CLINICAL STUDIES ON THE TREATMENT OF BARAṢ (VITILIGO) IN UNANI SYSTEM OF MEDICINE – A SYSTEMATIC REVIEW

Background: Baraṣ (vitiligo) is an acquired pigmentary, multifactorial, polygenic disorder, with a complex pathogenesis that is not yet well understood. Out of various propounded theories, some accepted suggestions are the autoimmune destruction of melanocytes, melanocytes adhesion, neurogenic damage, auto-toxicity, etc. Although several treatment modalities are available in the present scenario, but they have their own limitations, and the treatment challenges persist as it is. In Unani System of Medicine, Baraṣ is a well- recognized disease entity and has been treated successfully since antiquity with various single and compound drugs. In recent years, various clinical trials have been conducted to validate the claims of Unani Medicine in the management of Baraṣ.

Objectives: Our objective was to review the published scientific clinical studies, performed to evaluate the safety and efficacy of Unani drugs in the treatment of Baraṣ (vitiligo).

Methods: We searched 4 databases for vitiligo, using the terms “Bars OR vitiligo”, “Baraṣ OR vitiligo”, “Unani medicine” and “vitiligo”. We also hand searched journals available in the Library of CRIUM, Hyderabad. Additional efforts were made by general Google searches and reference searches of Unani treatment in Baraṣ. Prospective clinical trials included in this review were either randomized or non-randomized and controlled or single or double arm.

Results: A total of 63 articles were reviewed; out of them 50 articles based on animal studies, epidemiological reports, incomplete report, studies of general concepts, were discarded resulting into 13 articles. Different Unani drugs were used in the trials. Although each clinical trial reported beneficial effect, but very few trials were controlled and randomized.

Authors’ conclusions: There are too many clinical trials conducted to evaluate the safety and efficacy of Unani drugs in the treatment of vitiligo. But, appropriately designed, high quality clinical trials were not carried out and there was lack of standardized scoring system. Hence, it is still needed to conduct the well-designed randomized controlled clinical trials with standardized scoring system to scientifically validate the efficacy of Unani drugs in the treatment of Baraṣ (vitiligo).