A research article published (provisionally) online yesterday in BMC Complementary and Alternative Medicine [1] disclosed the results of a pilot clinical trial which gave 60 mg of Ginkgo biloba twice per day to people with vitiligo.

Vitiligo is generally thought to be an autoimmune condition in which melanocytes, or skin pigment cells, are attacked by the body's own immune cells and stop producing pigmentation. There are other theories including the interaction and contribution of biochemical, oxidative stress, genetic, neuronal and environmental factors. The condition results in patchy depigmented areas of skin which are more prone to sunburn. Treatment includes frequent and lengthy ultraviolet phototherapy; traditionally dermatologists will prescribe a topical steroid cream. Side-effects of topical steroids can include diabetes mellitus, osteoporosis, dermatitis and dermatoses.

Effectiveness of the clinical trial was assessed using the Vitiligo Area Scoring Index (VASI), the authors found "The progression of vitiligo stopped in all participants; the total VASI indicated an average repigmentation of vitiligo lesions of 15%." This was a small study over 12 weeks, with eleven participants completing the trial, two experienced no change and one experienced a very small 0.4% improvement. The remaining eight participants experienced significant improvement. No significant adverse effects were experienced and serum coagulation was unaffected.

Possible side effects of Ginkgo biloba include gastrointestinal disturbance, allergic reaction (to those sensitised to poison ivy), and Gingko biloba should be used with caution by people taking MAO inhibitors or SSRI antidepressants.

The authors conclude "Larger, randomized double-blind clinical studies are warranted and appear feasible."

Previous studies using Gingko biloba on patients with vitiligo include a double blind randomised trial in 2003 [2] over six months, which found a similar dosage of Ginkgo biloba arrested the spread of vitiligo in 20 out of 25 participants in the active group, and induced marked (75% or greater) repigmentation in 10 of those participants.

Gingko biloba is one of the top selling herbal medicines in the United States; Gingko biloba accounts for 1% of total prescriptions in Germany; The World Health Organization reports that the medicinal uses of ginkgo biloba supported by clinical data include treatment of the effects mild to moderate cerebrovascular insufficiency. Gingko biloba has a comparatively good safety record, making it tempting to self-administer in cases of vitiligo. The authors cautiously recommend that any attempt to use ginkgo in the management of vitiligo should be carefully monitored by a health care practitioner "given that there are still many questions about the correct dose, its true effectiveness, interactions with other conditions or therapies, and possible adverse reactions." [1]

References:
1. Szczurko O et. al: Ginkgo biloba for the treatment of Vitiligo vulgaris: an Open Label Pilot Clinical Trial. BMC Complementary and Alternative Medicine 2011, 11:21doi:10.1186/1472-6882-11-21

2. Parsad D, Pandhi R, Juneja A: Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Clinical & Experimental Dermatology 2003, 28(3):285-287.