In this section, we will explain the chemical processes behind vitiligo repigmentation in simple terms. Please note that such statements are a simplification of the original case study.
Our skin color is determined by a pigment called melanin—the more melanin, the darker the skin. In cases where melanin is scarce or absent, the skin appears white, as seen in vitiligo. Why do individuals with vitiligo have reduced melanin in their skin? This can be explained by a specific chain reaction.
Melanin is produced through a process called melanogenesis. For melanogenesis to function effectively, it requires melanocytes (the cells responsible for melanin production) and a cofactor called 6BH4. The process can be summarized as follows: 6BH4 + melanocytes + other elements → melanogenesis → melanin → skin colorIn vitiligo patients, however, this process is disrupted. Specifically, these individuals experience a significant deficiency of both 6BH4 and melanocytes, which are critical for melanin production.
In vitiligo patients, there is an excessive presence of hydrogen peroxide (H2O2) in the skin. High levels of H2O2 convert 6BH4 (cofactor paramount for melanin creation) into 6-biopterin, which is toxic to melanocytes (also paramount for melanin creation).In one step, H2O2 reduces 6BH4 levels—essential for melanin production—and also destroys melanocytes due to the increased presence of 6-biopterin (which is toxic for melanocytes).The reaction is:High H2O2 → Less 6BH4 and fewer melanocytes → Reduced melanogenesis → Low melanin → Loss of skin color → Vitiligo
This increase in H2O2 occurs because individuals with vitiligo have lower levels of catalase in their skin. Reduced catalase levels result in higher H2O2, which initiates the chain reaction leading to a reduction in melanin. The chain reaction is summarized in Diagram 1.
Our skin color is determined by a pigment called melanin—the more melanin, the darker the skin. In cases where melanin is scarce or absent, the skin appears white, as seen in vitiligo. Why do individuals with vitiligo have reduced melanin in their skin? This can be explained by a specific chain reaction.
Melanin is produced through a process called melanogenesis. For melanogenesis to function effectively, it requires melanocytes (the cells responsible for melanin production) and a cofactor called 6BH4. The process can be summarized as follows: 6BH4 + melanocytes + other elements → melanogenesis → melanin → skin color. In vitiligo patients, however, this process is disrupted. Specifically, these individuals experience a significant deficiency of both 6BH4 and melanocytes, which are critical for melanin production.
In vitiligo patients, there is an excessive presence of hydrogen peroxide (H2O2) in the skin. High levels of H2O2 convert 6BH4 (cofactor paramount for melanin creation) into 6-biopterin, which is toxic to melanocytes (also paramount for melanin creation).In one step, H2O2 reduces 6BH4 levels—essential for melanin production—and also destroys melanocytes due to the increased presence of 6-biopterin (which is toxic for melanocytes).The reaction is:High H2O2 → Less 6BH4 and fewer melanocytes → Reduced melanogenesis → Low melanin → Loss of skin color → Vitiligo
This increase in H2O2 occurs because individuals with vitiligo have lower levels of catalase in their skin. Reduced catalase levels result in higher H2O2, which initiates the chain reaction leading to a reduction in melanin. The chain reaction is summarized in Diagram 1.
Based on this context, Dead Sea Climatotherapy (DSC) has proven to be an extremely effective natural treatment for this issue as it is able to contemporarily incentivize catalase, reduce H2O2 and incentivizing melanogenesis.
The cream used artificially boosts catalase levels in the skin. Since low catalase is associated with high H2O2 and, consequently, vitiligo, increasing catalase significantly reduces vitiligo
The unique mineral composition of Dead Sea water has been shown to drastically reduce H2O2 levels in the skin within just 20 minutes of bathing. These mineral properties are exclusive to the Dead Sea.
The Dead Sea's unique location at the lowest point on Earth (-450 b.s.l) produces a distinct sub-band of UV rays that promotes melanin production and enhances skin pigmentation. This phenomenon creates an ultra-tanning effect that stimulates melanin production naturally.
Based on this context, Dead Sea Climatotherapy (DSC) has proven to be an extremely effective natural treatment for this issue as it is able to contemporarily incentivize catalase, reduce H2O2 and incentivizing melanogenesis.
The cream used artificially boosts catalase levels in the skin. Since low catalase is associated with high H2O2 and, consequently, vitiligo, increasing catalase significantly reduces vitiligo
The unique mineral composition of Dead Sea water has been shown to drastically reduce H2O2 levels in the skin within just 20 minutes of bathing. These mineral properties are exclusive to the Dead Sea.
The Dead Sea's unique location at the lowest point on Earth (-450 b.s.l) produces a distinct sub-band of UV rays that promotes melanin production and enhances skin pigmentation. This phenomenon creates an ultra-tanning effect that stimulates melanin production naturally.
The effectiveness of DSC is well-recognized and supported by leading dermatologists worldwide that consider it the most natural and effective treatment there is. Also, austrian and german public insurances as well as many other private insurances cover DSC treatments. The main case studies on the the effectiveness of DSC to treat vitiligo on adults have been conducted on Prof. Schallreuter´s patients, and those are:
It is important to note that repigmentation process, continues to develop even 3 to 4 months after DSC. It is highly recommended,once back home, to follow up with a cycle of phototherapy using a narrowband UVB lamp. This is why we are planning to launch a study to gather more precise and optimistic data on the average repigmentation achieved six months after DSC..
The informations and explanations provided are mainly based on the research of Prof. Schallreuter on vitiligo. In particular, you can visit the following scientific papers to have a deeper understanding of the topics mentioned.
Schallreuter, K. U., Moore, J., Wood, J. M., Beazley, W. D., Gaze, D. C., Tobin, D. J., ... & Hibberts, N. A. (1999, September). In vivo and in vitro evidence for hydrogen peroxide (H2O2) accumulation in the epidermis of patients with vitiligo and its successful removal by a UVB-activated pseudocatalase. In Journal of Investigative Dermatology Symposium Proceedings (Vol. 4, No. 1, pp. 91-96). Elsevier.
Schallreuter, K. U., Wood, J. M., & Berger, J. (1991). Low catalase levels in the epidermis of patients with vitiligo. Journal of Investigative Dermatology, 97(6), 1081-1085.
Schallreuter, K. U., Moore, J., Behrens‐Williams, S., Panske, A., Harari, M., Rokos, H., & Wood, J. M. (2002). In vitro and in vivo identification of ‘pseudocatalase’activity in Dead Sea water using Fourier transform Raman spectroscopy. Journal of Raman Spectroscopy, 33(7), 586-592.
Krüger, C., Smythe, J. W., Spencer, J. D., Hasse, S., Panske, A., Chiuchiarelli, G., & Schallreuter, K. U. (2011). Significant immediate and long-term improvement in quality of life and disease coping in patients with vitiligo after group climatotherapy at the Dead Sea. Acta dermato-venereologica, 91(2), 152-159.
Schallreuter, K. U., Moore, J., Behrens‐Williams, S., Panske, A., & Harari, M. (2002). Rapid initiation of repigmentation in vitiligo with Dead Sea climatotherapy in combination with pseudocatalase (PC‐KUS). International journal of dermatology, 41(8), 482-487..
