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Manjistha(Rubia Cordifolia)- A helping herb in cure of acne

June 2015

Authors:

Anand Chaudhary

Faculty of Ayurveda ,IMS .Banaras Hindu University

Vandana Meena

Banaras Hindu University

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Jour. of Ayurveda & Holisti

c Medicine

Volume-III, Issue-II

MANJISTHA (RUBIA CORDIFOLIA) - A HELPING HERB IN CURE OF ACNE

Vandana Meena

Anand K Chaudhary

INTRODUCTION:

Rubia cordifolia Linn. commonly known as Indian

Maddar is a perennial, herbaceous prickly climber with

long and cylindrical root with a thin red bark, well

known for its versatile action. It is distributed in the

Himalayas from Kashmir eastwards and Nilgiris and

other hilly districts of India.

[1]

One of its unique action is

anti-acne effect through anti-bacterial, anti-

inflammatory, anti-oxidant and anti-androgen action.

The roots and stems are well known source of

Anthraquinones, the roots have also been reported as

antioxidant, anti-inflammatory, anticancer,

immunomodulator and hepatoprotective and are

extensively used against blood, urinary and skin

diseases.

[2,3]

In ancient world, Manjistha is reputed as

an efficient blood purifier and hence is extensively used

against blood, skin and urinary diseases.

[4 ]

Externally,

Manjistha was applied on major burns, mixed with

honey on freckles and blemishes. It remained a potent

drug for obstinate skin diseases, erysipelas,

leucoderma, and oedema also used as febrifuge and

against blood disorders in Ayurveda. Traditionally, it is

used in many polyherbal formulations for various

ailments and cosmetic preparations because

of its

inflammatory, antiseptic and galacto-purifier activity.

[5]

Root is used externally and internally to gain lustre and

glow of the skin and aids to remove pimples, freckles

and discoloration.

[6]

Traditionally the roots are used to

treat various systemic problems and pigmentation

anomalies of skin and is an excellent aid in the

promotion of complexion. Dried and crushed orange

peels, powders of sandal, turmeric and Manjistha

makes an excellent face pack. The finely crushed root

powder along with little honey applied to face for

healing skin tissues damaged by injury or infection. The

root powder mixed with ghee, for the medicament of

acne.

[7]

Vanraji tribes of Kumaun Himalaya use the

whole plant pulp rubbed with honey as a cure for acne

and dark spots on face.

[8]

Acne, as a family of skin disorder is one of the most

prevalent dermatologic diseases in the world. It usually

affects almost everybody during the life.

[9]

The

pathogenesis of acne is complex but dependent on four

key factors including androgen-mediated stimulation of

sebaceous gland activity, follicular hyperkeratinisation,

colonization of the bacterium Propionibacterium acnes

and inflammation.

[10]

Mainly three types of acne:

comedonal, nodular and papulopustular. Comedonal is

non- inflammatory while nodular and papulopustular

are the inflammatory types.

[11]

There is a variety of

medication for acne vulgaris including topical agents,

oral antibiotics, oral retinoid and oral hormonal

therapies. The use of natural remedies, particularly

herbal medicine, dates back thousands of years. Over

the last decade, in view of increasing resistance to

existing anti-microbial agents, side effects and

sometimes high cost of treatment, interest in medicinal

herbs has been progressively increased.

[12,13]

There are

so many herbal drugs for ant- acne effect, which shows

ABSTRACT:

Acne is one of the most prevalent skin ailment affecting almost all teenagers, as it is chronic with frequent remission and

exacerbations is often associated with negative psychological consequences, diminished self-esteem and social withdrawal.

The Modern measures regarding the treatment of acne are more or less failure. Further it has some limitations, cost

effective and many side effects. To overcome from all these, a good herbal approach should be reached. Manjistha (Rubia

cordifolia) can be proven a best remedy to cure acne, due to its Varnya, Raktashodhak, Vishaghna, Rasayana, Krimighna

properties. Certain research papers has also proven that it possess anti-inflammatory, antibacterial, antioxidant and ant-

androgenic effects as these are important Pharmacotherapeutic agent to break the pathogenesis of acne.

Key Words: Manjistha, Acne, Varnya, Anti- inflammatory, Rubia cordifolia

Junior Resident,

Professor & Head. Department of Rasa Shastra,

Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu

University, Varanasi, UP, India.

Corresponding author email address: vandana.bhu@gmail.com

Access this article online: www.jahm.in

Published by Atreya Ayurveda Publications under the license CC-

by-NC.

Received on: 12/03/15, Revised on: 21/03/15, Accepted on:

28/04/15

Jour. of Ayurveda & Holisti

c Medicine

Volume-III, Issue-II

broadly four mechanism i.e. anti-inflammatory, anti-

oxidant, anti-bacterial and ant- androgenic, among

them Manjistha is one of important herbal remedy

showing all four properties.

MATERIALS AND METHODS:

The following are the process and eligibility criteria for

the inclusion of data pertaining to this review:

Information extracted from various Ayurvedic treatises,

text books of Ayurvedic and modern pharmaceutics,

Pharmacopoeias (Ayurvedic Formulary of India,

Ayurvedic Pharmacopoeia of India), available

dissertations/thesis were also investigated. A search

was undertaken in Google scholar, MEDSCAPE, BMC,

Science Direct, MEDLINE (www.pubmed.com)/pubmed

database, SCOPEMED, and other relevant databases,

using keywords like manjistha, rubia cordifolia, acne,

ayurveda etc.

Literary observation of Mukhadushika (Acne)

In Ayurveda mukhadushika is described under the

heading of Ksudrarogas. These diseases are called

ksudra (minor) as they are of lesser severity in

comparison to mahavyadhis or vyadhis

(major or medium

diseases)

The silk cotton tree thorn like eruption on the

face due to vitiation of kapha, vata and rakta which are

found on the face of adolescent are called as

mukhadushika or yauvan pidika.

[14]

In Ayurvedic

samhitas a very short description is available about the

disease Mukhadushika. All the samhitas have pointed

out kapha, vata, and rakta as the causative factor of the

disease. In Sharangadhara Samhita vakrasnigdhata

(oily face) and pidika have been mentioned as due to

shukradhatumala while Bhavaprakasa mentioned due

to svabhav.

[15,16]

The shalmali thorn like thick or hard

painful eruption, impregnated with meda, found on the

face of adolescent are called as mukhadushika.

[17,18]

Description of Manjistha in Ayurvedic texts

As per ‘Charaka Samhita’ the powdered dried roots

and fruits are taken internally for the treatment of skin

diseases and disorders of spleen.

[19]

Manjistha is also

mentioned in ten varnya

[20]

drugs and as Visaghna

[21]

Jvarahara.

[22]

It is also prescribed for treatment of major

burns, fractures and dysentery,

[23]

to improve

complexion and to treat skin diseases and blood born

diseases.

[24,25]

Manjistha paste is used along with honey

in Vyang.

[26]

It has properties of blood purifying agent

and pigment stimulant, tonic and are used in skin and

blood diseases.

[27]

Ayurvedic pharmacopoeia of India

therapeutically indicate it for Yoni roga (menstrual

disorder), Kustha (skin disease), Sarpavisa (snake bite),

Visarpa (herpes virus), Aksi roga (eye disease), Arsa

(haemorrhoids), Bhagna (Fracture).

[28]

Formulations

containing manjistha as main ingredient used for

treating skin disease are showing in table-1.

[29-38]

Manjistha is found to be one of the ingredients in

majority of the formulas available in market like

Manjisthadi kwatha, Mahamanjisthadi kwatha,

Manjisthadyarka, Aravindasava, Aswagandharistha,

Usirasava, Candanasava, Manjisthadi taila,

Kadiradikutika.

[39]

Therapeutic indications of Manjistha

mentioned in Ayurvedic Materia Medica are showing in

table-2.

[40]

Research Revelation of Manjistha

1. Anti-acne property

Methanol extract of Rubia cordifolia inhibit proliferation

of P. acne.

[41]

It is moderately effective against TNF-

alpha and show low activity against IL-8. It is regarded

as astringent and useful in external inflammations like

ulcers and skin diseases.

[42]

The anthraquinone rich

fraction of R.cordifolia in a gel formulation showed The

anti-acne activity against Propionibacterium acne,

Staphylococcus epidermidis, Malassezia furfur when

compared with standard Clindamycin gel.

[43]

2. Anti-inflammatory activity

The aqueous extract of R. cordifolia showed anti-

inflammatory effect in rats.

[44]

The anti-inflammatory

action is because of the presence of rubimallin. The

aqueous extract showed anti-inflammatory activity in

rats with carrageenan paw oedema in a dose

dependent manner, which is comparable to that of

phenylbutazone.

[45]

It also inhibited the lipoxygenase

enzyme pathway, which catalyses the production of

various inflammatory mediators such as leukotrienes

that are involved in asthma, arthritis, and other

inflammatory disorders and the production of cumene

hydroperoxides.

[46]

Notable nitric oxide scavenging

activity was exhibited in vitro by some extracts of R.

cordifolia.

[47]

A formulation of munjistin and purpurin

from cell culture manifested to have and ant-

proliferative action during the rapid development of a

model oedema.

[48]

3. Anti-microbial activity

Extract of R. cordifolia showed a significant inhibitory

activity against P. acnes standardized culture. The

evaluation was carried out by both dilution method as

suggested in MIC, there R. cordifolia extract was taken

600 μg/ml. The evidence of anti-acne activity of R.

cordifolia was further supported by Cup-plate

method.

[49]

Rubia cordifolia was effective against

Klebsiella pneumonia. The root extracts of R. cordifolia

have been studied for their antimicrobial activity

against various pathogenic bacteria. Sitosterol and

daucosterol possess antibacterial activity. The root

extracts constituents such as anthraquinones and

flavonoids suppressed the activity phytopathogens of

Gossypium.

[50]

Aldehyde aceate, dihydromollugin and

rubimallin reported to have significant antibacterial

Jour. of Ayurveda & Holisti

c Medicine

Volume-III, Issue-II

activity against Klebsiella pneumonia.

[51]

Ethanolic

extract inhibited ß-Lactamase producing uro-

pathogenic E. coli.

[52]

The chloroform and the methanol

extracts reported to have antibacterial activity on gram-

positive strains, although gram negative Pseudomonas

aeruginosa was also inhibited by the methanol extracts

in a dose dependent manner. According to Basu et al.,

the aqueous extract is active against Bacillus subtilis

and Staphylococcus aureus compared with

streptomycin and penicillin G.

[53]

The ethanolic whole

plant extract also showed same result.

[54]

Rubiacordone

A reported to have considerable antimicrobial activity

against Gram-positive bacteria like Bacillus subtilis,

Streptococcus faecalis and Bacillus cereus.

[55]

The green

synthesized silver nanoparticles using R. cordifolia plant

root extract was highly inhibiting the bacterial

pathogens like Vibrio alginolyticus, Pseudomonas

aeroginosa, Shigella spp, Plesiomonas shigelloides and

Vibrio parahaemolyticus. They had highest

antimicrobial effect against Pseudomonas aeroginosa

and Plesiomonas shigelloides.

[56]

4. Anti-oxidant activity

Alcoholic extract of root of Rubia cordifolia and its

constituent rubiadin were found antioxidant

property.

[57],[58],[59]

Hydroxyanthraquinones were the

predominant antioxidant phenolic constituents in the

root of R. cordifolia.

[60]

The antioxidant properties of R.

cordifolia extract for protection against lipid

peroxidation and reduced glutathione (GSH) content in

rat liver homogenate compared with vitamin E and

parabenzoquinone (PBQ).

[61]

Table 1: Formulations containing Manjistha as main

ingredient used for treating skin disease.

Sl.

No. Formulation Action References

Laghu

Manjisthaadi

kwatha,

Madhya

Manjisthaadi

kwatha, Brihat

Manjisthaadi

kwatha

Treatmen

t of skin

diseases

Bhav Prakash

samhita

Kustharogadhikara/

99-106

[29]

Maha

Manjisthaadi

kwatha

Treatmen

t of skin

diseases

Vrndamadhava

Vataraktadhikar,23

/86-87

[30]

Manjisthadhy

a tailam

Useful in

pidika

Chakradatta

55/61

[31]

Mukhakranti

mkar lepa

Improves

Glowness

of face

Chakradatta 55/45

[32]

Haridradavy

tailam

Improves

Glowness

of face

Chakradatta 54/53-

[33]

Kanak tailam Cure

wrinkles

Chakradatta 54/56-

[34]

Manjisthadi

tailam

Improves

Glowness

of face

Chakradatta 54/58-

[35]

Kumkumadi

tailam

Glowing

face

Chakradatta 54/61-

[36]

Manjistha

with honey

increases

complexi

Chakradatta

54/42

[37]

4 Raktachandan

adi lepa

Improves

Glowness

of face

Sharangdhar

Uttar khand 11/9

[38]

DISCUSSION:

Acne vulgaris is an extremely common skin disorder

that affects virtually all individuals at least once during

life. The incidence of acne peaks at teenage, but

substantial numbers of men and women between 20-40

years of age are also affected by the disorder. Acne can

have important negative psychosocial consequences for

the affected individual, including diminished self-

esteem, social withdrawal due to embarrassment and

depression.

[62]

The use of natural remedies, particularly

herbal medicine, dates back thousands of years. Over

the last decade, in view of increasing resistance to

existing anti-microbial agents, side effects and

sometimes high cost of treatment, interest in medicinal

herbs has been progressively increases.

[63 ]

The anti-acne

effects of Manjistha (Rubia cordifolia) include four

mechanism i.e. anti-bacterial, anti-inflammatory, anti-

oxidant, and anti-androgen activities. The microbiology

of the pilosebaceous unit involves three coexisting

groups of microorganisms: Gram-positive, coagulase-

negative cocci (staphylococci and micrococci);

anaerobic diphtheroids (Propionibacterium acnes and

Propionibacterium granulosum); and lipophilic yeasts

(Pityrosporum species). The microflora of comedones is

qualitatively identical to that of the normal sebaceous

follicle. The staphylococci and micrococci are aerobes;

therefore, their site of growth within the sebaceous

unit is superficial, and these organisms are unable to

reside in the anaerobic conditions of the infra-

infundibulum where the inflammatory reaction occurs

in acne.

[64]

The chloroform and the methanol extracts

reported to have antibacterial activity on gram-positive

strains, although gram negative was also inhibited by

the methanol extracts in a dose dependent manner.

Reactive oxygen species (ROS) are subsequently

generated from the hypercolonization of P. acnes

[65],[66]

in addition to metabolism in living organisms and from

UV exposure. Although ROS perform a useful function

in the skin barrier against acne microbes

[67],[68]

excess

formation affects skin condition by activating neutrophil

infiltration. ROS including singlet oxygen, superoxide

Jour. of Ayurveda & Holisti

c Medicine

Volume-III, Issue-II

anion, hydroxyl radical, hydrogen peroxide, lipid

peroxide and nitric oxide (NO) play an important role in

inflammatory acne as well as in tissue injury. ROS

stimulate the formation of nuclear factor jB (NF-jB)

[69]

promote TNF formation

[70]

and consequently activate T

lymphocytes and keratinocytes. The cytokines IL, TNF,

IFN, lipopolysaccharide (LPS), transforming growth

factor (TGF) and prostaglandin (PG) are then produced

and released.

[71-75]

In summary, skin inflammation is

initiated by CD4+ in T lymphocytes, regulated by TLRs

following neutrophil infiltration which generates ROS

and protease enzymes leading to follicular wall rupture

of sebaceous glands. This consequently changes the

composition of sebum, particularly linoleic acid.

Hyperkeratinization is initiated as well as a reduction in

desquamation. Subsequently, the proinflammatory

cytokines, NF-jB, IL, TNF, IFN, LPS, TGF, PG and GM-CSF

are released causing microcomedones. The resulting

microcomedones further develop into comedones and

inflammatory lesions.

[76]

Rubia cordifolia contains a wide variety of antioxidants

like alizarin, hydroxyl anthraquinones

[77]

and rubiadin

[78]

which have been using in various medicaments.

Hydroxy groups on one benzene anthraquinones to

show the activity; its ortho-dihydroxy structure could

greatly enhance their effect. The study of in vivo

antioxidant activity and its influence on ethanol-

induced immuno-supression showed that the

concurrent daily administration of madder prevented

the decrease of humoral and cell-mediated immune

response, phagocytosis index, leukocyte count,

glutathione content, catalase and superoxide dismutase

activities etc., which were comparable with that of the

combination of vitamin E and C.

[79]

Rubiadin prevented

lipid peroxidation induced by FeSO4 and butyl

hydroperoxide in a dose dependent manner.

[80,81]

Hexane and ethyl acetate fraction of root showed

maximum free radical scavenging activity due to

anthraquinones and their glycosides present in it. R.

cordifolia extracts can protect peroxidation and

reduced glutathione content in rat liver homogenate

compared with vitamin E and parabenzoquinone.

[82]

CONCLUSION:

In present scenario, there is a trend of prescribing

combination therapy for many diseases including skin

disease. This leads to an increase chances of drug

interaction and adverse effects, means there is need to

evaluate individual herbal therapy. Manjistha (Rubia

cordifolia) has multiple actions to combat this problem

and this will become a new approach in the

management of acne. The role of Manjistha in

supporting skin health is evidenced by traditional and

reported activities, which show that it act as potent

blood purifier, antioxidant, anti-inflammatory, anti-

stress, antimicrobial which can play an important role

to cure acne and improve skin health.

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mentioned in Ayurvedic Materia Medica

[40]

S. No.

Therapeutic effect

Sanskrit Term

Therapeutic effect

in Medical Term

1 Varnya

Improves

complexion

Jvarahara

Anti

pyretic

Vishaghna

Remove toxins

Mutravirecana

Diuretic

Raktasodhana

Blood purifier

6 Rasayana Rejuvenative

7 Vranaropaka Wound healing

9 Sonitasthapana Haemostatic

10 Pittasamsamana

Pacifies pitta

doshas

Asmaribhedana

Lithagogue

12 Krmighna

Antibacterial and

anthelmentic

Sothahara

Anti

inflammatory

Vedanasthapana

Analgesic

15 Caksusya Improves vision

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c Medicine

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