General management of Skin disorders

Pathogenesis of Skin Diseases

Skin diseases often present and get triggered by multiple factors which are broadly classified as Aharaja, Viharaja, Manasika and Agantuka in nature which primarily initiate Agni Vaisamya and Raktadushti thus paves the way for deeper dhatu involvement. The three vitiated humours namely Vata, Pitta and Kapha in turn vitiate the skin, blood, muscle tissue and lymph. All these taken together, constitute the seven-fold pathogenic substances for the genesis of18 skin diseases i.e., seven major (Maha Kushta) and eleven minor (Khudra Kushta). All the seven factors are involved together in causing skin diseases, not in isolation of any one of these never cause this disease.

For More Information about Poorvarupa (Prodromal Symptoms),  Common skin diseases mentioned in Ayurveda, Click Here.

Management of skin diseses in Ayurveda

In Ayurveda, skin disorders like any other diseases are treated with Samsodhana and Samsamana Chikitsa. As mentioned above, Samshodana Chikitsa plays a vital role in the management of skin disorders. Treatment of various skin disorders according to various Acharyas of Ayurveda are illustrated below.

In Vatajakusta (skin disorders dominated by Vata), medicated ghee is first administered internally. In Pittaja kusta (skin disorders dominated by Pitta), Raktamokshana (blood-letting) and Virechana (Therapeutic Purgation) should be administered, Raktamokshana (blood-letting) should be performed in the less acute stage of kusta by pracchana (rubbing with a coarse device) and in more acute stage of kusta by venesection. Kaphaja kusta (skin disorders dominated by kapha) is treated with Vamana (Therapeutic Emesis).

Sneha panam (Internal administration of medicated Sneha (unctuous substances):

Prior to Samshodana, Snehana is done with internal administration of following Snehas

• Mahatiktaka ghrita
  
• Tiktaka ghrita
  
• Vajraka ghritam
  
• Maha Vajraka ghritam
  
• Tuvaraka taila or
  
• Bhallataka taila 

1. Swedana (Sudation) is done one day prior to Vamana (Therapeutic Emesis) or three days in case of Virechana (Therapeutic Purgation). Usually Mridu swedana is done like exposure to sun or taking hot water bath etc.
2. Vamana (Therapeutic Emesis) is done with Kutaja (Holarrhena antidysenterica (ROTH.) A.DC.), Madanaphala (Randia dumetorum LAM.) and Madhuka (Glycyrrhiza glabra L.) mixed with the juice or decoction of Patola (Trichosanthes dioica ROXB.) and Nimba (Azadirachta indica A. JUSS.).
3. Virechana (Therapeutic Purgation) is done with
   1. Trivrt (Operculina turpethum (L.) S. MANSO), Danti (Baliospermum montanum (WILLD.) MUELL.-ARG) and Triphala (Terminalia chebula RETZ. & WILLD., Terminalia bellerica ROXB. & Phyllanthus emblica L.)
   2. Manibhadra gudam or
   3. Avipatikara choornam.
4. Depending upon the intensity of sodhana, Samsarjana krama (administration of regulated diet after the therapy) from 3 to 7days should be followed.
5. In patients with excess of Vata dosa after Virechana (Therapeutic Purgation), asthapana vasti (Medicated Decoction Enema) and anuvasana vasti (Medicated oil enema) should be administered.
6. Nasya (inhalation therapy) with rock salt, Danti (Baliospermum montanum (WILLD.) MUELLARG.), Maricha (Piper nigrum L.), Phanijjhaka (Origanum majorana L.), Pippali (Piper longum L.) and fruit of Karanja (Pongamia pinnata (L.) PIERRE) cures kusta caused by aggravation of kapha and krimi.
7. Vairecaniya dhuma (eliminative type of smoking therapy) cures krimi (worms), kusta and kilasa (vitiligo). (Ca. Ci 7:39-42)
8. After Samshodana, administration of following drugs are advised (Su.Ci.9:6)

• Herbal or herbo-mineral pastes or alkalies are used as external applications.
• Sulphur preparations: Administration of sulphur internally and externally is regarded as remedy par excellence for the cure of all types of skin diseases. (Ca. Ci.7:70)
• Siddhartaka snana: The water boiled with Musta (Cyperus rotundus L.), Madana (Randia dumetorum LAM.), Triphala (Terminalia chebula RETZ. & WILLD., Terminalia bellerica ROXB. & Phyllanthus emblica L.), Karanja (Pongamia pinnata (L.) PIERRE), Aragvada (Cassia fistula L.), Indrayava (Holarrhena antidysenterica (ROTH.) A.DC.), Darvi (Berberis aristata DC.) and Saptaparna (Alstonia scholaris R.BR.) should be used for bath. (Ca. Ci 7:81-82)
• Vomiting should be induced every fortnight, purgation should be done every month, blood-letting in small amounts should be done twice a year and snuffs should be given every third day. This is done for chronic and recurrent skin disorders. (Su.Ci.9:43)

Rasayanaprayogam: (A.H 19:53)

• Tuvara asthi (Hydnocarpus laurifolia (DENNST.) STEUM.)
• Bhallataka (Semecarpus anacardium L. F.)
• Bakuchi (Psoralea corylifolia L.) and
• Shilajatu (black asphaltum)

Samana Ausadas:

Kwatham:

• Patolamooladi Kwatha
• Manjistadi Kwatha
• Mahamanjistadi Kwatha
• Punarnavadi Kwatha
• Guluchyadi Kwatha
• Panchatiktakam Kwatha
• Aragwadhadi Kwatha
• Nimbadi Kwatha
• Sonithamrutam Kwatha
• Nimbamritadi panchatiktam kwath

Arista/Asava.

• Khadiraristam
• Aragwadaristam
• Saribadyasavam
• Nimbamrutasavam
• Chitrakasavam
• Chandanasava

Lehyam:

• Manibadra gulam
• Amrutha bhalataka lehyam
• Haridrakhandam
• Madhusnuhi rasayanam (Big)
• Markava rasayanam
• Gandhaka rasayanam

Guggulu:

• Amrutha guggulu,
• Kaishora guggulu

Gulika:

• Arogyavardhini vati
• Gandhaka rasayanam
• Doosivishari gulika
• Krimighna vati
• Krimisodhini vati
• Vilwadigulika

Ghritam:

• Guggulu tiktaka ghritam
• Tiktakam ghritam
• Mahatiktaka ghritam
• Kalyanakam ghritam
• Satadhoutaghritam

Aragwadhadi panchatikta ghritam

Churnam:

• Avipattikara churnam
• Rajanyadi churnam
• Nimbadi churnam
• Vara churnam
• Sudarsanamchurnam

Tailam:

• Guggulu marichadi tailam
• Vajraka tailam
• Maha vajraka tailam
• Durvadya tailam
• Maha marichady tailam
• Somaraji tailam
• Jeevantyadi yamakam
• Eladi tailam
• Dinesa eladi tailam
• Dinesa valyadi tailam
• Pamantaka tailam
• Gandhaka tailam
• Markava tailam
• Chemparathyadikeram
• Malatyadikeram
• Dhurdhoorapatradikeram
• Karappan tailam
• Kumkuma tailam

Lepam:

• Sindhuradi lepam
• Avalgujabeejadi lepam
• Rasottamadi lepam
• Rasakarpura lepam

Ras:

• Talakeswara ras
• Rasa manikyam
• Rasasindhuram
• Vyadhiharana rasa 

Source : Central Council for Research in Ayuredic Sciences