Probiotics for Vitiligo
As scientists discover more and more connections between our gut flora and our disease processes, studies like this one give hope to vitiligo patients who have few other options from the medical world. In their mouse study, the researchers purified a probiotic-produced chemical and confirmed both vitiligo improvement and immune cell changes in those mice given the substance. We know that bacterial products like this can modify our immune system in various ways, so these findings should not come as a major surprise.
Vitiligo (an autoimmune condition- meaning that the immune system attacks its own body’s tissues) hones in on destroying melanocytes in our skin. When our immune cells, called ‘macrophages’, kill and eat up our melanocytes, they also destroy the melanin which gives our skin its hues of brown. As areas have their melanocytes depleted, patches of skin become lighter and lighter.
While this may not be too noticeable in paler individuals who don’t get much sun, for most people the patches stand out. If those spots stay in usually-clothed areas, maybe it’s not a big bother, but vitiligo usually spread. Eventually vitiligo will show up somewhere obvious to others. This can be very distressing to go through, young or old.
Over the years, little has been found in conventional medicine that impacts the progression of vitiligo. At best, prescription Opzelura (ruxolitinib) cream, was found to improve pigmentation in 1 of 3 patients who used it. Otherwise, avoidance of sun and makeup coverage was advised.
In functional medicine, we have seen some patients slow or reverse vitiligo progression when the original autoimmune trigger was found. The primary identified trigger has been mold toxicity, but in a few cases, a food sensitivity played a role in the disease process. With mold detox in some or food avoidance with leaky gut therapy in others, we have seen improvements. Even then, the process may take from one to three years.
This chemical produced by Bacillus subtilis (a spore forming bacteria in some probiotic mixes) holds some promise for a pathway to interrupt the autoimmune process of vitiligo. While we would still look for root cause triggers and work to lower overall inflammation, a treatment to more directly quieten the immune cells involved in the attack on melanocytes would be much appreciated. In the study, the chemical was concentrated by genetically modifying the bacteria to produce high amounts before being given to the mice in the study. Theoretically, bacteria could be given in a capsule that would cause production of the same chemical inside our guts, but this remains to be tested.
Helping our patients restore healthier, more abundant lives after a vitiligo diagnosis requires knowledge, wisdom, patience, and innovations like this study. We look forward to more research on this area and the possibility that a probiotic can help our patients.
Original Article:
Ahmed A. Touni, Sara Muttar, Zoya Siddiqui, Rohan S. Shivde, Emily Krischke, Digvijay Paul, Mohamed A. Youssef, Anne I. Sperling, Rasha Abdel-Aziz, Hossam Abdel-Wahab, Katherine L. Knight, I. Caroline Le Poole. Bacillus Subtilis–Derived Exopolysaccharide Halts Depigmentation and Autoimmunity in Vitiligo. Journal of Investigative Dermatology, 2024; DOI: 10.1016/j.jid.2024.12.006
Thanks to Science Daily:
Northwestern University. “Microbial therapy offers new hope for vitiligo patients.” ScienceDaily. ScienceDaily, 28 January 2025. <www.sciencedaily.com/releases/2025/01/250128162834.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
