Vaman Karma in Yauvan Pidika (Mukhdushika) w.s.r. to Acne Vulgaris: A Case Study

Pankaj Kumar; Ragini Kumari; Sumit Kumar; Prabhas Chandra Pathak

Vaman Karma in Yauvan Pidika (Mukhdushika) w.s.r. to Acne Vulgaris: A Case Study

Kumar P.^1*, Kumari R.², Kumar S.³, Chandra Pathak P.⁴

DOI:

^1* Pankaj Kumar, Post Graduate Scholar, Dept. of Kayachikitsa, Govt. Ayurvedic College & Hospital, Patna, Bihar, India.

² Ragini Kumari, Post Graduate Scholar, Dept. of Kayachikitsa, Govt. Ayurvedic College & Hospital, Patna, Bihar, India.

³ Sumit Kumar, Post Graduate Scholar, Dept. of Kayachikitsa, Govt. Ayurvedic College & Hospital, Patna, Bihar, India.

⁴ Prabhas Chandra Pathak, Assistant Professor, Dept. of Kayachikitsa, Govt. Ayurvedic College & Hospital, Patna, Bihar, India.

Face is considered as an important part of the body as far as beauty and look is concerned. Hence, everyone in general and youngsters in particular are very cautious about beauty of their face. Acne vulgaris (A.V) is a disease of the pilosebaceous origin that causes non-inflammatory lesions (papules, pustules and nodules) and varying degrees of scarring. In Ayurveda Yauvanapidika (Acne vulgaris) is such a condition that disfigures the face during adolescent to younger age. If the condition remains untreated, it leaves permanent scars over the face. According to Ayurveda, vitiation of Kapha Dosha, Vata Dosha and Rakta Dhatu lead to development of Mukhadushika or Yauvanapidika which have resemblance with acne vulgaris in modern texts. Both modern and Ayurvedic sciences have considered the use of topical as well as oral medicines and their combination for the management of acne vulgaris. No doubt modern medication provides quick relief from acne vulgaris but cause noticeable side effects. Nowadays herbal formulations and Ayurvedic therapy are the superior choices for cosmetic purposes among the most of the population. So, the aim and objectives of this article is to minimize the side effects of Allopathic medicine in Acne vulgaris (A.V) as well as to popularized the Vamana therapy (one of the procedures of Panchakarma therapy) by a case study of 25 yrs old female patient having complaints of recurrent erythematic papules and pustules along with dark spots on her face. She was given Shodhana Therapy (Vamana therapy) and then Shaman Chikitsa (Panchkol Phanta, Chitrakadi Vati, Liv 52 DS). She got good result in Yauvanapidika (Acne vulgaris).

Keywords: Acne vulgaris, Madanaphala Pippali, Samsarjana Krama, Snehapana, Vasantika Vamana, Yauvanapidika

Corresponding Author	How to Cite this Article	To Browse
Pankaj Kumar, Post Graduate Scholar, Dept. of Kayachikitsa, Govt. Ayurvedic College & Hospital, Patna, Bihar, India. Email:	Pankaj Kumar, Ragini Kumari, Sumit Kumar, Prabhas Chandra Pathak, Vaman Karma in Yauvan Pidika (Mukhdushika) w.s.r. to Acne Vulgaris: A Case Study. J Ayu Int Med Sci. 2022;7(7):150-154. Available From https://jaims.in/jaims/article/view/1962

Introduction

Acne in adult patients may start during adolescent and persist or have an onset in adulthood. Acne has various psychological^[1] effects that impact patients quality of life.^[2]

Acne is a common skin problem that affects almost 85% of teenagers, mostly occurs on face and some time on chest and upper back too. This condition resembles with Yauvanapidika^[3] or Mukhadushika^[4] described in Ayurveda under the caption of Kshudraroga.^[5]

Acne vulgaris is related to the pilosebaceous follicle. It is considered as adolescent disorder which is characterized by formation of open and closed comedones, papules, pustules, nodules and cysts. According to studies, several factors such as disturbed hormonal (androgen) production, excess sebum production, hyper keratinization are involved in pathophysiology of acne. Accumulation of excess sebum, epithelial cells and keratin obstruct the pilosebaceous follicle. This obstruction causes formation of a keratin plug and follicle swelling below skin surface, resulting in acne lesion.^[6,7]

Colonized bacteria of skin such as Propionibacterium. acnes may cause severe kind of infection which leads to scarring and unpleasantness of face.^[8,9,10]

In modern medicine, several treatments are available for acne vulgaris but treatment must comply with type and severity of the lesions. Treatment mainly includes prolonged use of antibiotics, comedolytic and anti-inflammatory agents.^[11]

Though, these medicines are better treatment options for acne management, the side effects of these medications such as increase frequency and severity of skin dryness, scaling, erythema, burning, stinging, itching and bacterial resistance limits their use.^[12,13]

In Ayurveda, acne has been elaborated as one of the Kshudra Rogas (minor ailments). Acne is called as Yuvanpidika and Tarunyapitika as it manifested in Yuva or Taruna (adolescence). As the disease has local spread over the face and due to the inflammatory and scarring nature of lesions, acne is also called as Mukhadushika.^[14,15] Yuvanpidika or Tarunyapitika or Mukhadushikais characterized

by Saruja (mildly painful), Ghan (firm on touch), Medogarbha (filled with oil/sebum) and shape of Shalmali Kantaka (thorn of Salmalia malabarica).^[16,17]

The disease Yauvanapidika occurs due to vitiation of Kapha, Vata, and Rakta.^[18] Swabhava (natural status) has also been considered as one of the causative factors. Though the Tarunyaavastha (adolescent period) is the age for Shukra Pradurbhava and the incidence of Vaktre Snigdhata (unctuousness on face) and Pidika (boil) formation on faeces Mala (waste product) of Shukra Dhatu.^[19]

So, development of the acne in this age is obvious this indicates a specific phase of life cycle, where Dhatu maturation is going on and for the same, secretion of various growth hormones definitely took place.

Imbalanced hormonal levels play an important role in the development of various diseases like Mukhadushika or Yauvanapidika.

To treat, modern medical science suggests hormonal therapy, antibiotics, and some surgical or para-surgical measures. Treatment of acne has its challenges due to the considerations of patient preferences, male, female, onset age, pregnancy and lactation. As these measures have certain limitations, alternatives are being searched for significant relief. Herbal formulations that purify blood, check the status of Kapha and Pitta can be used safely in the condition for longer duration. Taking into consideration of the above facts, present study was planned to evaluate the effect of Vamana as Shodhana therapy.

Case Study

A 25 yrs. old female patient with R.N. - 1380; C.R.N - A11349 from Patna came in OPD of Govt. Ayurvedic College and Hospital, Patna. She complaints of recurrent erythematic papules and pustules along with dark spots on her face. She doesn't have any other systemic disease nor any report of examination. Her general examination was quite normal. On the basis of signs and symptoms we diagnosed her as Yauvanapidika.

Treatment

a. Shaman Chikitsa

b. Shodhana Therapy

A. Shaman Chikitsa

Medicine	Matra	Kaal	Anupan	Duration
Panchkol Churna (Phanta)	5gm	Pratah - Sayankal	Kwatha	7 days
Chitrakadi Vati	1 tab	Pratah - Sayankal	Koshna Jala	7 days
Liv 52 DS	1 tab	Pratah - Sayankal	Koshna Jala	7 days

B. Shodhana Therapy^[20]

Poorva Karma

Uses	Drugs	Matra	Anupana
Deepana - Pachana	Panchkola Churna	5 gm BID	Ushnajala
Snehapana	Panchatikta Ghruta	25ml to 200ml Arohana Krama	Ushnajala
Sarvanga Abhyanga	Vishtinduk Tail	Q.S.

Pradhana Karma

SN	Procedure	Drug	Matra
1.	Akantapana	Ksheera	0.5 -1lit.
2.	Vamana Karma	Madanaphala Pippali	3 gm
		Vacha churna	3 gm
		Saindhava lavan	5 gm
		Madhu	20 ml
3.	Vamanaopaga	Yashtimadhu Kashaya	3 lit.
		Cow milk	3 lit.
		Saindhava jala	3 lit.

Paschat Karma

Procedure	Drug	Matra
Kavala	Ushnajala	-
Dhoompana	Haridra Ghruta Varthi	-
Samsarjana Karma	Peyaadi Karma	5 days
Pathyaaahara	-	14 days

Fig. 1: Yauvanapidika (Acne vulgaris) Before Treatment

Fig. 2: Yauvanapidika (Acne vulgaris) After Treatment.

Vamana is a procedure in which Doshas (waste products or toxins) are eliminated through Urdhva Marga i.e., mouth.^[21]Specially the Kapha and Pitta Dosha brought to Amashaya (stomach and duodenum) from all over the body by the specific preoperative procedures (Snehan Swedana Karma) and then eliminated out by inducing the emesis. Curative and rehabilitative therapy.

Ayurveda believes in strong relationship between macrocosm and microcosm and states that the seasonal changes will influence the biological systems resulting into the accumulation and aggravation of particular Dosha in a particular season like accumulation and aggravation of Kapha in Hemant Rutu (winter season) and Vasant Rutu (spring season) respectively, accumulation and aggravation of Pitta in Varsha Rutu (rainy season) and Sharad Rutu (autumn season) respectively.

Vasantika Vamana is done in spring season approximately in the month of March and April for the elimination of vitiated Kapha Dosha which in turn helps to prevent the forth coming Kapha disorders and associated Pitta disorders or diseases originating or settled in the place of Kapha like bronchial asthma, allergic bronchitis, rhinitis, sinusitis, migraine, hyperacidity, indigestion, anorexia, obesity, overweight, dyslipidemia, diabetes mellitus, acne vulgaris, psoriasis, eczema, urticaria etc.

Panchakarma is the most essential part of Ayurveda treatments. It is preventive, preservative, promotive, curative and rehabilitative therapy.

The umbrella of Panchakarma includes five major therapeutic procedures Vamana (therapeutic emesis), Virechana (therapeutic purgation), Niruha Basti (therapeutic decoction enema), Anuvasan Basti (therapeutic oily enema) and Nasya (therapeutic errhine) and many allied therapies. Ayurveda practices Tridosha (Vata, Pitta and Kapha) theory. For the correction of abnormalities of Tridosha and related body constituents, specific therapy among the Panchakarma is practiced like Vamana for Kapha Dosha, Virechana for Pitta Dosha, and Basti for Vata Dosha predominantly.

Vamana Yoga which may comprises of Vacha Churna,^[22] Madanphala Pippali,^[23] Saindhava and Madhu may be used in skin disease, while Yashtimadhu Phanta may be used as : Vamanaopaga Dravya. Literature study confirm that Vamana reduces symptoms of skin disease like; Bahusrava, Kandu, Pidaka, Shotha, Daha and Vedana. Study confirmed that Snehana and Swedana as Poorvakarma provides Samshodhana effect. Ingredients of therapy possess Kushthaghna^[24] Amapachana, Kaphagna and Krimighna^[25] qualities which pacify symptoms of diseases. Vamana Yoga help to eliminate Kapha Dosha thus reduces pathological progression of disease. Vamana Karma expels out toxins present in the Rasadi Dhatu and purifies Dushya of skin disease. Vamana cleared channels which improve process of body nourishment, it further cleared Bahyaroga Marga and increase Indriya Bala of Twacha thus reduces severity of skin disease.

Conclusion

On the above discussion and results, we can use Vamana Karma for the management of acne like skin problem as well as the elimination of vitiated Kapha Dosha which in turn helps to prevent the forth coming Kapha disorders and associated Pitta disorders or diseases originating or settled in the place of Kapha like bronchial asthma, allergic bronchitis, rhinitis, sinusitis, migraine, hyperacidity, indigestion, anorexia, obesity, overweight, dyslipidemia, diabetes mellitus, acne vulgaris, psoriasis, eczema, urticaria etc.

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Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2022-06-27	2022-06-29	2022-07-06	2022-07-13	2022-07-20
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	16%

Case Report

Acne vulgaris

Journal of Ayurveda and Integrated Medical Sciences