Polypodium leucotomos as an adjunct treatment for vitiligo?

Polipodium Leucotomos

Extracts of the tropical fern Polypodium leucotomos appear to possess beneficial properties for the vitiligious skin.

Polypodium leucotomos (also classified as Polypodium aureum) and Polypodium decumanum (also classified as Phlebodium decumanum) are indigenous to the Honduran rainforests but also can be found throughout the South American tropics and in parts of Latin America and the Caribbean. In Brazil, the common name is samambaia ; in Mexico and other Spanish-speaking tropical countries, the plant is known as calaguala .

Three randomized, double-blind, placebo-controlled studies have demonstrated (PubMed) significant improvements in vitiligo when oral Polypodium leucotomos therapy was combined with NB-UVB. Participants received 250 mg oral P. leucotomos or placebo three times daily, combined with NB-UVB twice weekly for 25-26 weeks. Patients attending >80 percent of required phototherapy sessions showed significantly increased re-pigmentation in the head and neck area in the P. leucotomos group versus placebo, and no significant differences were seen in the other body areas (PubMed).

Clinical research has also shown that it has antioxidant (PubMed) and photoprotective (PubMed) properties. Taken orally, it provides protection against the harmful effects of ultraviolet (UV) radiation from the sun and other sources. However, it should not be considered as a replacement for a good sunscreen and protective clothing.

The mechanism of action of Polipodium leucotomas extract is fairly complex and can be summarized into the following main points:
  • Acts as a scavenger to mop up free radicals and reactive oxygen species
  • Inhibits the depletion of Langerhans cells
  • Reduces the number of sunburn cells
  • Protects DNA by inhibiting the formation of cyclobutane pyrimidine dimers (cancer-causing cells) induced by UVB radiation.

Indigenous people of the rainforest have long used the plants to treat and alleviate symptoms of autoimmune disorders and inflammatory conditions, including vitiligo, psoriasis, arthritis, lupus, kidney problems and malignant tumors. Its use as a tea for blood cleansing began with the Mayans, and continues today in Honduran culture.

Polypodium leucotomos extract is marketed as a dietary supplement in many countries under different names, such as Heliocare®, Calaguala and others.

The recommended dose of i.e. of Calaguala 500 mg capsules containing 100% pure Calaguala rhizome (Polypodium leucotomos) and Samambaia rhizome and leaf (Polypodium decumanum) is 2-3 capsules twice daily. It is rapidly absorbed and provides early protection that lasts few hours against the initial signs of sunburn - skin redness, or erythema reaction. However, its photoprotective effect extends beyond just decreasing the erythema reaction. The antioxidant properties of orally administered P. leucotomas extract work at protecting the skin at a deeper cellular level which is not achieved with topically applied antioxidants.

To date, Polipodium leucotomos has demonstrated an exceptional safety profile, but it has not been clinically tested in patients less than 18 years and in pregnant or breastfeeding women. Reports show that related fern species, Polypodium vulgare, may interact with medications that affect the function of the heart or blood pressure. As always, discuss this with your doctor before considering purchase.

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