There are few substances which should be avoided by vitiligo patients and other people with normal skin pigmentation should also be careful in using these products, especially if they have a family history of vitiligo.
Hydrogen peroxide: commonly used to disinfect the skin and for the cleaning of wounds.
Hydrogen peroxide (H2O2) is a clear liquid, slightly more viscous than water. It has strong oxidizing properties and is therefore a powerful bleaching agent that has found use as a disinfectant, as an oxidizer, and in rocketry (particularly in high concentrations as high-test peroxide (HTP) as a monopropellant), and in bipropellant systems.
Hydrogen peroxide has been used as an antiseptic and anti-bacterial agent for many years. While its use has decreased in recent years due to the popularity of better-smelling and more readily-available over the counter products, it is still used by many hospitals, doctors and dentists in sterilising, cleaning and treating everything from floors to Root canal procedures.
To date there is ample evidence that patients with vitiligo accumulate millimolar concentrations of hydrogen peroxide (H2O2) in their epidermis as well as in their blood lymphocytes/monocytes.
Retinoic acid and its by-products used in certain topical preparations.
Retin-A (Retinoic Acid) is often used to improve the appearance and texture of the skin. It produces a mild, superficial peel of the epidermis. Retin-A has effects on the both the superficial (epidermis) and the deep(dermis) parts of the skin. The major benefit is to decrease the effects of sunlight caused aging by increasing the speed with which the surface cells are replaced.
In the epidermis it thins the outer later, or stratum corneum, which makes the skin more permeable. However the overall thickness of the epidermis is increased. The epidermal cells are also more active.The production of collagen in the dermis is increased.
The most common problems are redness and sensitivity to the sun but serious complications are rare. If Retin-A is used repeatedly there is a risk of loss of pigment or lightning of the skin. Some patients say that the irritation is painful but scarring does not occur.
Benzoyl peroxide: Benzoyl peroxide is highly effective in the treatment of most forms of acne. It is typically placed over the affected areas in gel or cream form, in concentrations of 10% and lower. However, it can cause dryness and irritation. A small percentage of people are sensitive to it and this is characterised by burning, itching, peeling or possibly swelling.
The main mechanism of action of benzoyl peroxide depends on the release of oxygen free-radicals, which are capable of oxidizing bacterial proteins. However, this same mechanism can also damage melanocytes in people with skin depigmentation.
Hydroquinone: Hydroquinone, also benzene-1,4-diol, is an aromatic organic compound which is a type of phenol.Hydroquinone has a variety of uses principally associated with its action as a reducing agent which is soluble in water. It is a major component in most photographic developers where, with the compound Metol, it reduces silver halides to elemental silver.
In human medicine, hydroquinone has been used as a topical application to reduce the color of skin as it does not have the same predisposition to cause dermatitis as Metol does. This use is banned in some countries (e.g. France) because of fears of a cancer risk.
This is a product that inhibits melanogenesis. It may achieve this by inhibiting one or more steps in the tyrosine-tyrosinase pathway of melanin synthesis. As a results it causes skin depigmentation. Arbutine is a glucoside of hydroquinone and is hydrolysed to hydroquinone. Both products cause skin depigmentation.
Trichloroacetic acid -Trichloroacetic acid (also known as trichloroethanoic acid) is an analogue of acetic acid in which the three hydrogen atoms of the methyl group have all been replaced by chlorine atoms.
It is prepared by the reaction of chlorine with acetic acid in the presence of a suitable catalyst.
Phenolic acid -Coffee is particularly rich in bound phenolic acids, such as caffeic acid, ferulic acid, and p-coumaric acid. Black mulberries, European juneberries, black currants, fruits of blue-berried honeysuckle, and blackberries. Most spices contain phenolic acids such as tannic, gallic, caffeic, cinnamic, chlorogenic, ferulic and vanillic acids.
Glicolic acid - Glicolic acid is a Fruit acid containing natural chemicals and is also known as alpha hydroxy acids (AHA). They occur naturally from certain fruits such as grapes, citrus and apples, which are then modified in a laboratory. Many face masks contain this acid, especially the face masks made from the fruit peelings.
Fairness Creams - There are many products which promise to make your skin complexion lighter, India is one of the big market for such products, please be aware that these skin creams are nothing but bleaching agents mixed with other fragrant creams, and they make the skin lighter by removing the pigmentation from the skin and excessive use or if you skin has a tendancy for vitiligo or hypopigmentation, it could very well trigger vitiligo.
Bindi ( Dot on the forehead used by ladies for makeup) is used in India by ladies of all ages, It as a glue which can result in vitiligo if the skin is allergic to this glue.
There are lots of other industrial compounds which can cause loss of pigmentation and due care should be taken while handling any such chemicals.