Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Neurodermatitis
Neurodermatitis is a pores and skin downside wherein the individual affected by the situation retains scratching his or her pores and skin on a regular basis i.e. there’s extreme urge to itch.
The lesions / patches of neurodermatitis seem dry, thick, scaly, leathery, crimson, brown, yellow, gray or purple in color and scarring with development of lesion. Although precise causes usually are not recognized, irritants like tight clothes or insect bites, scratching can act like triggers. It additionally coexists with dry pores and skin, atopic dermatitis or psoriasis.
Signs embrace pruritic and desquamate pores and skin lesions, erosions, hyperkeratosis and induration, altered pigmentation, erythematous plaques, lichensification and hyperpigmentation.
On this article we are going to attempt to perceive neurodermatitis from an Ayurveda perspective.
Associated Studying – Neurodermatitis
Neurodermatitis: Ayurveda Understanding
There isn’t a one specific situation defined in Ayurveda texts which could be precisely correlated with neurodermatitis. Right here we are going to attempt to perceive sure circumstances defined within the context of Kushta – pores and skin problems in correlation with neurodermatitis. We can even perceive neurodermatitis by trying on the situation and its signs from a dosha perspective. We will additionally see that neurodermatitis can be not a single situation, it may be related to many pores and skin illnesses.
Kandu – Neurodermatitis is marked by ‘itching of the skin’ and may occur in lots of areas of the physique. The primary symptom of neurodermatitis is ‘repeated itching’. The affected person approaches the doctor to get ‘remedy for itching’. Subsequently, neurodermatitis could be merely thought of as ‘Kandu’ (Ayurvedic identify for itching) and in addition handled on the traces of ‘kandu chikitsa’ with out falling into complexities of diagnosing the given situation. There are various circumstances whereby kandu is a foremost symptom. When common administration of kandu together with medicines, therapies and eating regimen are administered, itching in all these circumstances can be relieved. So, on this situation, we’re treating the ‘chief complaint or symptom’ of the illness, kandu on this context, immaterial of the illness wherein it manifests. That is precisely why the affected person has approached the doctor.
Vata hyperlink & Vataja Kushta – Neurodermatitis is alleged to be related to dry pores and skin, atopic dermatitis or psoriasis. In all these circumstances, dryness is frequent. Dryness is brought on by vata vitiation or pores and skin vitiated by aggravated vata. So, Vataja Kushta – pores and skin problems brought on by aggravated vata could cause a situation resembling neuro-dermatitis. All kinds of kushta having vata predominance could have most signs like these of neurodermatitis. We will see that stress and anxiousness also can provoke itching signs. Stress and anxiousness also can worsen vata.
The subtypes of kushtas whereby there’s vata predominance current with scientific image of neurodermatitis. They’re as under talked about –
– Eka Kushta
– Charma / Charmakhya Kushta / Hasti Charma Kushta
– Kitibha Kushta
– Vaipadika Kushta
– Vicharchika Kushta
– Mandala Kushta
Eka Kushta – Dry, thick, scaly and leathery pores and skin is a marking characteristic of neurodermatitis. We will see this sample in eka kushta which is a kshudra kushta – minor pores and skin illness. It’s marked with giant patches and resembles the pores and skin of a fish and there’s absence of sweating. Since there isn’t any sweating, the pores and skin will get dry and kleda – pointless fluid is held again within the physique. This situation can be brought on by mixed aggravation of vata and kapha, whereby right here vata dries up the kapha and therefore there’s itching additionally, although not specified amongst the signs of eka kushta.
Charma / Charmakhya / Hasti Charma
The pores and skin will get thicker together with change of color in itchy spots of neurodermatitis. Such a situation is present in Hasti Charma, a sort of Kshudra Kushta – minor pores and skin illnesses. The superior stage or manifestation of neurodermatitis could be thought of as hasti charma. Hasti charma is one among the many eleven kinds of kshudra kushta – minor pores and skin illnesses. The patches are thick and devoid of layers. This situation can be brought on by joint vitiation of vata and kapha.
Kitibha Kushta – That is additionally a sort of kshudra kushta which presents with black and brown lesions / patches which might really feel like a wound scar on contact – kina khara Sparsha. The patches are dry and laborious, as defined in neurodermatitis. This situation is usually correlated with psoriasis, with which neurodermatitis is usually related. This situation can be brought on by mixed aggravation of vata and kapha.
Vaipadika Kushta – That is yet one more vata-kapha kind of pores and skin dysfunction belonging to the kshudra kushta class. On this situation there are painful cracks in palms and soles. Neurodermatitis shouldn’t be restricted to palms and soles, however it could happen in these areas too. Steady scratching on already current cracks and fissures on the pores and skin of toes and arms can result in patches resembling neurodermatitis.
Vicharchika Kushta – It’s a kshudra kushta triggered as a result of predominant aggravation of kapha. It presents with a number of itchy boils or eruptions / blisters of blackish brown color together with extreme itching sensation and oozing (exudation). Extreme itching and discoloration as present in vicharchika can be present in neurodermatitis.
Mandala Kushta – It’s a Maha Kushta – higher pores and skin illness brought on by predominant aggravation of kapha which resembles neurodermatitis in its presentation. The patches or lesions on this situation are within the type of round raised patch / patches that are white or crimson in color, stiff, unmovable, elevated, round and mingled with each other. The affected person experiences heaviness across the affected patch. It’s mentioned that the older patches of neurodermatitis exhibit whitening or paleness surrounded by darker hues, which resembles a scientific image of mandala kushta.
Relying on the totally different colors which might be manifested within the patches of neurodermatitis, many different kinds of kushta – pores and skin illnesses presenting with these numerous colors and kshudra rogas – minor illnesses which additionally current with these colors and different signs of neurodermatitis could be thought of within the comparability and correlation.
Can predominant aggravation of kapha trigger neurodermatitis?
Itching in accordance with Ayurveda, by default, is related to kapha. Kapha is the principle dosha answerable for all types of itching. Pathological improve of kapha would trigger itching. Kapha is unctuous and liquid in nature. So, when kapha abnormally builds up within the physique undoubtedly there can be itching, however the pores and skin can even seem unctuous and there could also be exudates. However these usually are not the options of neurodermatitis. Then again, vata-kapha involvement could cause circumstances just like neurodermatitis. This will occur solely when the dryness of vata within the vata-kapha dysfunction turns into dominant over the wetness and unctuousness of kapha and dries it up.
Primarily based on the looks of ‘neuro dermatitis’ lesion
By look, neurodermatitis is significantly giant in measurement. Additionally it is dry, thick, scaly and leathery. These options are present in eka kushta and kitibha kinds of kushta, each of them fall into the class of kshudra kushta i.e. minor pores and skin illnesses.
Primarily based on the signs of neurodermatitis
Sl No | Symptom of Neurodermatitis | Dosha involvement |
1 | Pruritic pores and skin lesions | Vata, Kapha or Vata-Kapha |
2 | Desquamative pores and skin lesions | Vata |
3 | Erosions with hemorrhagic tendencies | Vata, Vata-rakta |
4 | Hyperkeratotic pores and skin | Vata |
5 | Induration of dermis | Vata, Vata-Kapha |
6 | Altered pigmentation / hyperpigmentation | Vata, Pitta |
7 | Atrophic modifications | Vata |
8 | Erythematous plaques | Vata, Vata-Kapha |
9 | Excoriation | Vata |
10 | Nocturnal itching | Vata |
11 | Pores and skin ache | Vata |
Right here we will see that vata is predominant in nearly all doshas. Pittingn it the opposite approach, vata aggravation causes the predominant signs of neurodermatitis.
Ayurveda Therapy of Neurodermatitis
Nidana Parivarjana
Retaining away from the causative components and triggers of the illness is the important thing technique to keep away from the illness, its development or recurrence. Amongst these, vata or kapha aggravating components and all etiological components enlisted as causal of kushta needs to be stored away.
Dosha Pratyanika Chikitsa
Dosha aggravation and dosha predominance in neurodermatitis needs to be analysed correctly and addressed accordingly.
Vyadhi Pratyanika Chikitsa
Addressing the foundation explanation for the illness needs to be the principle strategy in coping with neurodermatitis and that root trigger could be a illness presenting with signs just like neurodermatitis i.e. the kinds of kushta which have been talked about above. Another illness presenting with a pores and skin situation which seems nearer to neurodermatitis needs to be handled. When the principle illness is handled comprehensively, the illness which has branched out from it, neurodermatitis on this case, can even be addressed. Mainly, kushta chikitsa i.e. therapy line of kushta needs to be adopted when it comes to implementing panchakarma measures, medicines, life-style modifications and eating regimen which might handle the illness from its roots.
Panchakarma measures
Virechana is the very best treatment in circumstances of neurodermatitis. The Sneha – unctuous substances given earlier than administration of virechana as part of preparatory process, needs to be chosen from the context of kushta chikitsa. If solely virechana is to be given as a daily / day by day detox, the medication needs to be in an oil or ghee type, ready with medicines / herbs that are cures for kushta and are antagonistic to the causal dosha / doshas.
Exterior therapies
Since vata is predominant dosha inflicting neurodermatitis and signs therein, it is extremely essential to maintain the pores and skin unctuous and never enable it to dry. For this, oil therapies needs to be completed steadily. Taila Dhara – showering of natural oils and in addition software of medicated oils on the bothered half / elements of the pores and skin in neurodermatitis are preferrred interventions. Udwarthana with natural powders combined in oils shall be used as and when wanted as scrubs to take away useless tissues and pores and skin particles.
Milk ready with Nalpamaradi Kashayam needs to be used for showering over the neurodermatitis patches.
Efficient formulations
Beneath talked about are among the essential and efficient formulations within the therapy of neurodermatitis –
– Tiktaka Kashayam / Ghrta
– Mahatiktaka Kashayam / Ghrta
– Guggulutiktaka Kashayam / Ghrta
– Aragwadhadi Kashayam / Ghrta
– Gandharvahastadi Kashayam
– Gandharvahastadi Eranda Tailam
– Nimbamritadi Eranda Tailam
– Ksheerabala Tailam / Ksheerabala Tailam 101
– Trivrit Leham
– Madhusnuhi Rasayanam
– Nalpamaradi Tailam – exterior
– Shatadhauta Ghrtam – exterior