Review Article
Year: 2024 |Volume: 5 | Issue: 05 |Pages: 15-20
REVIEW ON VYANGA W.S.R. TO MELASMA AND ITS AYURVEDIC MANAGEMENT
About Author
Correspondence Address:
Dr. Abhilasha Lagad BAMS, M. D (Kayachikitsa) Assistant Professor and Ph.D.Scholar, Department in Kayachikitsa, Dr.D.Y.Patil College of ayurved and Research Centre Pimpri, Pune -18 (Maharashtra) India. Email id- lagadabhilasha@gmail.com Contact no. 8805075897
Date of Acceptance: 2024-05-23
Date of Publication:2024-06-05
Article-ID:IJIM_311_09_24 http://ijim.co.in
Source of Support: Nill
Conflict of Interest: None declared
How To Cite This Article: Lagad A., Gogate V. Review on Vyanga W.S.R. To Melasma and its Ayurvedic Management. Int J Ind Med 2024;5(5):15-20 DOI: http://doi.org/10.55552/IJIM.2024.5504
Abstract
Vyanga (Melasma) is a common, acquired and symmetrical hyper melanosis characterized by more or less dark brownish maculae, with irregular contour, but clear limits, on photo exposed areas, especially the face, forehead, temples, and more rarely on the nose, eyelids, chin, and upper lips. In Ayurveda, Vyanga (Melasma) has been elaborated as one of the Kshudra Rogas (minor ailments). Vayu aggravated by Krodha (Anger) and Ayasa (Rest), get associated with Pitta and suddenly produces a thin, grey colored circular patch when reaches the face. Both modern and Ayurvedic sciences have considered the use of topical as well as oral medications and their combinations for the treatment of Vyanga (Melasma). In Ayurveda, Vyanga (Melasma) has been treated both by Antah-Parimarjan (Internal Intervention) and Bahi-Parimarjana (External Intervention) Chikitsa (Treatment). Though, several Ayurvedic texts such as Sushruta Samhita, Ashtanga Samgraha & Hridaya, etc., have elaborated the pathophysiology and treatment of Vyanga (Melasma), the available references are scattered. The treatment for Vyanga (Melasma) in Ayurveda is devoid of side effects it is very effective and it promises to stop the recurrence. The detailed description of its Hetu (causative factors), Samprapti (prognosis), the treatment (local and internal) is given in Ayurved Samhitas. Thus, there is need of in-depth review and compilation of Ayurvedic texts and literatures. This review may be helpful in better understanding of comparative pathophysiology and management of Vyanga (Melasma).
Keywords: Vyanga, Hyper Pigmentation, Melasma, Lepa
Introduction
Beauty is defined as the qualities in a person which pleases the aesthetic senses. It includes shape of the body, colour and texture of the skin, hair and nails. In the olden scripture, the beauty is termed as “Shubha” signifying pure, neat and complete with both inner and outer expression of a body and soul. Beauty is also defined as “Roopam Gunam Vayastyag Iti Shubhanga Karanam” i.e., the long lasting outer and inner beauty which is responsible for the attractive presentation of oneself. Cosmetic therapy is the treatment modality of improving the appearance or beautifying the body especially the face and hair. Ayurveda offers safe, effective as well as economical aids for beauty care. By using herbs, flowers, essential oils and naturally occurring minerals, Ayurvedic cosmetics brings the skin to a perfect balance. According to Sushruta Samhita, Vyanga is the Kshudra roga[1], which mainly affects the skin of the face. It is considered as a Rakta Pradoshaja Vyadhi[2]. Dushti (Contamination) of either Pitta or Rakta causes impairment to one another due to their Ashrayaashrayi Bhava. Specific etiological factors i.e., Krodha, Aayas are mentioned in the text but generally Nidana (Diagnosis) causing the vitiation of Vata, Pitta Dosha and Rasa, Rakta Dhatu Dushti (Contamination) play an important role in the manifestation of Vyanga. The causative factors described in the modern text are useful to support above fact.
Sun exposure, drug intake e.g., oral contraceptive pills, hormonal changes at a particular stage, vitamin deficiency etc. causative factors can be considered as Mithya Ahara (Faulty food habbits) and Vihara (Faulty day to day activities). The appropriate management of melasma and its understanding can be achieved by adopting various Ayurvedic concepts and therapies related to cosmetology.
MATERIALS AND METHODS
The present article is review of Ayurvedic texts, modern literature and various research papers. Materials related to Vyanga and Melasma have been collected from Ayurvedic Brihatrayi, laghutrayi, and other Ayurvedic books. Various modern texts, journals and Various websites have been searched to collect information on the relevant topics.
Conceptual Study
Ayurvedic Disease Review
Ayurveda consider Vyanga as Raktapradoshaja vikara (Blood realated diseases). All Acharyas of Ayurveda mentioned it in Kshudra roga. Main causative factors for Vyanga are anger, stress and excessive hard work. In this Doshas and Dushya involved are Udaanvaayu, Bharajaka pitta, Ras and Rakta dhatu.
Nidana (Causative Factors)
1. Vata and Pitta Prokapaka Ahara sevana. (Food which aggravates more Vata & pitta)
2. Ahitkara Ahara sevana. (Faulty food eating)
3. Krodha and Shoka.
4. Excessive hard work.
Samprapti (Pathogenesis)
As per Ayurveda due to various aetiologic factors vitiated Vata and Pitta dosha affect Ras and Rakta dhatu and get accumulated on facial skin resulting in occurrence of Vyanga.
Agni: - Vishamagni (Faulty digestion)
Sadhya-Asadhyata: - Sadhya (Treatatable)
Rupa: - (Symptoms)
1. Sudden onset on facial skin.
2. Appearance of Niruja (Painless), Tanu (Thin) and Shyava Varna Mandalas (Bluish Black Patches).
Vagabhata described that symptom of Vyanga varies on the basis of Doshik predominance.
Discussion
Modern Disease Review
As per modern Melasma is a most common acquired pigmentary disorder that manifests as symmetric hyper-pigmented macules and patches that mainly affects the face. This disorder is most common in women but it can occur in men also.
Epidemiology
Its prevalence in women is around 50%-70% in pregnancy stage and 8%-29% of women on oral contraceptive pills. In men its prevalence is between 20.5%-25.38% of the cases. In men malar pattern is more common than the Centro-facial and mandibular patterns. A Study conducted in male patients with melasma has shown that the levels of testosterone were low indicating a role of subtle testicular resistance in the pathogenesis of melasma.
Etiology
There are many factors that can cause melasma or blemishes or hyperpigmentation whether is a mild or severe form is usually associated with one or a combination of the following factors.
1. Pregnancy: - The pigment may or may not fade after the delivery.
2.Hormonal imbalance: - This includes intake of oral contraceptive pills and injected progesterone hormone and imbalance of thyroid hormone.
3. Sun Exposure: - Exposure to ultra violet radiations from sunlight are also a very strong risk factor.
4. Genetic Factors: - It is common in Hispanic and Asian racial groups with Fitzpatric skin types 4-6.
5. Cosmetics: - Scented or deodorant soaps, toiletries and cosmetics can cause a phototoxic reaction.
6. Poor immune system.
7. Medications: - Patients receiving phenytoin are having more risk of occurrence of melasma.
8. Nutritional deficiency.
9. Stress.
Classification and Clinical Features of Melasma
Histological Classification
1. Epidermal Melasma: -This type is characterized by dark brown patches with a well-defined border. In this type melanin deposit in basal and supra-basal layer of epidermis. This type of Melasma typically responds very well to the treatment and is more readily apparent under black light.
2. Dermal Melasma: - This type is characterized by light brown or bluish Patches with a less defined border. This type does not respond very well to the treatment.
3. Mixed Type: - This is the most common type of the Melasma diagnosed and is characterized by a combination of light and dark brown patches. It shows partial response to treatment.
Clinical Classification
1. Centro-facial Pattern: - The Patches mostly appear on cheeks, forehead and nose.
2. Malar Pattern: - The Patches mostly appear on cheeks and nose.
3. Mandibular Pattern: - The patches mostly appear on chin.
Treatment: The treatment as per modern science has many side effects and the recurrence after the treatment is very common. The treatment for Vyanga in Ayurveda is very effective with no recurrence and no side effects.
As per Ayurveda drugs having Kushthagna (Anti psoriatic), Raktashodhaka(Blood purifier), Twaka Prasadaka(Skin tone elevator) and Varnyakara(Skin colour improver) Properties are helpful in the management of Vyanga or Melasma.
Ayurvedic Management of Vyanga
Line of treatment as per Ayurveda is as follows.
1. Nidanparivarjan i.e. removal of cause.
2. Shodhana Chikitsa (Evacuation treatment)
(A) Shiravedana (Bloodletting Process)
(B) Abhayanga (Massage): - This can be done with one of the following Yogas (Formulations): -
. Manjishathadi Saneha
. Kumkumadi Tailam
. Kasisadi Ghrita
. Sarshapa Oil
. Chandanadi Tailam
(C) Nasya: - This can be done with one of the following Yogas (Formulations): -
. Bhringraja Swarasa
. Milk+water
. Siddha Ghrita
3. Shamanchikitisa (Conservative treatment)
a) For Internal use: - Various Ayurvedic Preparations as mentioned in Ayurvedic Classical Texts.
Anubhut Ayurvedic Medicines
- Kaishora Guggulu
- Kaanchaara Guggulu
- Manjishthadi Kwatha
- Gandhaka Rasayana
- Arogyavardhini Vati
- Panchatrikta Ghrita Guggulu
- Ashwagandha Ghan Vati
b) For External use (Lepa and Udavartana)
(i) Lepa: - Various Lepas are mentioned in Brihatrayee and Laghutrayee. Some are Shita lepas (Cool coating of ayurvedic formulations) and others are Ushna lepas. (Hot coating of ayurvedic formulations)
- Eladi Gana Lepa
- Arjuntvagaadi Lepa
- Ingudi Majja Lepa
- Manjishthadi Lepa
- Kanaka Tailam
- Kumkumaadi Tailam
- Shalmali Lepa
- Yavchurnadi Lepa
- Masoora Lepa
- Jattiphaladi Lepa
- Jeerakadi Lepa
- Dviharidraadi Lepa
- . Raktachandanaadi Lepa
- Utpalaadi Lepa
- Varuntavakchuran with Ajaadudha (Goat milk)
(ii) Udvartana
. Shirish+Lamajjaka+Naagkeasra+Lodhra.
. Haritaki+Lodhra+Neempatra+Karanja+Daadima bark.
Conclusion
As per Ayurveda Vyanga is the disease mentioned in Kshudra Rogadhikara. It is the most common disease being noticed now a days affecting one's life quality. The treatment for Vyanga or Melasma in Ayurveda is very effective with no recurrence and no side effects.
In Ayurvedic treaties there is great treasure of single and compound drugs which are capable of disintegrating the Samprapti and fully curing the disease Vyanga.
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