Types of Eczema
How do you know you have eczema?
Eczema – Ayurveda perspective
Ayurveda management of Eczema
Home Remedies for Eczema
Abstract from articles on Eczema
Tridosha concept of Ayurveda
Eczema is a medical condition where patches of skin become rough, itchy and inflamed. Itching leads to scratching which in turn results in bleeding.
- Atopic dermatitis: The most common and chronic type of eczema. It is characterized by dry and itchy red rashes on the skin. It is often seen in babies and young children, but can occur in adults as well.
- Contact dermatitis: It occurs due to contact with some irritants for example-some chemicals, soaps etc. It is characterized by burning sensation, itching and redness of the skin exposed to irritants. It will be relieved once the irritants are removed.
- Dyshidrotic dermatitis: This is characterized by itchy and scaled skin. The skin often gets red, cracked and painful. It is seen on fingers, palms and soles of feet. This type is commonly seen in women.
- Nummular dermatitis: It is characterized by dry and round patches of skin. This condition arises in winter months and commonly seen in men.
- Seborrheic dermatitis: It is characterized by itchy, red and scaly rashes on the scalp, on the eyebrows, on the eyelids, on the sides of the nose and behind the ears.
- Eczema looks like dry, dark patches on the skin with severe itching.
- Dry and Rough patches on the skin
- Severe itching
- Red rashes
- Crusting or oozing
- Thickened brown or grey patches on the skin
- Sometimes small blisters will appear which ooze while itching.
- The skin can flare up, subside and then flare up again.
*Eczema can occur anywhere on the skin- but it is commonly seen on the inner elbows, behind the knees, on the scalp and on the cheeks.
*In most cases, symptoms subside as age advances.
How do you know you have eczema?
You know that you have eczema if we have the symptoms described above. Sometimes itching presides he other symptoms. Usually, itching begins in the inner side of the knees and elbows and on the cheeks.
Is eczema contagious?
Eczema is not contagious. It cannot spread from person to person.
Causes of eczema
The actual cause which triggers the disease is still unknown.
It is believed to be caused by an overactive immune system that responds aggressively on exposure to several irritants.
Sometimes, it is caused by a normal response to proteins which are a part of our body. Here, the body loses the ability to distinguish between proteins and invaders of proteins like virus or bacteria.
Studies have revealed that individuals with a family history of allergy and asthma are more prone to develop eczema.
An eczema outburst can be the result of exposure to;
- Chemical in detergents or dishwashing liquids or some soaps which dry up the skin
- Synthetic garments
- Weather changes
- Animal Dander
- Chronic Upper respiratory infections
- Certain foods
Diagnosis of eczema:
There is no specific test to diagnose eczema.
A patch test can reveal the allergens which trigger eczema in cases of contact dermatitis.
Here a patch is placed on the skin. Anything for example a detergent sample) which is believed to trigger the itching or flaring up of eczema is placed on the patch. If it is an allergen, there will be itching, scaling and redness of the skin.
The ayurvedic perspective of eczema:
Kushta is the name given to different skin disorders or diseases by Ayurvedic scholars.
According to Charaka Acharya Kushta is innumerable types. But there mainly 7 types of Kushta and in another classification there are 18 types.
Causes of Kushta:
Ayurveda scholar has not mentioned any specific cause for Kushta.
- Mithyahara vihara ( consumption of junk foods or wrong combination of foods like fish and milk, a wrong manifestation of daily routines, lack of personal hygiene etc. ) is considered to be a causative factor.
- Papakarmas ( sins) manifested during the present life or previous birth- this statement emphasises the lack of a proper causative factor for the disease. The modern concept of unknown aetiology for eczema can be co-related here.
The causative factors lead to the imbalance of tridoshas which in turn affect the skin, lymph, blood and meat and make a serious impact in their fundamental structure and alter the skin colour and tone. If it is left untreated, it can destroy the whole body.
Types of Kushta
Kushta is classified into seven types.
As mentioned earlier, all three doshas are involved in the aetiology of Kushta. But depending on the predominance of doshas, it has 7 types according to Vagbhata.
Depending on the signs and symptoms, each type has several subdivisions as follows. Thus, it can be said that there are 18 types of Kushtam.
(Refer to Appendix for Tridosha theory of Ayurveda))
|Vata Pitta kushtam||Rikshajihwam|
|Vatakapha kushtam||1.Charma kushtam 2. Eka kushtam 3. Kitibham 4. Sidhmam 5. Alasam 6. Vipadika|
Symptoms of Kushta
- Kaapala kushtam:
- Reddish black discolouration of the skin – skin looks like earthen pot.
- Skin will be dry, rough and thin
- The territories of the affected skin spread unequally
- Severe Pricking pain
- Mild Itching
- Spreads and alleviates easily
- Udumbara kushtam:
- Skin and hair becomes bronze coloured like fig
- Yellowish veins on the affected areas of skin
- Thick and slimy
- Severe e burning sensation and pain
- Spontaneous occurrence and inflammation
- Mandala kushtam:
- Skin rash would be stable, immobile, thick, oily, reddish-white coloured
- Spreads slowly
- Rashes will adherent to each other
- Severe itching and oozing
- The outer edges of the rash would be smooth, yellow and round.
- Vicharchika kushtam:
- Small blackish blisters with severe itching
- Severe oozing from the blisters
- Black rashes with reddish edges
- The middle part of the rash would be a bit higher than the edges.
- Pricking pain and burning sensation
- Rough blisters covering the rash
- Similar to Bear’s tongue( Riksha jihwam)
- Worms from the rash (severe infection leads to degradation of tissues and result in emerging of worms).
- Charma kushtam:
Rough skin similar to that of an elephant
- Big base
- Similar to fish flakes
- No sweating
- Kitibha kushtam:
- Sidhma kushtam:
- Soft inner side with rough outer edges.
- Scratching will cause dust like particles
- Smooth, thin
- White and bronze coloured
- Occurs mostly on the head
- Alasaka kustham:
Itchy, reddish blisters
- Tearing of palms and soles with severe pain and middle itching and red blisters.
- Raised patches with severe itching
- Affects extended body parts
- Occurs on joints with extended base and severe burning sensation
- Will be covered with reddish black blisters
- Oozy with worms
- Pundareeka kushtam:
- The shape of the lotus leaf
- White raised lesion covered with red dots and reddish edges
- Itching, burning sensation and pain
- Gets inflamed easily and results in the flow of viscous white bloody liquid.
- Visphota kushtam:
- Thin patches covered with reddish-white blisters
- Paama Kushtam:
- Oozy and small blackish red blisters with severe itching and pain.
- Mainly occurs on bumps, hands and elbows.
- Charmadala kustam
- Red blisters prone to crack
- Sensitive to touch
- Itching, burning sensation and severe pain
- Kaakanaka kushtam:
- The appearance of reddish blisters, which further become black coloured and finally exhibits the symptoms of all the above-mentioned types of Kushta.
- Severe burning sensation and pain
Symptoms of Kushta affecting skin and Sapta ( Seven)dhathu:
- Kushta affecting the skin: Pricking pain, discolouration and dryness
- Kushtam affecting rakta dhathu( blood): sweating, numbness and oedema
- Kushtam affecting mamsa dhathu ( meat/muscles): blisters on pas and feet, excess viscosity of joints
- Kushtam affecting medo dhathu( adipose tissue): Immobility of hands and legs, cracking of body parts
- Kushtam affecting asthi majja dhathu( bone & bone marrow): degradation of the nasal septum, reddish eyes, voicelessness, worms on the lesions
- Kushtam affecting Shukla dhathu ( semen): the disease will spread to spouse and kids as well.
The symptoms of kushtam affecting the subsequent dhathu will include the symptoms of kushtam affecting the previous dhathu as well.
For example symptoms of medo dhathu affected Kushta will have symptoms of kustha affecting rakta dhathu as well.
Prognosis of Kushta:
- Kustha with dominant Tridoshas is Varjya( impossible to treat and therefore should be left without treatment).
- Kushta which affects asthi majja Shukla dhathu( bone, bone marrow and semen)is varjya as well.
- Kushta affecting Medo dhathu( fat layer or adipose tissues) can be managed with treatments.
- Vata Pitta and Kapha pitta kushtam, kustha affecting rakta and mamsa dhathus( blood and meat), are kruchra sadhya( difficult to treat).
- Eka doshaja kushtam( kushtam arising due to the imbalance of vata or pitta or kapha), Kushtam affecting only the skin and Vaha Kapha kushtam can be cured by treatments.
Ayurvedic treatment of Eczema:
The detailed description of cause and symptoms of Kushtam( wide range of skin disorders in Ayurveda) proves that eczema can be compared to different varieties of kustha.
For e.g. Dyshidrotic dermatitis can be compared to Vipadika kustham and treated accordingly.
Deep research on the Kushta topic in Ayurveda proves that eczema van has a wide range of Ayurveda treatment depending on the signs and symptoms exhibited by the patient. Usually patients exhibit symptoms which are interlinked to each other and cannot be given a specific name.
The treatment line of eczema begins with snehapana( drinking medicated oil or ghee) in Ayurveda.
- Dasamooladi ghrutham Tikthaka ghrutham and Mahatiktaka ghrutham are the best-used medicines for snehapana in a Kushta rogi. The medicines have proven the best result in the management of eczema as well.
- Drinking od Sarshapa tailam ( mustard oil) has a significant effect on the management of all types of skin diseases including eczema.
- Aragadwa ghrtuham prepared using the root of Aragwadha ( Cassia fistula) and ghee should be consumed with Khadira kwthitha jalam( water boiled with Acacia catechu bark) and it is very effective in the management of eczema.
The above- mentioned medicines can be used to apply on the lesions as well which can tremendously increase the soothing of lesions.
Raktamoksha can be done in eczema patient. Under all the necessary precautions, a leech can be used to suck blood from lesions. There are more complicated surgical procedures for the manipulated blood effusion from the body described in Ayurveda texts- which are not normally followed nowadays. ( e.g. incision of veins on the forehead or hands to let the affected blood out).
Virechana is also indiv=cated in the treatment of an eczema patient where the patient will be given an Ayurveda laxative and have his bowls clear, to let the increased and dosha out of the body and preparing the body to accept and digest the medicines administered).
Other medicines used in the management of eczema:
- Vajraka ghrutham
- Maha vajraka ghrutham/ Triphaladi ghrtham
- Patoladi kashayam
- Neeli thailam
- Manibhadram lehyam
- Neelithulasyadi kashayam
- Saptasama gulika
Home remedies for Eczema:
- Neem (Azadirachta Indica): Neem is a bitter and antibacterial herb that has a cooling effect. Studies have proved that it purifies the blood. Massaging with neem oil will help to relieve eczema symptoms and will help in the regeneration of the skin.
- Madhu (Honey): Honey has an antimicrobial and anti-inflammatory agent. It helps in soothing the dried skin patches due to eczema.
- Manjishta (Rubia Cordifolia): Manjistha is a herb that is a natural cure for eczema because it pacifies Pitta, calms itching and acts as a blood purifier. For a thorough skin clarifying effect, mix neem and manjistha in equal proportions and consume half a teaspoon of this mixture twice a day with warm water after meals.
- Turmeric (Curcuma Longa): Boil half a teaspoon of Turmeric on low heat and use this solution to wash the affected areas to reduce inflammation.
- Shatavari (Asparagus Racemosus): Shatavari is a cooling herb that calms Pitta and is a great help for the digestive system. Also, coconut oil treated with Shatavari root paste is good for applying on affected areas.
- Licorice (Glycyrrhiza Glabra): It is an anti-inflammatory herb in nature and soothes itching. Boil 2 tbsp. dried licorice root and 6 cups water on low flam for 40 minutes.Use this with a cold compress or can b added to bath water for relief.
- Aloe (Aloe Barbadensis Mill.): Aloe vera is deeply moisturisinng and deeply nourishing. Aloe vera gel can be applied directly on drid eczema lesion for sooting relief.
- Avoid pickles , curd, egg,dried fish, dried meat, cannd food items and fries
- Drink plenty of water.
- Include more fruits and vegetables in the diet.
- Eczema can be triggered by allergens. Like gluten, diary products, prawns, and peanuts.
- Avoid spicy and oily foods
- Use water boiled with neem bark and leaves to bath.
- Wash the skin with natural cleansers like besan (gram flour) can be gentle and moisturizing. This is particularly helpful in baby eczema.
- Stay away from hot, humid temperatures and avoid tight clothing.
- Take mild sun baths as this helps to gt enough Vitamin D which helps in boosting immunity.
- Wear light, cotton clothing and avoid sweating.
- Avoid stress by practicing Yoga and Pranayama.
The Ayurveda management of eczema cannot be spontaneous – organized and systemic management is essential for the complete cure of the disease. The patient should follow the pathya ahara vihara for the time period advised by the Ayurveda consultant.
Following the Dina charya and Ritu charya described by Ayurveda scholars and avoidance of virudha aahara can help in prevention and reoccurrence of eczema.
- Eczema: Cause and Treatment in Ayurvedic Perspective Causes and Treatment of Eczema in Ayurveda- A Review of The Literature
A review of the literature by Naomi Ikuma and published in January 2016 details the Allopathic and Ayurveda classification of Eczema and its Ayurveda management in detail.
A study by B.P Shaw and A.K Jain revealed that external application of Vernia Anthalmintica( known as Iron weed) powder and Nimbadi( known as neem) oil , have resulted in considerable relief of symptoms in some Ezcema patients.
According to a recent clinical study by Mandip and H.M Chandola, Pattient was submitted to Vamana with Aragwadha for 8 days and was then given Shirishadi decoction orally and Snuhyadi lepa externally for treatment of eczema. This combined treatment provided 18.2 % of complete remission. However, the remission rate increased to 22.6 % when Rasayana was added to the treatment.
- A case discussion on eczema:
This article was published by Pallavi Hegde, D T Hemanth, S V Emmi, M P Shilpa, Pradeep S Shindhe, and Y M Santosh in January 2010.
A case report of a 45-year-old male, who presented with complaints of rashes of both foot associated with intense itching and burning sensation, oozing of left foot was taken as the case study.
In 2009 a study carried out at the University of Edinburgh concluded that the defects in a particular gene known as the filaggrin gene are linked to a considerably higher risk of developing allergic disorders such as eczema, rhinitis, and asthma.
A 45-year-old male presented with the complaint of rashes over both foot associated with intense itching for 4 years. The patient also complained of oozing from nonhealing wound of the left foot. (approximately 4 × 3 cm) associated with burning sensation, for 3 years.
There were dry scaly lesions over the right foot and thick serous discharging on the left foot (approximately 4 Χ 3 cm). A foul smell was present, with a thick serious discharge and mild oedema. There was tenderness over the lesions with elevated local temperature and surrounding indurations.
Routine haematology (Hb, TC, DC, ESR) and urine investigations were within normal limits. The skin lesion was sent for culture and sensitivity test and report showed that there is no growth.
The patient was administered classical Virechana (purgation therapy). The details of the procedures are described in Table 1
Procedures administered to the patient
The features of cellulite improved by 5 days and eczematous changes improved by 1 month leaving some amount of hyper pigmentation over the feet. The patient was advised to wear socks during his work.
With a follow up for a period of 1 year, the patient has shown no signs of recurrence. Meanwhile, he was prescribed oral medication viz Arogyavardhini vati one tablet thrice daily for one month and Panchatiktaka guggulu ghrita 10 ml twice daily, i.e., morning at 7 a.m. and evening 7 p.m. at least 1 h before food with hot water in sips for next 1 month.Discussion
The lipid layer of the skin is usually thin in eczema patints.The lipid layer plays a major rol in water retention in the skin. As it gets thinner, the skin gets dehydrated .The immune system then overreacts to the allergens and causes inflamed, irritated, or sore skin.
Mode of Action
Agnideepaka Aushadhi (appetizer)
Oral administration of certain medicines that augments and assists the process of digestion, thus ensuring the optimal state of GIT. The drugs do the Aamapachana. Deepana Pachana Aushadhi not only improves the digestive capacity, but also enhance the metabolic activity of the cells.
Snehapana (drinking medicated ghee)
Administration of medicated ghee is a prerequisite procedure which is carried for a specific period of 5–7 days based on the acceptance capacity of patient and symptoms. This helps with the exit of the toxins from the body. It also adds up greasiness to the body. During the process of Snehapana patient was asked to drink sips of warm water until the smell of ghee was lost in his burp (Jeerna Udgara) and felt hungry.
Sarvang Abhanga (whole body oil massage)
Helps to bring the Dosha (toxins) from all over the body (periphery – Shakha) to the excretory channels (centre – Koshtha). This is carried for 3 days after Snehapana.
Bashpa Swedana (sudation therapy)
The process of sweating also involves the elimination of waste and Dosha (toxins) from the body. These natural functions of sweat are utilized for the therapeutic purposes in Swedana process. Immediately after oil massage, the patient has to undergo sudation therapy by setting in the steam chamber until symptoms of proper sweating are present.
In this procedure, the Doshas (toxins) collected in the excretory channels will be expelled out through the anal route. Virechana drugs cause irritation and enhance the motility of the intestinal wall along with excessive secretion, which helps in smooth and easy expulsion of Doshas (toxins). The patient was given purgative drugs. The patient purchased for 16 times which is considered as moderate purgation.
Samsarjanakrama (post procedure)
In this procedure, a strict bland diet was maintained for 3 days for proper bowel functioning.
The patient had features of cellulite with the wound. Care was taken by daily dressing with medicated decoction wash (Panchavalkala Kwath Prakshalana). Panchavalkala Kwath Prakshalana has cleansing as well as healing property.
As the patient was Building constructer by occupation the cause for his eczema was cement (chemical) irritation, hence, it was the clear case of exogenous eczema. This way the patient was monitored for diet, along with purification measures for removal of toxins by purgation therapy. The skin diseas can affect the patient psychologically than any other diseases. So, the patient during the treatment procedure was also counselled and followed Pranayama and Yoga. The patient was managed only on Ayurvedic treatment modalities.
Our main aim is to purify the body by removing the Doshas(toxins) and boost the immune system. Thus enabling the patient to live a healthy and peaceful life.
Eczema is a disease having its impact on the body as well as on mind. The ayurvedic line of management aims to give a blissful life by improving the immune system of the individual by removing the toxins, and even controlling the mind.
Tridosha is the fundamental concept of Ayurveda. Vata, Pitta and Kapha are the tridoshas. Perfect balance of tridoshas leads to health and imbalance leads to disease.
How Tridoshas spread in the body:
Tridoshas are present all over the body. But they are concentrated in particular body parts. The upper part of the body up to chest is dominated by Kapha, Pitta dominates the region between chest and umbilicus, Vata dominated the region below the umbilicus.
( hrutnabhyoradho madyordhwa samshraya).
Tridosha predominance in the day, night and life:
Kapa dominates the first part of the day, night and life – means morning hours of the day, early hours of the night and childhood are dominated by Kapha.
Putta dominates the middle part of the day, night and life which means noon, midnight and adulthood are dominated by Pitta.
Vata dominates evening hours of the day, last hours of the night before the morning and old age.
Tridosha and digestion:
Kapha, Pitta and Vata dominate in the first, second and final segment of digestion respectively.
The significance of Tridosha in disease:
Vagbhata describes dosha as the one and only cause for all diseases. He has detailed that the root cause of disease always lies in dosha – like a bird cannot escape its shadow while flying the body cannot escape from tridosha. The abnormality of doshas destroys the balance of sapta dhathu and then mala and thus creates disease.
Qualities of Vata ( Vata Guna):
- Ruksha – Dryness
- Laghu- lightness
- Sheeta – cold
- Khara – roughness
- Chala – movement
Qualities of Pitta (Pitta Guna):
- Sasneham – oily
- Tikshnam – intense
- Ushnam- hot
- Laghu- lightness
- Visram- bad smell
- Drava- liquidity
Qualities of Kapha( Kapha Guna):
Seetha – cold
Guru – heavy
Manda – mild
Shlakshna – smooth
Body types as per Ayurveda- Prakriti
Ayurveda emphasizes the importance of the concept of Prakriti by the statement that Prakriti is inherent in human beings like poison in poisonous insects. The Prakriti of an individual is determined at the time of conception depending on the qualities of sperm and ovum.
Tridosha Prakriti where all 3 doshas are found equally is considered to be the best( shreshta tridoshaja).
Dwidoshaja prakrithi comprising of any 2 doshas( Vata- Pitta or Vata-Kapha or Pitta-Kapha) are considered to be Nindya( bad).
Vata Lakshana: Characteristics of normal vata
Utsaha – enthusiasm
Uchwasa – Inhalation
Niswasa – exhalation
Cheshta – movement
Dhatu gati sama – proper development of dhatu
Sama moksho Malam – proper elimination of mala ( urine and faeces)
Vega pravartanam – proper functioning of vega (natural urges for urination, defaecation, ejaculation, passing flatus, vomiting, hunger, burping, yawning, sneezing, thirst, tears, breath heavily on exertion, coughing,)
Reference: ADHARANIYA VEGA – INIMITABLE CONCEPT IN EXTENT OF DISEASE MANIFESTATION AND TREATMENT
Vata Vridhi Lakshana: Characteristics of Increased Vata
- Karshya – emaciation.
- Karsnya – blackish discolouration
- Usnakaamatva – temptation to use hot or to be in hot surroundings.
- Kampa – tremors.
- Ānāha – distention and disturbing in intestines.
- Śakrt grahān – constipation.
- Bala bhramsha – lack of energy
- Nidra bhramsha. – disturbed of sleep
- Indriya brahmsha. – disturbed sensations and actions
- Pancha Jnanendriya: ( 5 organs of sense):
- The eye – the organ of sight having visible forms as its object.
- The ear – the organ of hearing, having sound as its object.
- The nose – the organ of smell, having smell (odours) as its object.
- The tongue – the organ of tasting, having flavours as its object.
- The skin – the organ of feeling, having touch (contact) as its object.
- Pancha karmendriya (5 organs of action)
- The mouth (the organ of speech)
- The feet
- The hands
- The anus
- The genitals
Vata Kshaya Lakshana:: Characteristics of Decreased Vata
- Anga saada: tiredness
- Alpabjashitwam: speaks less
- Sanjna moham: loss of consciousness
- Symptoms of Kapha vrudhy
Pitta Lakshana: Characteristics of normal Pitta
- Darshana (vision).
- Pakti (digestion)
- Ushnam – body warmth
- Trishna and kshut – thirst and hunger
- Deha Mardava – the softness of the body.
- Prabha – radiance.
- Prasada – pleasant.
- Medha – intellect..
Pitta Vridhi Lakshana: Characteristics of Increased Pitta
- Daha – burning sensation
- Raga – reddish discolouration
- Ushnapakita – heat, increase in temperature, the formation of pus, ulcers
- Sveda – sweating
- Kleda – oozy inflammation
- Sruti – inflammation with pus / oozing
- Kotha – putrefaction- decomposition
- Sadana – debility
- Murchana – fainting
- Mada – toxicity
- Katuka Amla Rasa – Tastes bitter and sour
- Pandu Aruna Varjitha – the appearance of colour other than yellowish white and crimson
Pitta Kshaya Lakshana: Characteristics of Decreased Pitta
- Agnimandya – slow digestion
- Satyam: feeling cold
- Prabha hani: loss of complexion
Kapha Lakshana: Characteristics of normal Kapha:
- Sneha – oily.
- Bandha – binding.
- Gaurava – heaviness.
- Vrusata – virility.
- Bala – power.
- Ksama – tolerance.
- Dhrti – patience and bring knowledge into action
- Alobha – not greedy.
- Sthiratva – stability.
Kapha Vridhi Lakshana: Characteristics of Increased Kapha
- Sneha – oily
- Kathinya – hardness
- Kandu – itching
- Sheetatva – coldness
- Gaurava – heaviness
- Bandha – obstruction
- Upalepa – coating, as if tied with a wet cloth
- Staimitya – stiffness, loss of movement
- Shopha – inflammation
- Apakti – indigestion
- Atinidrata – excessive sleep
- Shveta varna – white discolouration
- Svadu lavana rasa – sweet, salty taste in the mouth
- Chirakarita – delay in all activities
Kapha Kshaya Lakshana: Characteristics of decreased Kapha
- Bhramam: dizziness
- Shunyata: feeling empty
- Hrudravam: palpitation
- Shithila sandhita: joints become loose
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