E-ISSN:2456-3110

Research Article

Darunaka

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 6 June
Publisherwww.maharshicharaka.in

A comparative clinical study to evaluate the efficacy of Malatyadi Taila Shiro Abhyanga over Dhurdhuradi Taila Shiro Abhyanga in the management of Darunaka (Dandruff)

Panchaxarimath M.1*, M Kadlimatti S.2
DOI: http://dx.doi.org/10.21760/jaims.8.6.2

1* Manasa Panchaxarimath, Assistant Professor, Department of Kayachikitsa, BLDEAs AVS Ayurveda Mahavidyalaya, Hospital and Research Centre, Vijayapura, Karnataka, India.

2 Sanjay M Kadlimatti, Principal and Professor, Department of Kayachikitsa, BLDEAs AVS Ayurveda Mahavidyalaya, Hospital and Research Centre, Vijayapura, Karnataka, India.

Great individual cleanliness is critical for both well-being and social reasons. Among maintaining great individual cleanliness, hair cleanliness is most imperative and necessary too. Darunaka aka dandruff, also known as Pityriasis Captitis, is one of the foremost common and widely seen dermatological maladies that influences most of the world's populace. The cardinal symptoms for Darunaka are Daruna (rough/flakes), Kandu (scalp itching), Rukshata (dry scalp), Kesha Bhumi Prapatana (cracking of the scalp), Kesha Chyuti (hair fall). A clinical study was conducted to assess the comparative effect of Malatyadi Taila over the Dhurdhuradi Taila Shiro Abhyanga in Darunaka (Dandruff). 40 patients with Darunaka were taken and randomly divided into 2 groups consisting of 20 patients in each group such as Dhurdhuradi Taila as Group A and Malatyadi Taila as Group B. The oil application (Shiro Abhyanga) is adopted for both the Taila with a duration of 1 month. Grading of severity were given for clinical signs and symptoms based on the before and after treatment. The overall effect of the study showed 25% of complete cure, 65% of mild cure and 10% of them have felt no change in Group A, and in Group B 80% of complete cure, 15% mildly cure, and 5% have felt no change. Darunaka management certainly benefited from the usage of Malatyadi Taila. There was a substantial improvement in clinical symptoms after just one month, and it was cost effective, adaptable, and safe.

Keywords: Darunaka, Ksudraroga, Shiro Abhyanga, Dandruff, Malassezia fungus

Corresponding Author How to Cite this Article To Browse
Manasa Panchaxarimath, Assistant Professor, Department of Kayachikitsa, BLDEAs AVS Ayurveda Mahavidyalaya, Hospital and Research Centre, Vijayapura, Karnataka, India.
Email: 		Manasa Panchaxarimath, Sanjay M Kadlimatti, A comparative clinical study to evaluate the efficacy of Malatyadi Taila Shiro Abhyanga over Dhurdhuradi Taila Shiro Abhyanga in the management of Darunaka (Dandruff). J Ayu Int Med Sci. 2023;8(6):7-12.
Available From
https://jaims.in/jaims/article/view/2532

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-04-29 2023-05-02 2023-05-09 2023-05-16 2023-05-23
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 17%

© 2023by Manasa Panchaxarimath, Sanjay M Kadlimattiand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Nowadays, hygiene has become the most important factor. A cosmetic is a substance or product used to improve or modify the appearance of the face, hair, and body texture. Many cosmetic products are designed for hair, face, and body use. Today, Hair cosmetics are an important tool to increase patient adherence to hair loss and scalp treatments. How shampoos, conditioners, straighteners, and hair dyes harm hair when used in excess. Ayurveda is one of the most ancient systems and holistic health science of life and health. Tatra Vaa Gati Gandhanayor Iti Vata which means all the movements in the body is controlled by Vata.

Darunaka in Ayurveda refers to Ksudra Rogas (minor ailments). The Dosa involved in Darunaka is Kapha Vata. Different Acharya’s considered Darunaka as Kapala Roga, Shiroroga and also in Kshudra Roga. Shiro Abhyanga is one of the lines of treatment mentioned by Acharya Vagbhata in Astanga Hridaya and Acharya Chakrapani in Chakradatta in the management of Darunaka.

Hence, an attempt is made to know the effect of Malatyadi Taila over Dhurdhuradi Taila in Darunaka. A clear reference for Malatyadi Taila is found in Bhaishajya Ratnavali and Chakradatta. No clear reference for Dhurdhuradi Taila for Darunaka only in Kandu and Keshachyuti is mentioned in Sahasra Yoga Taila Prakarana. Dhurduradi Taila is already considered a traditional medicine for Darunaka / Dandruff. Darunaka is considered under the context of Ksudra Roga. The reference of Ksudra Roga found in Vedic mythology that Garuda Purana contains 15000+ verses known in many versions. In Samhita Kala Acharya Charaka has not explained Ksudra Roga separately, Sushruta elaborated on 44 Ksudra Rogas, and Vagbhatta mentioned 36 Kshudrarogas. Acharya Vagbhatta, and Sharangadhara explained Kapala Rogas and considered Darunaka under Kapala Roga.

In later periods Yogaratnakar, Bhaishajya Ratnavali, Vangasena, etc. have also explained Darunaka under Ksudrarogas. 

Kshudraroga refers to minor skin diseases or minor ailments. Kshudraroga comprises two words Kshudra and Roga.[1] Kshudra = Alpa or short/minor/small Roga, Roga = illness or ailments.



Kshudraroga[2] are therefore minor/short/mild diseases.

They are named Kshudraroga because Nidana (etiology), Lakshana (clinical features), and Chikitsa (treatment) are described in Kshudra (briefly). Kshudraroga covers a major part of skin diseases. As the name suggests, Kshudraroga is a minor and less serious illness.

Dandruff[3] is a common chronic scalp condition marked by flaking of the skin. Keratinization is the cause of mutation in the gene coding for filaggrin, a key protein involved in skin barrier function. Dryness and scaling of the skin are present; it is a common inherited disorder of keratinization. Dandruff is not a contagious or serious issue. But it can be embarrassing and sometimes difficult to treat, but usually controlled. More stubborn cases of dandruff often respond to medicated oils and Shampoos. For teens and adults, the aetiology factor for dandruff includes dry skin in the winter season, Sensitivity to hair products, itching, and white flakes of dead skin on the scalp, and the shoulders, and a red scaly Scalp. The overgrowth of yeast - like fungus (Malassezia) can also cause dandruff, Malassezia lives on the scalps of most adults. But for some, it irritates the scalp and can cause more skin cells to grow which leads to severe skin conditions like seborrheic dermatitis, pityriasis captitis, tineacaptitis, etc. Dandruff affects self-esteem and confidence; all these factors are neglected by one and carried throughout their day-to-day which makes people feel very awkward and could make sufferers feel self-conscious and embarrassed in public. Dandruff, the mildest form of this dermatitis, is probably far more common and is present in an estimated 15-20% of the population. It may increase sharply with rapid urbanization.

Aim and Objectives

To evaluate the efficacy of Dhurdhuradi Taila over Malatyadi Taila in the management of Darunaka.

Materials and Methods

A total of 40 patients satisfying the analytic standards for Darunaka regardless of their sex and religion were selected by random sampling technique for the present study from OPD of the Kayachikitsa Department, later when requesting authorization from the institutional


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ethics committee the required material was Dhurdhuradi Tail[4] and Malatyadi Taila.[5]


Inclusion Criteria

1. Patients were selected irrespective of sex, religion, occupation, economic status, food habits, and chronicity. 

2. Age group between 15 to 50 years.

3. Only the cases of classical clinical features of

Exclusion Criteria

1. Patients with features other than the Darunaka.

2. Any other skin disorders like scalp psoriasis, eczema, urticarial rashes.

3. Any open wound if noted

Diagnostic Criteria

1. According to the text, the presence of signs and symptoms of Darunaka is essential for the diagnosis.

2. Routine haematology tests such as CBC, ESR, and RBS were performed to rule out any other pathology.

Assessment Criteria

Subjective Parameter

  • Kandu

Objective Parameter

  • Digital USB Microscope
  • Rukshata
  • Keshabhumi Prapatana
  • Keshachyuti

Intervention

Group A

Dhurdhuradi Taila daily (only for the scalp). 

Duration: 28 days

Follow Up: Every 15 days

Group B

Malatyadi Taila daily (only for the scalp). 

Duration: 28 days

Follow Up: Every 15 days

Observation

Application group of 40 registered patients. Patients were selected randomly and divided into two groups containing every 20 individuals through online randomization software mentioned above in materials and methods.

Result

The age group selected for the study is between 15-50 years. The observations of the present study in the age category reveal that 75% of the age group is between 15-30 years, and 25% of the age group is between 30-50 years. About 35% are male and about 65% are female. In terms of habitat, 97.5% are found in urban areas. Almost all the symptoms were observed in all the patients, but the rate of the Daruna (flakes) was observed at about 100%. Aggravating factors about 71.11% were exposed to cold weather, and about 28.88% were exposed to wind exposure, it is observed that most of the Darunaka are seen in cold weather. The overall effect of the symptoms in Group B shows that the Taila is highly significant in the improvement in Darunaka. 

In both groups, all of the patients with Darunaka selected for the trial demonstrated improvement in all of the measures. On the other hand, Malatyadi Taila exhibited a more significant result than Dhurdhuradi Taila. The changes between the groups were also found to be significant in both groups.

Discussion

Darunaka is explained under the context of Kshudra Roga & Kapalgata Ragas. There are 44 Kshudra Rogas explained by Sushruta and under 9 Kapala Gata Rogas by Vagbhatta. In Vedic mythology, we come across the word Darunaka or Kshudra Roga in Garuda Purana.

In Garuda Purana, under the section of Dhanvantari Samhita in the 179th chapter that is Ksudraoga Darunaka is elaborated illustrating that the scalp becomes "rough and encrusted". Another well-known Purana, which is one of the main books of Hindu philosophy, is Srimad Bhagavatam. We come across the word Daruna in this text, which is "Daruna Cestasah," which means "very hard-hearted," and thus the word Daruna means "hard, rough, and dreadful."


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So, in this context, Darunaka (minor ailment) is rough, hard/harsh relating to the scalp. Considering Nidanas, Pragvata (exposed to wind), Dhooma (exposed to smoke), Atapa (exposed to sun), and Raja (exposed to dust) among the Nidanas mentioned, as well as the related Darunaka ailment. Darunaka is primarily Kapha-Vata vitiation but is also associated with Pitta and Rakta. Daruna, Kandu, Keshabhumi Prapatana, Kesha Chyuti, and Rukshata are the Lakshnas considered for the present study by Sushruta.

Daruna here means Kathina, harsh, here it is related to flakes of Darunaka, Kandu is related to itching, Keshabhumi Prapatana is related to cracking of the scalp, Kesha Chyuti is related to hair fall and Rukshata is related to dryness of the scalp. Other Lakshnas include Swapa and Twak Sphutana. As Darunaka is Kapha-Vata vitiation and Pitta and Rakta as associated with Doshas and present Lakshnas like Daha (burning), and Raga (redness). Murdhni Taila[6] plays an important role in the present study. It is known as the application of the Taila on the head, Shiro Abhyanga is a part of Murdhni Taila. We find the reference in classics about the qualities of Shiro Abhyanga as it removes Kandu, Rukshata, and Mala, and about 2.4 minutes is explained for absorption of Sneha in conditions like Ruksha. Because 300 Matrakala oil enters into the hair follicles and 400 Matra Kala enters the skin, which aids in medication absorption, patients were instructed to massage for at least 2-5 minutes approximately.[7]

Probable mode of action                             

The contents of Dhurdhuradi Taila are predominantly of Tikta, Kashaya Rasa, Ushna Veerya, Katu Vipaka, Laghu, Mridu Gunas, and Tridoshahara also helpful in all skin disorders. Similarly, Malatyadi Taila is predominantly of Kashaya, Tikta Rasatmaka, Ushna Veerya, Katu Vipaka, and Laghu, Teekshna Gunas. Which are beneficial in lowering Vata and Kapha imbalance. They also have qualities like Kandughna, Twachya, and Kustaghna, which are very effective in alleviating the symptoms of Darunaka. A soft and gentle massage improves blood circulation in the Kapala Pradesha. Snigdhata, which is found in the Taila, relieves dryness and therefore reduces shedding. The Gunas of components in Tailas deal with microbicidal and other aspects of the ailment.


Digital USB Microscopic Images

jaims_2532_01.JPG

jaims_2532_02.JPGFigure 1: Dhurdhuradi Taila

Figure 1: a & b – Before treatment microscopic images of the scalp, c & d - After treatment microscopic images of the scalp

jaims_2532_03.JPG

jaims_2532_04.JPGFigure 2: Malatyadi Taila

Figure 2: e & f – Before treatment microscopic images of the scalp, g & h - After treatment microscopic images of the scalp

Discussion on overall results
The use of Malatyadi and Dhurdhuradi Taila showed a significant impact on Darunaka management. In just one month, there was a significant improvement in clinical symptoms.


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As a result of the aforesaid research, we may deduce that

Group A - In this 25% are completely cured, 65% are mild cured, and 10% of them have no change in the treatment.

Group B - In this 80% are completely cured, 15% have a mild change, and 5% have no change in the treatment.

However, statistical data shows that group B (Malatyadi Taila) had a greater mean reduction in all the 5 symptoms (Daruna, Kandu, Keshabhumi Prapatana, Keshachyuti and Rukshata) than group A (Dhurdhuradi Taila). As a result, we may conclude that the Malatyadi Taila is more important than Dhurdhuradi Taila among the two groups.

Conclusion

Snehana, in any form, is beneficial and equally nourishes the body and has been used as a primary treatment in all Doshaja Vikaras since the Samhita time. Darunaka is a condition described in Kapala Gata Rogas, and in today's science, it can be co-related to Dandruff. Many therapeutic options for Darunaka have been listed in Samhitas because of the intensity and frequency of recurrence. Shiro Abhyanga is one of these modalities. In the current study, application of oil to the afflicted scalp, i.e., a type of Snehana in the Kapha-Vataja Vikara, both the Taila Dhurdhuradi and Malatyadi Taila possess Tikshna and Ushna properties, hence it helps to alleviate Kapha and equally provides Snehamsha Guna for Vata and it is also simple, cost-effective, and OPD-based treatment, as well as universally accepted.

Acknowledgments: I would like to express my sincere gratitude to Dr. Sanjay M Kadlimatti, for his unwavering support and guidance during the study. I would like to extend my acknowledgment to Dr. Shreya and Dr. Gouri for their help and support.

Reference

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2. Kaviraj Ambikadutta, Susruta Samhita by Shastri, Chaukhambha Sanskrit Sansthan Varanasi, Vol 1, Reprint 2006,13th chapter, Shloka 34.


3. Amy J. McMichael and Maria K. Hordinsky, Hair and Scalp Disorders Medical, Surgical and Cosmetic Treatment edited by CRC Press Taylor & Francis Group, LLC,2nd edition 2018, pg 83 and 86.

4. Ramnivas Sharma, Surendra Sharma, Sahasrayogam, Chaukhambha Sanskrit Pratisthan, Delhi 2004, Taila Prakarana, pg 96.

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12. Nirmala Saxena. Vangasena Samhita or Chikitsa Sara Sangraha. Vol.2 Choukhamba sanskit series office, Varanasi. Adhyay, Kshudra Roga. Chapter 67 Shloka 125-129; Pg-814.

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