Principles Of Treatment Of Skin Diseases And Tips

Abstract

Skin is the largest organ of the body covering and constitutes the first line of defense. The skin protects the body from harmful agents such as ultraviolet rays and from infective organisms in the atmosphere. It has many specialized cells and structures which are divided into three layers – epidermis, dermis and hypodermis. The epidermis is the outermost layer of the skin and protects the body from the environment. The dermis is located beneath the epidermis which has a subcutaneous fat layer and large blood vessels and nerves. This layer contains lymphatics, blood vessels and sweat glands and nerve endings. The hypodermis is located between the dermis and tissues and organs. Hypodermis contains sweat glands, hair follicles and skin appendages. Skin is a vital part of the body’s health and well-being. It senses pain, temperature and pressure and is more prone to injuries externally and internally. In this topic, we are going to discuss its causes, functions and common skin problems with its ayurvedic aspect in detail.

Skin diseases, Tips, Principles Of Treatment Of Skin Diseases And Tips, Facts about skin, Common skin problems, Functions of skin, Ayurvedic aspect on skin disease, Prevalence of skin disease, Diet and lifestyle

Intoduction

A skin infection is an infection of the skin in humans and other animals which is associated with soft tissues such as connective tissues and mucous membranes. It can be due to a wide variety of germs whose symptoms vary from mild to serious. Skin diseases are a common ailment which affects all ages from neonates to the elderly and causes harm in a number of ways. There are different types of skin infections such as bacterial skin infections, viral skin infections and fungal skin infections. In ayurveda, Twacha is used for the skin which is responsible for the proper functioning of the skin. In ayurveda, it is due to an imbalance of tridoshas and dhatus which has a negative impact on the quality of life. Lack of internal equilibrium manifests through the skin.

Facts About Skin

The skin makes up 15% of the total body weight.
The average adult has 21 square feet of skin which contain 11 miles of blood vessels.
There are over 300 sweat glands.
The thickest skin is found on the feet and the thinnest layer of skin is found over the eyelids.
The skin renews itself every 28 days and sheds about 9 pounds of dead skin cells.
As skin nerves are connected to muscles they quickly react to the temperature.
Sleep is vital for healthy, vibrant and youthful skin.
There are over 5 types of receptors in the skin which respond to pain and touch.

Common Skin Problems

The most common skin diseases are categorized as under –

Rashes – It is red, an inflamed area which is caused by irritation, allergy as well as by structural defects. It includes acne, dermatitis, eczema and pityriasis rosea and psoriasis.
Viral Infections – These occur when a virus penetrates and infects the inner layer of skin. It is due to herpes simplex, measles and warts.
Bacterial Infections – It is due to various bacterial infections which affect the topmost and deep layer of the skin. It is commonly due to Staphylococci and Streptococci. This infection spread throughout the body causing folliculitis and cellulitis.
Fungal Infection – As we know harmless fungi are always present on the skin and when these organisms enter the body it affects the skin, hair and nail which suppresses the immune system. When fungi spread deep within the body cause many serious diseases.
Pigmentation Disorders – It is due to melanin which is produced in the body. Loss of pigmentation (hypo-pigmentation) is due to the absence of melanocytes and malfunctioning of the cells such as in Vitiligo. When there is an increase in pigmentation, hormonal changes cause Hyperpigmentation.
Other Conditions – Wrinkles (due to the breakdown of the collagen and elastin within the dermis layer), spider veins and varicose veins (when blood vessels become enlarged and visible through the surface of the skin.
Trauma – It is due to some injuries caused by a blow or a burn. Whenever the skin is broken, the body becomes more susceptible to infection and diseases.

Functions Of Skin

The skin has main four functions as follows-

Protection – It s the first line of defense against the external environment, The epidermis is continuously shedding tons of dead cells which protect the body from –

Mechanical Impact – It is due to pressure, stress and trauma. It breaks through the skin with a loss of function.
Fluids – Skin prevents the absorption of harmful substances or excess water loss through the skin.
Radiation – If the skin is not present, ultraviolet rays radiate from the sun damaging the underlying tissues in the body. So, the Skin protects from harmful radiation.

Thermal Protection – Temperature is regulated by the skin through the sweat glands and blood vessels in the dermis. Vasodilation in the dermis makes the body easier for release of heat and lower temperature through the skin. The fatty subcutaneous layer acts as an insulation barrier to prevent loss of heat by decreasing the effect of cold temperature.
Sensation – The skin dermis is helpful in detecting different sensations of heat, cold and contact and pain. It protects us from first and second-degree burns.
Endocrine Functions – Skin is the main source of Vitamin D, which produces D3 (Cholecalciferol) in the lowermost layer of the epidermis.

Ayurvedic Aspect

In Ayurveda Skin (twak) is one among 5 jnanendriya and is considered a upadhatu of Mamsa Dhatu which is present at swat channels (swedavahi srotas) and hair (Loma). According to Sushrutha and Bhavamishra, there are 7 layers and according to Charaka, there are 6 layers of twak. Skin is immemorial owing to which is conferred upon skin, complexion and beauty by society. In ayurveda is due to the prime importance of diet and skin ailments. It commonly comes under the spectrum of Kushta (causes disfigurement). It is commonly due to physical, physiological and psychological effects which are reclassified into Sannikrishta (proximal cause) and Viprakrishta (remote cause).

Sannikrishta Nidana – 7 dravyas and factors are involved in the pathogenesis of Kushtha. It includes 3 doshas (Vata, Pitta and Kapha) and 4 dushyas (Twak, Rakta, Mamsa and Ambu ).
Viprakrista Nidana – It involves Kulaja factors, Janmottara kalaja (ahara, vihara and manasika factors).

Janmottarakalaja – It has three groups- Aharaja (food-related), Viharaja (lifestyle-related) and Manasika (psychological).
Kulaja Nidana – It arises from the day of conception by conjugation of Shukra and artava with bijabhaga avayava dushti.
Poorva Janmakrita – It is due to kushtha in a previous life.
Papakarma – Due to sinful activities.

Kushtha is tridoshaja vyadhi and is classified as Mahakushtha and Kshudra kushtha. Nidana can be classically described into the following categories-

Aaharaja Nidana – It includes the excess intake of Guru, Liquid and taking excess Guru and Snigdha Ahara which produces dushti in Rasavaha srotas. The viruddha ahara leads to impairment of agni which does not digest light food and leads to indigestion and further produces Amavisha. For example- When milk and fish are taken together it leads to vitiation of blood and leads to obstruction in the channels of the body. The vitiation of blood leads to dermatological issues.
Viharaja Nidana – It is due to the suppression of the natural urges and complications due to panchakarma, late night sleep and exercises.
Mansika Nidana – It has several factors such as Chinta (worry), sorrow and sinful activities which leads to a negative impact on the mind and leads to stress which aggravates dermatological disorders.
Sansargaja Nidana – Infective disease.

Pathogenesis

The vitiation of doshas spread throughout the body and vitiate dhatus manifest kushtha rogas. According to Acharya Susruta is due to the aggravation of Pitta and Kapha doshas which produces Avarana of Vata and leads to an aggravation of Vata doshas. This Vitiated Vata enters into Tiryaka Siras with other vitiated doshas and leads to further vitiation. Then it reaches Bahya Rogamargas (Twak, Rakta, Mansa and Lasika) and spreads to the whole body producing round lesions (Mandala). If these doshas are not treated then they enter deeper dhatus of the body leading to complications.

Clinical Features

Clinical features of Kushtha according to doshas predominance are as follows –

Vataja Kushtha – The lesions of the skin become rough, dry and hard which are reddish black in colour and associated with pain.
Pittaja Kushtha – It is associated with Burning (daha), erythema and blister formation. There is the removal of dead tissues from fingers and superinfections.
Kaphaja Kushtha – The Lesions are cold and dense which is associated with stickiness and maggot formation. Papules and nodules are seen.

Clinical presentation of kushtha according to particular dhatus –

Tvakagata or Rasagata dhatu – Loss of sensation, mild itching and dryness.
Raktagata Kushtha – Is characterised by numbness, itching and pus formation.
Mansagata Kushtha – General body swelling, pricking pain with cracking of the skin.
Medagata Kushtha – Is associated with Pus formation and general body aches.
Asthi-Majja Gata Kushtha – Redness of eyes with superinfected ulcers and hoarseness of voice.
Shukragata Kushtha – There is a deformity in fingers, general body aches and fast-spreading ulcers.

Premonitory Signs And Symptoms

Lack of touch sensation in the skin lesion.
Excessive sweating and absence of sweating.
Itching and pricking type of pain.
Discolouration and elevation of patches.
Burning sensation and numbness.
Mental and physical fatigue.

Management Principle

Patients with skin disease approach various healthcare systems to get the cure, in this Acharya’s emphasised Shodhana therapy which expels the morbid doshas out of the body.

According to Acharya Sushrutha – Vamana should be advised once every fortnight. Virechana once a month and Raktamokshana should be done twice a year.

According to Acharya Charaka,

Kushtha is dominated by Vata doshas which are first administered by Ghrita internally.
The kushtha is dominated by Pitta doshas which are administered by Virechana therapy.
Kushtha, which is dominated by Kapha doshas, is administered by Vamana Therapy.

Why Virechana In Kushta?

Kustha (skin disorder) is the raktapradoshaja vyadhi. Pitta is the mala of rakta dhatu and when an excessive amount of pitta doshas is expelled from the body it purifies the rakta doshas which is helpful in purifying the rakta dhatu.
Virechana karma has specific action which has action on saptadravyas and on Vata doshas which is the main factor for skin disorders.
Virechana is the best shodhana karma for malaroopa pitta and it is located in the liver and gallbladder.

Correlation Between Skin And Doshas Along With Lakshan

Twacha is the site of Vata and Pitta Predominance which is due to imbalances of doshas-

Hyperpigmentation and discolouration due to Vara Vriddhi Lakshan and Pitta Vriddhi Laksha.
Pitta kshaya Lakshan involves the loss of glory and coldness of the skin.
The dryness of the skin and burning sensation is due to Kapha Kshaya Lakshan and Vata Vriddhi Lakshan.

Prevalence Of Skin Diseases

Unhygienic practices.
Overuse of antibiotics and steroids.
Excessive and improper use of chemicals and cosmetics.
Faulty diet: taking of heavy unsuitable foods, or taking meals before the previous food is digested.
Taking milk along with fish and meat.
Forceful inhabitation of vomiting as vitiated Vata gets aggravated and spread all over the tissues of the body.

Principles Of Treatment Of Skin Diseases And Tips

Punaha Punaha Shodhana in Bahudoshajanya Tvak Rogas.
After Shodhan and Raktamokshana, Ghritpana is essential in preventing Vata Prakopa.
Lepa is applied after Shodhana and Raktamokshana.

Diet And Lifestyle

1. PATHYA (WHOLESOME)

Diet should be balanced and digestible.
Sattwik diet is very essential for essential healthy skin.
Diet should include green leafy vegetables and seasonal fruits.
Periodic fasting is good for health.
Maintains good hydration, adequate water and fruit juice.

2. APATHYA (UNWHOLESOME)

Avoid sour, salty and spicy foods and milk products and smoking must be avoided.
Spices, tea, coffee and alcohol should be consumed as little as possible which produces a sense of heat and leads to allergic conditions and dermatoses.
Suppression of natural urges.
Avoid excess irritation of the skin.
Patients with skin disorders must avoid the use of meat, fat and milk, Vidahi food (which causes a burning sensation) and Abhisyandi (which increases moisture inside the tissues).

3. ROLE OF MENTAL STRESS IN SKIN DISORDERS

Emotional conflicts, Psychogenic stressors cause a few skin diseases.
Emotional stress, pain and anger cause localised sweating on the palms, soles and on the forehead.
There is a close relationship between the Psyche (mind) and Soma (body) which causes a group of chronic illnesses.

4. FRESH COOL AIR, EXERCISE AND MILD SUN

They are potent natural skin restorers, as they stimulate the skin and sympathetic system which is dependent on the vitality of the skin and body.
Yogic practices are beneficial in improving the proper circulation in the body and relaxing the musculature.
Extreme cold and heat are injurious to the body as strong rays of the sun produce degenerative changes and even neoplasms in white people so umbrellas and solar hats are useful aids.

5. CLOTHING

Avoid tight-fitting/nylon/synthetic clothes in summer weather.
Wear loose cotton clothes and soft slippers/chappals as nylon clothes, synthetic clothes interfere with the absorption and evaporation of sweat which causes contact dermatitis.

6. BATHING

The skin should be thoroughly dried up after bathing.
In summer and humid zones one must have clean and cool water.
In cold weather, one must take lukewarm water.

7. SOAP

The least alkaline soap must be used.
Herbal oil must be used for washing the face.

8. OIL

It nourishes the skin and hair which makes them smooth.
In cool and dry weather oil massage is beneficial.
Coconut, mustard and olive oil are commonly used.
Ghee and oil are abundant to massage the skin of children.
It is useful for chapped lips, feet and hands.

9. SHAVING

10. COSMETICS

They contain certain chemicals to which individuals become sensitive as it harms the skin and causes blockage of the pores which causes slow degeneration hence avoid cosmetics as possible.
Have a patch test before using any skin product.

11. HAIR CARE

Avoid strong shampoo, soaps and hair spray. Instead, use hair conditioners.
Always use clean and normal water to wash the head. Avoid using warm water.
Avoid frequent combing and brushing as frequent combing and brushing tend to irritate the scalp and cause atrophy of hair.
Avoid exposure to dust and polluted environment.