White skin patches, that are also termed as hypopigmentation or vitiligo, can have various causative factors. It could be due to an infection with fungus, autoimmune condition, genetic cause, and more. One cause, however, that is often overlooked is nutritional deficiency. According to experts, Dr Nishtha Patel, Consultant Dermatologist at Kosmoderma, and Kiran Bhatt, Cosmetologist and Vice President of Junoesque, if patchy skin is associated with nutrient deficiency, there are three main vitamins whose deficiency predispose this condition—vitamin B12, vitamin D and folic acid.

Here is why:

Vitamin B12 is an essential vitamin needed for good skin and its deficiency has been linked with depigmented patches on the skin. “Homocysteine, an amino acid, needs vitamin B12 for its metabolism inside the body. But in the state of this vitamin’s deficiency, homocysteine accumulates in the body and leads to oxidative damage to the cells, including melanocytes,” says Bhatt, adding that damaged melanocytes can lead to vitiligo.

Also, Patel says, vitamin B12 is needed for synthesis of methionine, a precursor of S-adenosylmethionine (SAMe), a component needed for methylation. Methylation is quintessential for regulating the gene expression involving even the genes that support melanin production. Under the circumstances of vitamin B12 deficiency, there is impairment of melanin synthesis and thus hypopigmentation.

This ‘sunshine vitamin’ is produced by the skin after exposure to UV rays of the sun. Patel says: “Vitamin D has a direct positive association with skin health as the cells responsible for skin’s pigmentation, melanocytes, express the receptors of vitamin D (VDRs). The active form of vitamin D, named calcitriol, enhances the growth and multiplication of melanocytes and thus stimulates melanin production.”

Various researches have found out low vitamin D levels in individuals with vitiligo, thus showing its importance. The treatment options include oral supplementation with vitamin D or topical application.

According to Bhatt: “Vitamin B9 is also linked with the body's methylation process and synthesis of DNA. When the body has deficiency of folic acid, the levels of homocysteine rises in the body, causing free radical damage to the body cells and destroying melanocytes. A combination of vitamin B12 and folic acid in the individuals with vitiligo has shown to improve the skin’s hypopigmentation.”

White patches on the skin mostly denote some underlying cause and the most overlooked factor is vitamin deficiency. There is substantial evidence linking vitamin D, B12 and B6 deficiency with vitiligo and thus their supplementation becomes primary.

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