HERBS

PSORIASIS

ABOUT THE DISEASE

Psoriasis is one of the most irritating skin disorders. It is an autoimmune non infectious disorder characterized by reddish patches with silvery scales in the skin.

ETIOLOGY

The causes of psoriasis are not yet clear, however, the studies have shown genetic association with this disease, and thus it can have a family history. Apart from the lifestyle disorders like stress, consumption of alcohol, smoking, obesity etc; improper diet is also associated with aggravation of this disease. Certain drugs like NSAID’s, Calcium channel blockers, Lithium, Beta blockers etc have also been found responsible for aggravation of psoriasis.

PATHOLOGY

Psoriasis is a chronic inflammatory skin disorder. It is characterized by hyper proliferation of keratinocytes along with increased growth and dilatation of superficial blood vessels. Various studies have showed that dysregulation of immune system has significant impact on initiation of above pathologic process.

SIGNS AND SYMPTOMS

The clinical features depend on the type of psoriasis. Most commonly found varieties of psoriasis are:-

1. Plaque psoriasis - In this, raised reddish skin plaques are found which are loosely covered with silvery scales. These lesions may cover large areas. The rashes may be itchy, painful and bleed on removal of scales.

2. Pustular psoriasis - It is characterized by red and scaly skin with small pus filled yellowish lesions (pustules). It commonly occurs in palms of hand and/or feet.

3. Guttate psoriasis - It is characterized with small round red spots. Mostly found in children or young adults. It is often aggravated after streptococcus infection.

4. Inverse psoriasis – It is clinically characterized by smooth and shiny reddish rashes mainly found on the folds of skin like armpits, inguinal region, behind the knee, nape of the neck.

5. Erythrodermic psoriasis - This is typically a more severe type of psoriasis characterized by bright red rashes on very large areas of body along with peeling of skin. It is generally associated with severe itching and pain.

Apart from above mentioned clinical features, other features like yellowness and pitting in the nails may also be present. If scalp is affected then hair fall may also occur.

In chronic cases of psoriasis, joints may also get involved leading to pain and stiffness. This is called as psoriatic arthritis.

AYURVEDIC VIEW

In Ayurveda, skin diseases mentioned as “Ekkustha” and “Kitibha” can be correlated to clinical presentation of psoriasis.

In Ayurvedic texts, diseases related to the skin have been mentioned under the broad term “Kustha”, it means “which deforms or changes the skin of body”. Acharya Sushruta have also named it as “Twagamaya” which means diseases related to skin.

Depending upon the severity, Kustha have been divided into two main types 1) Mahakustha – More severe and 2) Kshudrakushta – Less severe. These are further divided into seven types and eleven types respectively.

“Ekakustha” and “Kitibha” are mentioned under Kshudrakustha. These both are Vata and Kapha dominant diseases.

CAUSES

Acharyas have mentioned etiological factors for Kustha which covers all skin related disorders. These causative factors cover both physical as well as psychological aspects.

The causative factor are as follows :-

  • Intake of incompatible diet e.g, hot and cold, heavy and light, Sweet and salty meals together.
  • Excessive intake of oily meals.
  • Overeating and intake of food before the previous meal is digested.
  • Excessive physical exertion after heavy meals.
  • Regular habit of sleeping in daytime.
  • Improper administration of Panchkarma therapies.
  • Holding natural urges.
  • Hereditary disorders.
  • Anti ritual, anti social or other sinful acts.

PATHOGENESIS

The etiological factors lead to suppression of Agni which hampers the digestion leading to formation of Ama (Metabolic toxins). Ama dosha aggravates all three doshas Vata, Pitta and Kapha. Aggravated doshas through the microcirculation pathways (Tiryakwaha srotasa) vitiate Twacha (Keratinocytes), Mansa (Dermis), Rakta (Blood) and Lasika (Lymphatic fluid). This causes disturbance in normal skin physiological functions, increases the normal skin cell turn over rate leading to formation of Psoriasis.

CLINICAL FEATURES

According to Acharya Charaka, clinical features are as follows:-

1. Ekkustha - Dry skin, Rashes spreaded in larger areas, rashes covered with fish like scales.

2. Kitibha – Dark coloured Rashes, Lesions are Dry and rough.

PRINCIPLE OF TREATMENT

Line of Treatment includes Shodhana karma like Vamana, Virechana or Raktamokshana. It helps in removal of aggravated doshas. Shaman Karma (Conservative therapy) which includes Deepana, Pachana, and Raktashodhana chikitsa.

MEDICINES

1. Single Herbs – Manjistha (Rubia cordifolia), Neem (Azadirachta indica), Sariva (Hemidesmus indica), Khadira (Acacia catechu), Amalki (Phyllanthus emblica), Haritki (Terminalia chebula), Haridra (Curcuma longum),Amaltas (Cassia fistula), Vidanga (Embelia ribes), Karvir (Nerium indicum).

2. Churna (Herbal Powders) – Panchnimbadi churna, Manjisthadi churna, Giloy churna, Mustadi churna, Triphala churna.

3. Tablets – Arogya vardhini vati, Nimbadi vati, Kaishor guggulu, Panchtikta Ghrita guggulu, Yograj guggulu.

4. Rasa (Herbomineral preparations) – Gandhak Rasayan, Rasa Manikya, Swarn Makshik bhasma, Kusthakuthar rasa.

5. Kwath (Herbal decoctions) – Manjisthadi Kwath, Patoladi kwaath, Aragwadhadi kwaath.

6. Asava/Arishta (Alcoholic Preparations)– Kharidarishta, Sarivadyasava.

7. Taila (Oil preparations)- Karanja Taila, Nimba Taila.

HOME REMEDIES

1. Keep your gut clean. Constipated bowel leads to inflammation and opening up of pores of gut, which in turn increases permeability of toxins in the circulating body fluids causing flare ups of psoriasis.

2. Daily intake of 5 gms of Triphala powder at night with luke warm water helps in clearing up of bowels.

3. Keep your skin moisturized to prevent its drying and scaling. Daily application of olive oil or coconut oil or aloe vera gel helps in soothing the inflamed skin. Avoid fragrant cosmetics or heavy chemical based lotions on skin.

4. Avoid smoking and alcohol as it triggers the inflammatory process responsible for psoriasis.

5. Avoid refined flour, sugar items, frozen food items, red meat. These food items slow down the digestion process. Eat fibre rich food, like fruits and vegetables and drink 6-8 litres of water daily.

6. Daily Practise of yoga and pranayama helps in de-stressing of mind and body. It is good for general well being and improving psoriasis.

7. Increase the intake of turmeric in your daily diet. You can take ½ teaspoon of dried turmeric powder or turmeric capsules. It works as natural anti-inflammatory agent.

Disclaimer

The purpose of Ayurvidya is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider regarding your medical condition or treatment and before undertaking any new health care regimen.