something to do with an anti- inflammatory environment
8. People Who have vitiligo are also low in B vitamins, folate, and Many other important vitamins and minerals including Glutathione Which is an amino acid that either inhibits or complements many processes in the body which requires caution in the use of Glutathione.
9. There are three amino acid precursors that must be present in order for the body to make glutathione. (Cysteine, glutamate acid and glycine).
10. A cure for vitiligo is imminent. Many studies that are conducted for skin cancer or psoriasis or even Dermatitis, yeild a wealth of information for the advancement of a cure for Vitiligo. We are almost there.
Ahmed says
As a vitiligo patient what i found was
1- have a leaky gut which resulted from a damaged intestinal lining. These damages are due to poor diet, excessive smoking ir alcohol.
2 . Problems with thyroid and adrenal disfunction. You have to check your thyroid and adrenal function.
3. Zinc deficiency.
4. Gluten intolerance . Gluten will damage your gut and its molecular structure.
So toget over with all this these vitamin supplements helped me to get over with vitigo in 3 months
• Probiotics- helps to regenerate your gut
• N-Acetyl-Cysteine (NAC) will boost your immune system.
• Natural Vitamin E – this will repair your skin and help to recolor. Take 1 capsule two times per day.
• Vitamin B 1000mg (Methylcobalamin)
• Folate ( 5-MTHF)
• Vitamin C Complex, with bioflavonoids, 1000 mg daily, for 4 weeks.
• L-Glutamine, 500 mg daily.
• Zinc Citrate 15mg
•
Jodi Cerminaro says
I recently spoke at a medical college in my area and described my Vitiligo journey:
-Age 13(1977) / bad sunburn at the shore
patches started to appear on elbows and knees first
puberty, difficult teenage years
I was told I had and Autoimmune disorder that destroys (Melanin)pigment in the skin
During Teenage Years- Excessive tiredness, diagnosed with Underactive Thyroid
Levoxyl every day as treatment
-Age 24(1988) / had my first chid
My thyroid condition was thrown off balance during child rearing years
within a few years more spots appeared
started as small spots and as they grew they seemed to connect
my hands were the first to go completely white, I have white eyelashes and an eyebrow
1988 through 1995 / tried PUVA therapy at Lackawanna Dermatology office
I took an oral medication, treated several times a week for just a few minutes
I had to wear protective sunglasses when exposed to sunlight and wear sunscreen
after several months I had very minimal signs of coloring in a few areas(a few dots)
I went on vacation for two weeks and lost all signs of repigmenting, stopped treating
1995 to 2013 / I was busy with life, and raising two children, covering up every day
I took Copper supplements(through research) for a few months with no results
I try to stay away from spicy foods and eat clean
Almonds and Sunflower Seeds (All through my own research online)
*Self Tanner(w/gloves) mixed with moisturizer when indoors, sunscreen when outside
(Age 48)2013 or so / started going through Menopause
2013 through 2014- Facial Adema and Hives, cause unknown
treated with Benadryl and Prednisone, hospitalized several times for severe episodes
daily Zyrtec and Zantac combined kept it at bay
This shock to my immune system caused the Vitiligo to double in quantity in the last two years
Currently – National Biological – Narrowband UVB Light Phototherapy and Elidel Cream
**Dr. Severs-(#570-498-9282)
He is very knowledgable about this disorder, educate yourself.
As a patient, directly effected, I have done a lot of research, other offices have not been able to pronounce the word.
Be sensitive to the fact that it is not just cosmetic
It is very emotionally debilitating, I cannot wear sleeveless clothing or shorts
It has held me back from doing things in life
Dulce says
Jodi, I have read that you have done your own research. I have also done and I am doing my own research since no one is doing it for me. But, I need a partner. I have an idea that I would like to get your opinion on. If you are interested in working together towards a common goal, I am very ready to do so.
Although I do not have a background in cell biology, I am a teacher and I have been very good at doing Research and saved my life literally about 22 years ago when I was given synthetic thyroid medicine after having thyroid cancer surgery Without anyone checking my levels, I was just handed a pill and I went through what is called ” thyroid storm ” and as I was told by a cardiologist, many people do not survive it without having a heart attack. I was fortunate not to be one of those.
Synthetic thyroid hormone did not work for me and the endocrinologist told me that it was all in my head so I did research and I found out that it was not all in my head. My liver could not process T4 into T3 And the only way that I could function normally was to take Armour Thyroid and so I did and I am very glad that I did because it worked. So having said all that, I would like to work with a partner so that I am not staying up at night every day until 4 AM doing research plus needing someone to bounce ideas off of If you are interested, please text me at [email protected]. I said TEXT because I know longer check my email. I really look forward to hearing from you
Priyanka says
My 7 year old sister is suffering from non segmental generalized vitiligo , We have tried ayurvedic , homeopathy , and what not , Please help someone if anything possible …Thank u
Vaishali says
Hello.
My 5 y/o just got diagnosed.
Has anything helped your daughter? I am very scared and feel helpless. I am a scientist and the science is not there.
Mike says
Hello guys,
I have had a small spots of vitiligo on my chest since my childhood (1999) and have undergone many treatments using extract of Psoralea cordifolia seeds, but all the treatments were in vain. Using Psoralea extract or psoralen tablets will make your skin vulnerable to the harmful sun rays as the drug itself is a photosensitizing agent that makes your skin sensitive to UV rays of particular wavelength (so why used a drug that will sensitized your skin for unusual reasons). I have surveyed many health web sites, suggested diets (the do’s and don’ts), but it is very interesting to see that all have their own limitations and nothing come up with the cure. Till date, I am still getting new spots and I am under stressful conditions at office that increased the disease conditions. Until I have found the new techniques of home treatment using NB-UVB 311nm device without using Psoralen tablets. I am hoping that this device will help in regaining the skin tone. The first session I have used the device, I got severe blisters on the white patches and the area becomes pink in colour, which is accordingly as per suggested in the SOPs. Let’s hope for the best coz this diseases is killing me on social backgrounds. I suggest all to stop using PUVA treatment as NBUVB is an optimized way of vitiligo diagnosis free from any photosensitizing drug and to the best of my knowledge and my survey, NBUVB is showing a positive way of vitiligo treatment as per many research articles.
Suze says
I just want to leave a comment here to let people know that this blog post might be well intended, but it is misleading.
I have been doing UVB-NB treatments since 2012 and my vitiligo patches are nearly 100% repigmented. I had VERY widespread vitiligo, and since I started doing these treatments, the patches have stopped spreading completely. I have gone through periods where I only did the treatments 1 or 2 times per month, and my vitiligo still did not spread. Is there a risk of skin cancer? It is VERY negligible. What I do is put sunscreen on my body all over except for the patches of vitiligo. If you have vitiligo in only a few places and do not want to expose the entirety of your skin to the UVB radiation, you can look into a treatment called excimer laser, which treats only the patches with a focused beam of ultraviolet light. I have never done a session over 10 minutes long and I have been doing these treatments for years. Anyone doing 50 minute treatments is absolutely setting themselves up for a problem; that is an unheard of amount of time in my experience. Bottom line: USE SUNSCREEN on the non-affected areas of skin. Be persistent, and don’t give up faith. I thought my vitiligo would never go away, but little by little, the patches have been filling in. Stay strong, everyone. xoxo
Neels says
Hey Suze. I was diagnosed with vitiligo about a year ago. Have it on my hands, feet, forehead and armpits. It’s still very spotty.
I recently got a UVB NB lamp but I’m struggling with the TIME OF THE SESSIONS. I see posts where people expose their face a few seconds to the lamp to get a pink colour on lesions but I have to expose my face about 2 minutes on my second session.
My hands I’m currently exposing 4 minutes and not getting any pinkness.
Can anyone please help me with this.
Neels
Dulce says
Suze, I am glad that you are doing well with PUVA. The problem is that some people do very well with it but others do not. The same goes with all other possible vitiligo treatments. It is very confusing and is one of the reasons why it has taken so long to find a cure. Vitiligo is a very personal disease or disorder. Some people react well to some Treatments and some do not. I am glad you are doing well, continue doing well. I’m glad that you have found something that works for you. For the rest of us that PUVA did not work out, do not lose hope. The cure is just around the corner.
Vaishali says
Hello.
My son is 5 y/o and I feel lost with all the different information.
Have you been able to stay off the NUVb therapy for awhile or need it constantly?
Lakshmi Jayan says
Hi am from Banglore, India. For the last few years I am suffering from vitiligo. 90% of my face was covered by white patches. Tried so many medicines including phototherapy and heavy dose steroids. During the time of phototherapy pigmentation was occurred. Due to some reasons I was not able to continue phototherapy. When I stopped that pigmentation started going.I stopped all the Allopathy medicines and started Homeo Medicine. The result was unbelievable. My patches reduced to 70%. Along homeo medicine am exposing to sunlight before 10 A.M and after 4 P.M. Avoid all the spicy foods and citric fruits. Drinking copper treated water and applying a mix of turmeric and mustard oil in the night. Or you can use pure coconut oil. Our body will never cheat us. Support our body,help to produce melanin. It will work. All the best.
Suraj Gupta says
Hi Lakshmi,
Can you please tell us more about this HomeoPathy treatment that you have been doing. It will be great if you can please share more information about the doctor.
Thanks,
Suraj
unknown says
Hi Laxmi, Can you share the doctor’s contact details
Chuck says
Very true! Makes a change to see soenmoe spell it out like that. 🙂
lakshmi Jayan says
Hi sorry for the delay. Am taking medicines from kerala. If you have a good Homeopathy Doctor nearby you can consult them.Taking medicines manufactured by Dr.Reckeweg & Co. Germany. You will get the medicines in local homeo medical shop also.
anny says
hiall
i have vitiligo since 7 yrs and i used many steroids and phototherpy back in india and i got balacl sports on all over the patches. After coming to usa i have not used anything now i am seeing almost after 2. yrs whitepatches around my eyes and hands and fingers are visible now. can you guys help me with the home remidies or suggestions what to do now? i havent met any dermatologist in usa? what do u guys suggest please help me . i am feeling depressed now
Vindya Donahue says
I have vitiligo spots on both my feet and ankle areas, little on my knees and on both my elbows and some tiny ones on my wrist. I Have had this dis-ease, since my 20s. I’m 52 now, very happily married to my soulmate, who has been my pillar all these years, and who makes me feel that I am the most beautiful person in the world. I never thought I had a problem , till we go to a hot spring or the beach, and then I feel really awful. So recently, I went to the dermatologist and they put me on “Elidel” and the UVB-NB therapy. I now have the full body unit at home and have been religiously doing the treatment three times a week for 6 minutes. and applying elidel once a day. I started this treatment at the end of August, perhaps about 30 sittings so far. What I see so far, is that the spreading of old vitiligo spots seems to have stopped. When I started the treatment a month later I got a new one on my toe. But now I see some darker pigmented spots coming around some of them. Your message was very encouraging. Yes, its tough with the cancer threat. My Doctor warned me not to go above 10 minutes. ..I live in hope that this will disappear.I also put a towel over my face and head and wear a tank top and shots.
Thank You Suze for your wonderful positive message.
Thank you for this healing and wonderful site.
Donna says
Thanks, Size!
jaydeep nema says
Any side effects with Photo therapy with uvb uva
Praveen kumar says
I have 9 years old vitiligo.i have defferent doctor meet but not cure
lakshmi Jayan says
Try homeo medicine with light therapy. It will work.All the best
Kylie says
Hi , I’ve had vitiligo for 13 years, I’m 25 now and it’s just growing like crazy at the min. It’s so hard being a girl at the age 25 with white patches all over your skin. I never wanna go to the beach, hate summer time. I’m always putting fake tan on to try cover it but it still shows through. I’ve tried lots of creams and I’m now going to a doctors tomorrow to look at starting light theapry. Praying to god it works cause if it keeps growing at this speed I’ll be fully covered by 30.
lakshmi Jayan says
Hi dear,hope you doing well. No need to worry too much .after all this is only a loss of melanin in our body due to some autoimmune issues.There is two choices. Either we have to accept this or fight against this. I selected the 2nd one. Now almost my patches is covered. I took homeo medicine with light therapy. If we stopped phototherapy, chances are there to reoccur of patches.but atleast we can go out without fear.nobody is going to starring at you.Hope for the best . through good treatment you can get rid of your disease. For some ,at least we can control. It’s depend upon everyone’s nature of body.
Don’t use too much of covering creams. You will be alright. All the best
Courtney says
Hi, Last October I went to a doctor in regard to fluid in my knee and intense knee pain prior my half marathon I apparently had two micro tears in my knee. The doctor gave me a steroid shot in my knee to ease in the inflammation. In December I started loosing my pigment, and slowly the spot got bigger and bigger. Now, at a much faster rate white circles are forming even father down my shin. I went to a dermatologist last week and she said I have acquired vitligo as a side affect from a leaky steroid shot. I’m loosing pigment fast, she prescribed Elidel.
Has anyone else acquired this from a steroid shot? It doesn’t seem isolated because its spreading.
vijay says
Hi Courtney, I have similar condition, I had inflammation on my shoulder and I took a steroid injection. After couple of months I spotted the first white patch on my face. They are growing very face. I have started taking UVB treatment and its been 2 months. I have not observed any significant improvement yet.
Irina says
Hello Everybody!
My 8 years old dughter started having vitiligo 4 years ago. I read many comments on this site (not all). But I haven’t read about anyone who came to Cuba as we did. On Cuba there is a clinica which is specialized on on treating vitiligo and psoriasis. They are making special lotion called Melagenina Plus. There is not side effects at all! Unfortunately to my daughter it did not helped, thought we applied it for 3 years, but we went there because 2 people ( different accuattances of my dad) went there and bought lotions and there completely cured within 2-3 years. I am sure itmight help for someone. The name of the clinic is Histoterapia Placentaria.
Good luck to every one!
Irina
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