Vitiligo is a depigmentation disorder affecting 1 to 4 % of the world population. The most prevalent explanation for the development of vitiligo is autoimmune response. That is, the immune system triggers a reaction which in the end destroys the pigment containing cells in the skin (melanocytes). The reaction is specific to the pigment containing cells, thus vitiligo is not harmful in any way, and does not carry any significant disease risks.

However, the impact of vitiligo on the psychological development of adolescents is widely acknowledged. 16 to 35% of those affected by vitiligo suffer mental anguish. Persons affected with vitiligo have suffered from depression, sleep disturbances, suicidal thoughts, suicidal attempts, difficulties in relationships and avoidance of social situations. Vitiligo can be confused with the leprosy still endemic in South Asian countries, leading to further stigmatization. The Greater Toronto Area (GTA) has significant Caribbean, African, and South Asian populations, which are doubly at risk. The darker skin makes the vitiligo more apparent, and the presence of lesions similar to endemic communicable diseases carry difficult cultural stigma.

Conventional treatments for vitiligo include photochemotherapy (PUVA), phototherapy (UVB), vitamin D3 analogues, topical corticosteroids, topical immunomodulators, excimer laser, and surgery. There is scientific agreement that these treatment options have limited success. Some even present significant risks, including suspected increases in skin cancer risk by PUVA, skin atrophy with corticosteroids, and skin boils with UVB therapy. The low benefit to risk ratios of these therapies, and the high psychological impact of vitiligo make the search for a safe and effective alternative approach critical. We are conducting a pilot study of the feasibility of recruitment, safety and outcome variability in using Ginkgo biloba for the treatment of vitiligo in Canadian adolescents in the Greater Toronto Area in preparation for a full scale randomized controlled trial.