Management of vitiligo: An ayurvedic perspective

Shwitra or Shwet-Kushtha can be co-related with skin disease "vitiligo" in biomedicine. According to Ayurveda, the skin is one of the essential sense organs. Vata and bhrajaka pitta reside in the skin (called twak in Sanskrit). As the skin covers the whole body, bhrajaka pitta should be maintained in a proper state, and it needs continuous care. An imbalance in Vata and bhrajaka pitta may cause skin diseases. The first step (Step 1) in Ayurvedic management of vitiligo is purification therapies (shodhana karma) using herbal decoction of Psoralea corylifolia (bakuchi kwatha) and Euphorbia neriifolia (snuhi) aimed to induce multiple bouts of purgation. In the next step (Step 2), oil massage using oil selected on the basis of patient examination (rogi pariksa) and disease (roga). Step 3 is the exposure of lesions to the sun rays as long as the patient can tolerate (Soorya pada santhapam in Ayurveda). Herbomineral preparations include topical application of herbal Lepa, powders made up of medicinal plants (Curna), herbalized ghee preparations similar to paste (Ghrita, semi-solid preparations taken orally, by licking (Avaleha), herbalized oil preparations (Thaila), fermented solutions (Asava-Arista), and tablets (Vati/Gutika). Various minerals and metallic salts (Rasousadha) are also used. Bakuchi oil is Ayurvedic medicinal oil prepared from the dried fruits of P. corylifolia, and sesame oil is a popular therapy for vitiligo in Ayurveda that contain psoralen to stimulate melanocytes when exposed to ultraviolet light exposure. Details of above-mentioned therapy are discussed. Scientific rationale behind the use of these medications needs to be further explored with modern methods and research