Ayurvedic Dermatology: Therapeutic Strategies for Skin Disease Management

Human skin, the outer layer of the body, is the largest organ in the body. It is also the first line of defense. According to Ayurveda, the skin is one of the most important sensory organs. Ayurveda has its own unique principles for diagnosing and treating various skin diseases under the name Kuṣṭha. Taking into account the prevalence of various diseases, about 20% of the total number of patients visiting a doctor worldwide suffer from skin diseases, including cosmetic problems, every year. Skin diseases are a common condition that affects people of all ages, from newborns to the elderly, and causes numerous damages. In addition, people with skin diseases suffer from social stigma.


INTRODUCTION
Skin has always enjoyed special importance due to the aesthetic value that society places on skin tone and beauty.Ayurveda places special emphasis on ahara (diet) and vihara (lifestyle) to maintain health and prevent disease .In the recent past, the connection between diet and skin diseases has been well established in modern medicine.In Ayurvedic literature, skin diseases are described primarily in terms of Kushta, whose literary meaning means "one who causes disfigurement."The Ayurvedic medical system describes a wide spectrum of etiological factors of dermatological diseases.Etiological factors include physical, physiological, hereditary, psychological, psychosocial and papkarma factors (sinful activities/psychosocial stress and related psychological factors are mainly responsible for the manifestation and/or aggravation of many dermatological diseases), etc.The incidence of skin diseases is increasing due to the following factors: ⮚ Unappropriate daily diet and lifestyle; Eating intolerable and unhealthy foods; Eating before the previous meal has been digested; take milk with meat, fish (aquatic animals); bathe immediately after sunbathing or after physical activity), etc. ⮚ Excessive and inappropriate use of chemical products, cosmetics, soaps, shampoos, deodorants, etc. • Email: editor@ijfmr.com
⮚ Unnecessary and excessive use of antibiotics and steroids.
Main principles of treatment of the Skin Disease ⮚ Punaha-Punaha Shodhana in Bahudoshajanya Tvak roga (dermatological disorders) ⮚ After Shodhana and Raktamokshana, Ghritapana is necessary to prevent Vata Prakopa.

Good Clinical Practice (GCP) guidelines
• An accurate diagnosis is essential for quick and complete results.
• Shodhana (biocleansing) is necessary for all chronic skin diseases.
• Disease-specific Rasayana and Shamana Aushadhi (Palliative): Rasayana refers to rejuvenation therapy in Ayurveda and often includes antioxidant and immunomodulatory herbs and formulations.These are intended to boost the body's natural defense mechanisms and help with overall health.Shamana Aushadhi refers to palliative or symptom-relieving medicines.• Psychogenic Stress and Emotional Conflicts: Mental and emotional well-being is indeed an important aspect of holistic healing.You recommend calming the mind through yoga and prescribing Medhya Rasayana medicines, which are nootropics that support cognitive function and may help in reducing stress and anxiety.• Medhya Rasayana Medicines specific herbs like Ashwagandha, Brahmi, and Guduchi as examples of Medhya Rasayana medicines.These herbs help in managing stress and promoting mental well-being.• Rasa Aushadhi (Mineral Preparations): when using mineral preparations like Malla (arsenic) and Naga (lead), suggesting that they should not be administered for extended periods (more than 45 days).
Monitoring and using hepatoprotective and nephroprotective medications alongside these treatments is crucial to mitigate potential adverse effects on the liver and kidneys.If necessary, resuming treatment with Rasa Aushadhi after a 15-day break, possibly to reduce the risk of toxicity associated with prolonged use.• Asava-Arishta (Herbal fermented preparation) is suitable for elderly patients with poor digestion.
• When prescribing Guggulu kalpana (Commiphora mukul preparations), advise patients to crush the pill.• Topical therapy options, in order of hydration, include soaks, lotions, solutions, creams, and ointments.
• For irritant drugs, test on a small area before applying to generalized lesions to prevent severe allergic reactions, especially in Pitta Prakriti individuals (e.g., Bakuchi Lepa in Switravitiligo).• Avoid using irritating medications on pregnant women, children and the elderly as the skin is very soft and sensitive.• Avoid using irritating medications on sensitive areas: scrotum, genital area, eyelids, lips, etc. Avoid taking oils and oil-based medicines in the acute phase.• Before practicing Lepa Yoga (external use), rub samudraphena with rough leaves such as Gojihvā and Gomaya.This helps to increase local blood flow and therefore absorption.
• Drink enough water/liquid every day.
• Eat enough seasonal vegetables and fruit.
• Avoid vegetarian food , fatty, fast food/junk food diets.
Patients suffering from Kushta (a dermatological disease) turn to various healthcare systems in the hope of a cure.Skin diseases cause numerous accidents, suffering, inability to work and economic losses.Patients suffering from certain skin diseases for which western medicine has no cure seek Ayurvedic treatment with high hopes of curing their illness.By the time they approach an Ayurvedic doctor for treatment, the disease seems to have reached a chronic state, making treatment even more difficult.
All Acharyas have emphasized the use of Shodhana therapy for treating skin diseases, known as Kushta.Shodhana therapy is a method that helps to eliminate the imbalanced doshas (fundamental bodily energies) from the body.Kushta is generally considered a challenging condition to treat.However, when Shodhana therapy is applied, it becomes easier to cure the disease because it addresses the root cause of the problem.So, in simple terms, Shodhana therapy is crucial for managing complex and multifactorial skin conditions like Kushta by getting rid of the underlying imbalances in the body.

DISCUSSION AND CONCLUSION
Virechana is the best remedy for Kushta (dermatological diseases).Most kushtas fall into the Raktapradoshaja vyadhi category.Pitta is the mala of Rakta.Therefore, between Rakta and Pitta there is Avinabhava Sambandha.When excess Pitta is eliminated from the body, it also helps in purification of Rakta and heals the representatives of Raktapradoshaja vyadhis such as Kushta.Virechana Karma has a specific effect on Sapta-Dravya (Rasa, Rakta, Lasika, Udaka, Vata, Pitta and Kapha), the major factors responsible for skin diseases.Therefore, Virechana is the best shodhana karma of Pitta Pradhana Kushta and aims to prevent recurrences.Similarly, in Raktadushti diseases, the amount of Malaroopa Pitta present in the liver and gallbladder increases in the body.To eliminate this Pitta Malaroopa, the only treatment method is Virechana food.3