DIPLOMA in Ayurvedic Practitioners Course 2020 Module 2

DIPLOMA in Ayurvedic Practitioners Course 2020 Module 2 19 th & 20 th September 2020

Charma Roga (kushta) Skin disorders

Common skin disorders Atopic eczema, dermatitis, hives Psoriasis, psoriatic arthritis Acne, rosacea, cold sore Ringworm, scabies

Structure of the skin

Eczema, dermatitis, hives The Allopathic perspective

Eczema, dermatitis, hives The Allopathic perspective itchy, red, dry and cracked Most commonly affects: the backs or fronts of the knees outside or inside the elbows around the neck, hands, cheeks or scalp

Eczema, dermatitis, hives The Allopathic perspective Flare up: Condition worsens Inflammation increases Fluid oozing from the skin Pus / yellow crust Swollen and sore High temperature

Causes of eczema, dermatisis, hives The Allopathic perspective “The exact cause of atopic eczema is unknown, but it's clear it is not down to one single thing. ” – NHS allergies eg. food, soaps, stress, weather hereditary associated conditions such as asthma and hay fever

General advice – eczema, dermatitis, hives The Allopathic perspective Ø Manageable condition Ø Can improve with time Ø Most children grow out of it Ø Maintain food diary to find trigger Ø Stay away from triggers

General advice – eczema, dermatitis, hives The Allopathic perspective “Some foods, such as eggs and cows' milk, can trigger eczema symptoms. But you shouldn't make significant changes to your diet without first speaking to your GP” Referral to a dietitian (a specialist in diet and nutrition)

Treatment eczema, dermatitis, hives The Allopathic perspective Ø Main emphasis is relief for signs and symptoms Ø Currently no cure Ø Severity of eczema has significant impact on daily life Ø Counselling to help cope with the situation

Treatment eczema, dermatitis, hives The Allopathic perspective Ø Emollients Ø Antihistamines Ø Block the effects of histamine in the blood called Ø Help relieve the itching Ø Can either be sedating or non-sedating

Treatment eczema, dermatitis, hives The Allopathic perspective Topical corticosteroids / steroid tablets Very mild (such as hydrocortisone) Moderate (such as clobetasone butyrate) Even stronger (such as mometasone) Side effects Mild stinging sensation for less than a minute Thinning of the skin Changes in skin colour Acne (spots) – especially when used on the face in teenagers Increased hair growth Most of these side effects will improve once treatment stops.

Treatment eczema, dermatitis, hives The Allopathic perspective ► Bandages and wet wraps ► Special medicated bandages, clothing or wet wraps to wear over areas of skin affected by eczema.

Treatment eczema, dermatitis, hives The Allopathic perspective Seeing a dermatologist Allergy testing Topical calcineurin inhibitors – creams and ointments that suppress your immune system Bandages or wet wraps Phototherapy – ultraviolet (UV) light that reduces inflammation Immunosuppressant tablets – to suppress your immune system

Treatment eczema, dermatitis, hives The Allopathic perspective “Some people may find complementary therapies such as herbal remedies helpful in treating their eczema, but there's little evidence to show these remedies are effective. If you're thinking about using a complementary therapy, speak to your GP first to ensure therapy is safe for you to use” - NHS

Psoriasis, psoriatic arthritis The Allopathic perspective

Psoriasis, psoriatic arthritis The Allopathic perspective Flaky red patches of skin covered in silver scales Can be itchy or sore Can be minor irritation or severe Usually appear - elbows, knees and the lower back Usually periods when no or mild symptoms & periods when symptoms are more severe

Psoriasis, psoriatic arthritis The Allopathic perspective Affects 2% of people in the UK Can start at any age Most often develops in adults under 35 years old Increased production of skin cells Cells normally replaced every 3 to 4 weeks – reduced to 3 to 7 days

Cause of psoriasis, psoriatic arthritis The Allopathic perspective “Although the process isn't fully understood, it's thought to be related to a problem with the immune system … for people with psoriasis, it attacks healthy skin cells by mistake” - NHS ► Hereditary ► Certain events can trigger including, injury to your skin, throat infections, certain medicines and arthritis ► Weak immune system

Treating psoriasis, psoriatic arthritis The Allopathic perspective “There's no cure for psoriasis, but a range of treatments can improve symptoms and the appearance of skin patches” – NHS Topical treatment, eg. vitamin D analogues or topical corticosteroids Phototherapy (exposing skin to ultraviolet light) In severe cases, oral or injected medicines

Acne The Allopathic perspective

Acne The Allopathic perspective Face, back, chest Blackheads, whiteheads, papules, pustules, nodules, cysts Sebaceous gland produces too much sebum and blocks hair follicle Puberty – due to testosterone and oestrogen Period, pregnancy, PCOS Hereditary Cosmetics, medications

Treating acne The Allopathic perspective Topical retinoids Topical antibiotics Azelaic acid Antibiotic tablets Combined oral contraceptive pill

Rosacea The Allopathic perspective Redness / blushing across nose, cheeks, forehead Butterfly rash Dry skin Swelling around eyes Sore eyelids Thickened skin (mainly on nose)

Causes of rosacea The Allopathic perspective Alcohol Spicy food Cheese Caffeine Hot drinks Aerobic exercise

Treating rosacea The Allopathic perspective Topical creams / gels Antibiotics Steroids

“ Charma Roga (kushta) The Ayurvedic perspective ”

Structure of the skin

Charma Roga (kushta) Types of skin disorder 18 types of skin disorder in Ayurveda: 7 Maha kushta (major) 11 Shudhra kushta (minor)

Maha kushta (major) Skin disorders 1. Kapāla kushta – vata 2. Udumbara kushta – kapha 3. Mandala kushta – pitta 4. Saushra griva (deer’s tongue) – vata/pitta 5. Puncharike – pitta 6. Sidhma – vata/kapha 7. Kanaka – vata/pitta/kapha

Shudhra kushta (minor) Skin disorders Aka kushta – vata/kapha 2. Charma kushta – vata/kapha 3. Kitibhaya – vata/kapha 4. Viyapatika – vata/kapha 5. Alasaka - vata/kapha 6. Dadhruma – pitta/kapha 7. Charmadhala - pitta/kapha 8. Parmar - pitta/kapha 9. Visporta - pitta/kapha 10. Shataruwa – pitta/kapha 11. Vicharchika – kapha 1.

Charma Roga (kushta) From the Ayurvedic perspective – main emphasis is Ø Identifying causative factors Ø Eliminating causative factors

Nidhana (causative factors) Skin disorders Oily foods (Snigdha) Red fish (Mathsya) Sesame (Tilla) Milk / dairy products (Sheera) Yoghurt (Dhadi) Heavy foods (Guru) Root vegetables like potatoe (Mansa mulaka) High wheat and carbohydrate content food (Pishta) Sweet food (Guda) High water content food - eg. melon, cucumber (Drava) Cold water or cold drinks (Sheetambu) Sour and salty food (Amla Lavana)

Nidhana (causative factors) Skin disorders Incompatible food and drink (Virrudha anna pana) Certain methods of food preparation (Karma Sanskarana Bhojana) Cold and hot food eaten together (Sheeta / ushna virya) Incorrect or excessive fasting (Langana) Eating before last meal is fully digested (Adyasana) Indigestion (Ajeerna) Inappropriate or excessive consumption of raw food (Navanna)

Nidhana (causative factors) Skin disorders Incorrect Pancha Karma (detox) treatment (Panchakarma apachari) Yawning, hunger, thirst, vomiting, hiccups (Vega avarodha) Excessive exercising (Viyayama) Worrying or feeling sadness (ati santapa) Overeating (Ati bojya) Overtiredness (Shrama) Feelings of fear and insecurity (Bhaya)

Nidhana (causative factors) Skin disorders Sleeping at incorrect time / incorrect sleeping patterns (Nidra jagera) Sexual intercourse too soon after eating (Viya vaya) Insulting your guru (Guru apachari) Karma (Papa karma)

Purva rupa & rupa Skin disorders Translucent or shiny skin (Ati slaksha) Rough (Karasparsha) Pale (Swetha) Pale turning darker (Vivarna) Excessive sweating (Sweda) Hot / burning sensation (Daha) Itchy (Kandu) Piercing pain (Thoda) Dizziness / giddiness (Ati brama)

Nidhana (causative factors) Skin disorders Bumpy skin (Tawasvapa) Dark colouration (Varuna) Constant pain (Shula) Quick onset of symptoms (Seegra utpathi) Roughness, embarrassment, discomfort, depression, impatience – negative feelings of the mind and body (Rukshushva) Easily triggered / irritated (Kopana) Prickly heat / shiver (Romaharsha) Black discolouration (Krushna)

Samprapti (pathogenesis) Skin disorders Consumption one or more causative factors All 3 doshas can become imbalanced Creates ama (circulates with Ambhu Vaha Srotas) Imbalanced dosha circulates through all dhatus mostly stays in rasa, rakta and mansa dhatu

Charma Roga (kushta) & dosha Vata type rasa dhatu, superficial layer of skin Pitta type rakta dhatu, blood tissue Kapha type mansa dhatu, muscular tissue

Charma Roga (kushta) & dosha Vata symptoms: Dry (shosha), rough (ruksha) pinching pain / insect bite feeling (thoda) (shula) contraction of the skin (sankosha) shrivelling, creaking, cracking sounds (ayama) sound of dry scratching (parosha) coarseness prickly black / crustiness (kara) heat / shivers (harsha) / brown / pink colouration (krushna varuna)

Charma Roga (kushta) & dosha Pitta symptoms Hot (daha) Red (raga) Oozing (parishrava) Inflamed Fishy Wet (paka) smell (vishra gandha) (kleda) Peeling skin / scabs falling off (anga patana)

Charma Roga (kushta) & dosha Kapha symptoms: Pale colour (swetha) Cold (sheetha) Itchy (kandu) Bumpy (situlya) Stagnant Deep (utseda) (guru) Soft (snehana) Pus (snehana) Rotten appearance (snehana) Insects like to bite it (jantuji)

Chikithsa Skin disorders Vata – drinking ghee / oleation Pitta – virechana (purgative) / rakta mokshana (blood letting) Kapha – vamana (vomiting) or ama pachana

Chikithsa Skin disorders HERBS Neem Chitraka Manjistha Patola White sandalwood Brahmi Red sandalwood Bhunimba Ajwain Daru haridhra Ghee Venivel Khadira Haridhra Amla Camphor Mustha Moringa Triphala Acacia

Chikithsa Skin disorders Minerals Shelarjit Gandaka Animal products Honey Ghee

Chikithsa Skin disorders Arishta Taila Kadira arishta Neem oil Triphala kwatha Pinda oil Dashamoola arishta Visarpahara oil Ashoka arishta Neelyadi oil Sarshapadi oil Seethodaka oil Kumari oil

Chikithsa Skin disorders Shodhana Panchavalkana Neem bark Jasmine water Clove Triphala Dhooma Neem – 5 parts of neem plant crushed and mixed with neem oil Coconut leaves Steam inhalation with lemon grass, mint leaves or eucalyptus oil

Chikithsa Skin disorders Alepa Vasti Triphala paste Castor oil Dashanga lepa Triphala oil Neem paste Mahanarayana oil Dermaved Neelyadi oil Charma lepa

Chikithsa Skin disorders FORMULATED CHOORNA Triphala Dhatri Hinguashtaka Nimbhadi Sitopaladi Avipathikara Paaka choorna Manibadhra Chandanadi Chopachini Pittahara Amahara