International Journal For Multidisciplinary Research

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Irsal-e-Alaq (Leech Therapy) in Nodulocystic Acne: A Clinical Perspective from a Case Report

Author(s) Dr. Aatika Hussain, Dr. Sana Sultan, Dr. Mohammad Mohsin
Country India
Abstract Abstract
Background: Acne conglobata is a severe form of nodulocystic acne marked by interconnected inflammatory nodules, cysts, and abscesses, often resistant to treatment and prone to scarring. In Unani medicine, it is linked to accumulation of Ghaleez Akhlaat (thick morbid humours) and managed through systemic purification (Tanqiya) and localized evacuation (Istifragh).
Case Presentation: A 19-year-old male presented with a 6-month history of painful, erythematous nodules and cystic lesions on both cheeks, unresponsive to topical therapy. Baseline investigations were normal. Treatment included Majoon Ushbah (6 g twice daily) for systemic purification and weekly Irsāl-e-‘Alaq (leech therapy) for four weeks.
Results: Marked reduction in pain, swelling, erythema, and discharge was observed, with complete healing and no scarring. The outcome was attributed to the Musaffi (blood-purifying), antimicrobial, and antioxidant effects of Majoon Ushbah, enhanced by the localized evacuation and bioactive effects of leech saliva—containing hirudin, bdellins, eglins, hyaluronidase, calin, and histamine-like vasodilators—offering anti-inflammatory, anticoagulant, antimicrobial, and microcirculation-boosting actions.
Conclusion: Combining systemic Musaffi therapy with localized leech therapy proved effective for resistant nodulocystic acne, providing a safe, well-tolerated, and scar-preventive alternative for inflammatory skin disorders refractory to standard care.
Keywords Acne conglobata, nodulocystic acne, Unani medicine, Majoon Ushbah, leech therapy, Irsāl-e-‘Alaq, Musaffi, Tanqiya, Istifragh.
Field Medical / Pharmacy
Published In Volume 7, Issue 4, July-August 2025
Published On 2025-08-23
DOI https://doi.org/10.36948/ijfmr.2025.v07i04.54007
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