RINGWORM- Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama

It is the most common and annoying skin infection, affecting people of all ages. Ringworm, also known as dermatophytosis, dermatophyte infection, or tinea, is a fungal infection of the skin. The term is a misnomer, since a fungus, not a worm, causes the infection. The lesion caused by this infection resembles a worm in the shape of a ring — hence the name. Ringworm is usually specifically used to describe tinea corporis (ringworm of the body), although it can sometimes be used to describe tinea infection in other locations, such as tinea cruris (ringworm of the groin).

SIGNS AND SYMPTOMS

Symptoms vary depending on site of infection. A skin infection may cause the following:

red, itchy, or scaly patches, or raised areas of skin called plaques

patches that develop blisters or pustules

patches that may be redder on the outside edges or resemble a ring

patches with edges that are defined and raised.

When nails are affected, they may become thicker or discoloured, or they may begin to crack. This is called dermatophytic onychomycosis, or tinea unguium. When the scalp is affected, the hair around it may break or fall off, and bald patches may develop. The medical term for this is tinea capitis.

CAUSES

Three different types of fungi can cause ringworm: Trichophyton, Microsporum, and Epidermophyton.

Ringworm of the scalp (tinea capitis) often starts as isolated scaling in the scalp that develops into itchy, scaly bald patches. It’s most common among children.

Ringworm of the body (tinea corporis) often appears as patches with the characteristic round ring shape.

Jock itch (tinea cruris) refers to ringworm infection of the skin around the groin, inner thighs, and buttocks. It’s most common in men and adolescent boys.

Athlete’s foot (tinea pedis) is the common name for ringworm infection of the foot. It’s frequently seen in people who go barefoot in public places where the infection can spread, such as locker rooms, showers, and swimming pools.

PATHOPHYSIOLOGY

Mannans in the cell walls of some dermatophytes, such as T. rubrum, have immune-inhibitory properties. This allows the fungus to stay on the skin without being sloughed off prior to invasion of the skin. The causative fungus can produce proteases (enzymes that digest keratin), serine-subtilisins (enzymes that digest protein by initiating the nucleophilic attack on the peptide bond through a serine residue at the active site), and keratinases (enzymes that penetrate keratinized tissue), which allow the fungus to invade the horny layer of the skin and spread outward. Infection is usually cutaneous and confined to the outer, non-living, cornified layers of the skin. The fungus is unable to penetrate the deeper tissues in healthy immunocompetent hosts because of host defense mechanisms, such as activation of serum inhibitory factor, polymorphonuclear leukocytes, and complements. Scaling of the active border results from increased epidermal cell proliferation in response to the fungal infection.

DIAGNOSIS

Clinical examination

Skin biopsy

Fungal culture

KOH exam

TREATMENTS

Jock itch, athlete’s foot, and ringworm of the body can all be treated with topical medications, such as antifungal creams, ointments, gels, or sprays. Ringworm of the scalp or nails may require oral medications such as griseofulvin (Gris-PEG) or terbinafine. Medications and antifungal skin creams may be recommended for use containing clotrimazole, miconazole, terbinafine etc.

PROGNOSIS

Generally good with complete clearance in2-4 weeks.

COMPLICATIONS

Spread to other areas of the body

Spreading the infection to other individuals

Hair loss and scarring

Nail deformities

Tinea capitis can produce life-long permanent hair loss

Disease & Ayurveda

                Krimi – Raktaja

Nidana

Causative factors for krimi are the same as that of Kushtha.

Sparsa

Aahaara               together      – By touch and sharing food, bed etc.

Sayya

            Amrijothbhava            – Due to lack of proper personal hygiene

Purvaaroopa

        Not mentioned separately

Samprapti

            Due to contact with krimi (microbes or parasites) and due to lack of proper hygiene, the microbes enter the body through skin, wounds or cuts, mouth, nose or eyes. They enter the bloodstream and release toxins. The vitiated rasa-raktadhatus cause the symptoms, mostly on skin. Such body reactions are understood as allergic manifestations and mostly are seen as skin rashes.

Lakshana

Kotha – papules

Pitaka – pustules

Kandu – itching

Ganda-cysts or small lumps or even enlarged lymph nodes in severe cases

Divisions

  • Bahyam-external
    • Aabhyantaram-internal
  • Bahirmalaja-from external impurities
  • Kaphaja-from kapha
  • Rakthaja-from rakta
  • Pureeshaja-from faecal matter

Prognosis

            Kricchrasadhyam

Chikithsa

The Ayurvedic treatment of Krimi depends upon the type.

Here, the infestation is external and it is raktaja. The main procedure is to physically remove the krimi from skin and other body parts infested. Also following good hygiene and preventive measures are advised.

Samana

Apakarshana – extraction with hand or tool

Uthkharshana-powder massage

Lepana-external application of herbal combinations

Parisheka-Pouring medicated herbal decoctions on the area

Sodhana

In raktaja krimi, minimal sodhana therapies to balance Pitta (like virechana) is indicated as the samprapti is mostly confined to the skin and not originated from the gastrointestinal tract. If other associated signs & symptoms are present sodhana of koshtha is done in strong patient.

Commonly used medicines

        Vidangakrishnadi kashayam

            Vidangasavam

            Aragwadharishtam

            Avipattichoornam

            Krimisodhinivatika

Brands available

        AVS Kottakal

            Vaidyaratnam oushadhasala

            SNA oushadhasala

Home remedies

No home remedy is effective in completely curing the ring worm. But trying these herbs can reduce the severity of infestation.

Garlic

Apple cider vinegar

Aloe vera

Turmeric

Coconut oil

Diet

  • To be avoided

Red meat, fried non-veg items, and sea foods

Heavy meals and difficult to digest foods – cause indigestion.

Junk foods and spicy food- cause disturbance in digestion and reduces the bioavailability of the medicine

Carbonated drinks – makes the stomach more acidic and disturbed digestion

Refrigerated and frozen foods – causes weak and sluggish digestion by weakening agni (digestive fire)

Curd – causes vidaaha and thereby many other diseases

  • To be added

Light meals and easily digestible foods

Green gram, soups, buttermilk boiled with turmeric, ginger and curry leaves

 Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc

Behaviour:

Maintain proper personal hygiene.

Avoid sedentary lifestyle. Be active.

Better to avoid exposure to excessive sunlight wind rain or dust.

Maintain a regular food and sleep schedule.

Avoid forcing or holding of natural urges like urine, faeces, vomiting, hiccups etc.

Avoid Stress and emotional imbalance as much as possible.

Yoga

Following a routine with regular exercises and specific yoga asanas like Ardhamathsyentra asanam, Halasanam, Vakrasanam, Dhanurasanam etc is recommended.

Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.

Yoga can maintain harmony within and with surroundings.

Ardha mathsyentra asanam

Halasanam

Vakrasanam

Dhanurasanam

All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.

RESEARCH ARTICLES

doi: 10.1186/s12906-017-1970-2

A randomized, placebo-controlled, double blind, parallel, single centre study was conducted on 28 subjects with severe to very severe tinea or onychomycosis. All patients were randomized in a ratio of 1:1 for treatment or placebo group. Subjects in the treatment arm received Calmagen® cream or lotion, while subjects in the placebo arm received a similar inert topical preparation. Tinea subjects were treated with cream for four weeks, while onychomycosis subjects were treated with lotion for 12 weeks. The Calmagen® cream and lotion containing AMYCOT® represent a potentially safe and efficacious natural alternative in the treatment of Tinea and onychomycosis.

doi: 10.4103/idoj.IDOJ_515_19

A case-control study was done to evaluate various epidemiological and clinical factors including the presence of tinea unguium as a risk factor for Chronic and recurrent dermatophytosis (CRD) in a total of 80 patients.  Among them, 55% had chronic dermatophytosis and 45% hadrecurrent dermatophytosis respectively. The presence of tinea unguinum was not significant.

These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.

Dr. Rajesh Nair, Ayurveda Doctor

Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.

Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.

Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.

Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
rajesh@ayurvedaforall.com

Whatsapp – +91 9446918019, +91 8075810816

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