Mukhadushika (Pimple/Acne Vulgaris): Cure and Care by Ayurveda

This article was published in the Nagaland Post on June 4, 2017.

Introduction to Mukhadushika (Acne Vulgaris)

In the modern era, factors such as stress, increasing pollution, hormonal changes, dietary changes, and lifestyle shifts have led to a rise in acne vulgaris among young individuals. Adolescents are particularly susceptible to this condition. Acne vulgaris, derived from the Greek word "acme," meaning "prime of life," is a common problem that can cause severe psychological distress and potential scarring. Although acne is not life-threatening, it significantly impacts the quality of life of those affected. The goal of treatment is to clear lesions, prevent scarring, and minimize treatment-related side effects and psychosocial consequences.

Classification of Acne

Acne can be classified based on the predominance of specific skin lesions:

• Comedonal (Non-inflammatory): Mild
• Papular (Inflammatory): Mild-to-moderate
• Pustular (Inflammatory): Moderate
• Nodulocystic: Severe

This classification follows increasing severity, with cutaneous scarring as the ultimate result.

Etiology of Acne

1. Increased Sebum Secretion: Androgens control sebaceous gland activity. Testosterone, produced in the testes and, in females, the adrenal glands and ovaries, affects the face, pubic area, and armpits. Hormonal changes, particularly during menarche, make sebaceous glands hyperactive.
2. Microbial Colonization: Propionibacterium acnes, a normal commensal of the pilosebaceous apparatus, plays a role in acne pathogenesis.
3. Occlusion of Pilosebaceous Duct: Chemicals can induce a keratinous plug, leading to sebum retention and microbial growth.
4. Exogenous Substances: Tars, chlorinated hydrocarbons, oily cosmetics, corticosteroids, lithium, oral contraceptives, and anticonvulsants can aggravate acne.

Factors Worsening Acne

• Menstrual Cycle: Hormonal changes before menstruation can worsen acne.
• Anxiety and Stress: Increased cortisol and adrenaline levels can exacerbate acne.
• Oil-based Makeup: These can block pores and worsen acne.
• Hot and Humid Climates: Increased sweating can aggravate acne.
• Greasy Hair Products: These can have similar effects as oil-based makeup.
• Squeezing Pimples: This can worsen acne and lead to scarring.

Stages and Types of Acne

• Comedones: Open comedones (blackheads) and closed comedones (whiteheads).
• Papules and Pustules: Inflamed lesions.
• Nodules and Cysts: Deeper, severe lesions.

Ayurvedic Management

Ayurvedic treatment involves two main approaches: Shodhana Chikitsa (Purification Therapy) and Shamana Chikitsa (Palliative Therapy).

Shodhana Chikitsa

1. Vaman (Emesis): Effective for subsiding Kaphaja abnormalities and acne.
2. Nasya (Errhine Therapy): Administering medicines through the nasal route for diseases above the clavicle, including acne.
3. Virechana (Purgation): Specific for Pitta Dosha, removing excess Pitta from the body.

Shamana Chikitsa (External Treatment)

• Topical Applications: Powders, pastes, oils, ghee, and gels made from Ayurvedic herbs.
• Lepa (Face Pack): Prepared with Chandana, Maricha, Arjuna bark, and milk, or Manjistachurna with Madhu.
• Kumkumadi Taila: For facial massage.
• Internal Medications: Nimba churna, Haridradilepa, Manjistadi taila, Masuradal with milk, Haridrachurna with Arka ksheera.

Surgical and Para-Surgical Treatments

• Chedana (Excision)
• Agni Karma (Cauterization)
• Kshara Karma (Application of Alkaline Substances)
• Rakta Mokshana (Bloodletting)
• Siravyadha (Venesection)

These procedures are used when medical treatment is ineffective, though they may have complications.

Diet and Lifestyle Recommendations

Avoid:

• Hot, spicy, oily, fried, and pungent foods.
• Junk food, fast food, and incompatible food combinations like milk with fish.

Recommended:

• Bitter foods such as Patola, Giloya, and Methika.
• Fresh green leafy vegetables.
• Adequate water intake, especially lukewarm water.
• Regular skin cleaning.
• Mental relaxation techniques like meditation and yoga.

Conclusion

Mukhadushika (acne) is a common issue among adolescents. Ayurveda offers a holistic approach to managing acne through Shodhana and Shamana Chikitsa, with treatments tailored to the severity of the condition. The goal is to mitigate symptoms, prevent scarring, and improve overall skin health.

Note: Ayurvedic medicines and treatments should be taken under the supervision of a qualified Ayurvedic doctor/physician. The information provided is for general educational purposes and should not be used without consulting a qualified Ayurvedic doctor/physician.