Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Neurodermatitis
Neurodermatitis is a pores and skin drawback through which the individual affected by the situation retains scratching his or her pores and skin on a regular basis i.e. there may be extreme urge to itch.
The lesions / patches of neurodermatitis seem dry, thick, scaly, leathery, pink, brown, yellow, gray or purple in color and scarring with development of lesion. Although actual causes should 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’ll attempt to perceive neurodermatitis from an Ayurveda perspective.
Associated Studying – Neurodermatitis
Neurodermatitis: Ayurveda Understanding
There is no such thing as a one explicit situation defined in Ayurveda texts which could be precisely correlated with neurodermatitis. Right here we’ll attempt to perceive sure circumstances defined within the context of Kushta – pores and skin issues in correlation with neurodermatitis. We can even perceive neurodermatitis by wanting 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 pores and skin’ and may occur in lots of areas of the physique. The principle symptom of neurodermatitis is ‘repeated itching’. The affected person approaches the doctor to get ‘treatment 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 a lot of circumstances whereby kandu is a foremost symptom. When normal administration of kandu together with medicines, therapies and food regimen are administered, itching in all these circumstances shall be relieved. So, on this situation, we’re treating the ‘chief grievance or symptom’ of the illness, kandu on this context, immaterial of the illness through which 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 attributable to vata vitiation or pores and skin vitiated by aggravated vata. So, Vataja Kushta – pores and skin issues attributable to aggravated vata could cause a situation resembling neuro-dermatitis. All kinds of kushta having vata predominance might 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 may be vata predominance current with scientific image of neurodermatitis. They’re as beneath 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 massive patches and resembles the pores and skin of a fish and there may be absence of sweating. Since there is no such thing as a sweating, the pores and skin will get dry and kleda – pointless fluid is held again within the physique. This situation can be attributable to mixed aggravation of vata and kapha, whereby right here vata dries up the kapha and therefore there may be 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 attributable to 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 attributable to mixed aggravation of vata and kapha.
Vaipadika Kushta – That is yet one more vata-kapha sort of pores and skin dysfunction belonging to the kshudra kushta class. On this situation there are painful cracks in palms and soles. Neurodermatitis will not be restricted to palms and soles, however it will probably 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 brought about 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 – larger pores and skin illness attributable to 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 pink in color, stiff, unmovable, elevated, round and mingled with each other. The affected person experiences heaviness across the affected patch. It’s stated 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 primary dosha liable for every kind of itching. Pathological enhance of kapha would trigger itching. Kapha is unctuous and liquid in nature. So, when kapha abnormally builds up within the physique undoubtedly there shall be itching, however the pores and skin can even seem unctuous and there could also be exudates. However these should 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.
Based mostly on the looks of ‘neuro dermatitis’ lesion
By look, neurodermatitis is significantly massive in dimension. It is usually 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.
Based mostly 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 virtually all doshas. Pittingn it the opposite manner, vata aggravation causes the predominant signs of neurodermatitis.
Ayurveda Therapy of Neurodermatitis
Nidana Parivarjana
Retaining away from the causative elements 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 elements and all etiological elements enlisted as causal of kushta must be saved away.
Dosha Pratyanika Chikitsa
Dosha aggravation and dosha predominance in neurodermatitis must be analysed correctly and addressed accordingly.
Vyadhi Pratyanika Chikitsa
Addressing the basis reason behind the illness must be the primary method 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 must be handled. When the primary 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 must be adopted by way of implementing panchakarma measures, medicines, life-style modifications and food regimen which might tackle the illness from its roots.
Panchakarma measures
Virechana is the perfect treatment in instances of neurodermatitis. The Sneha – unctuous substances given earlier than administration of virechana as part of preparatory process, must be chosen from the context of kushta chikitsa. If solely virechana is to be given as an everyday / each day detox, the medication must be in an oil or ghee kind, ready with medicines / herbs that are treatments for kushta and are antagonistic to the causal dosha / doshas.
Exterior therapies
Since vata is predominant dosha inflicting neurodermatitis and signs therein, it is rather necessary to maintain the pores and skin unctuous and never enable it to dry. For this, oil therapies must be performed continuously. Taila Dhara – showering of natural oils and in addition utility of medicated oils on the troubled half / elements of the pores and skin in neurodermatitis are superb interventions. Udwarthana with natural powders blended 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 must be used for showering over the neurodermatitis patches.
Efficient formulations
Under talked about are among the necessary 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