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Jour. of Ayurveda & Holisti
c Medicine
Volume-III, Issue-II
11
MANJISTHA (RUBIA CORDIFOLIA) - A HELPING HERB IN CURE OF ACNE
Vandana Meena
1
Anand K Chaudhary
2
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
1
Junior Resident,
2
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
12
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
13
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
1
Laghu
Manjisthaadi
kwatha,
Madhya
Manjisthaadi
kwatha, Brihat
Manjisthaadi
kwatha
Treatmen
t of skin
diseases
Bhav Prakash
samhita
Kustharogadhikara/
99-106
[29]
2
Maha
Manjisthaadi
kwatha
Treatmen
t of skin
diseases
Vrndamadhava
Vataraktadhikar,23
/86-87
[30]
3
Manjisthadhy
a tailam
Useful in
pidika
Chakradatta
55/61
-
62
[31]
Mukhakranti
mkar lepa
Improves
Glowness
of face
Chakradatta 55/45
[32]
Haridradavy
tailam
Improves
Glowness
of face
Chakradatta 54/53-
55
[33]
Kanak tailam Cure
wrinkles
Chakradatta 54/56-
57
[34]
Manjisthadi
tailam
Improves
Glowness
of face
Chakradatta 54/58-
60
[35]
Kumkumadi
tailam
Glowing
face
Chakradatta 54/61-
66
[36]
Manjistha
with honey
increases
complexi
on
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
14
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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[40]
S. No.
Therapeutic effect
in
Sanskrit Term
Therapeutic effect
in Medical Term
1 Varnya
Improves
complexion
2
Jvarahara
Anti
-
pyretic
3
Vishaghna
Remove toxins
4
Mutravirecana
Diuretic
5
Raktasodhana
Blood purifier
6 Rasayana Rejuvenative
7 Vranaropaka Wound healing
9 Sonitasthapana Haemostatic
10 Pittasamsamana
Pacifies pitta
doshas
11
Asmaribhedana
Lithagogue
12 Krmighna
Antibacterial and
anthelmentic
13
Sothahara
Anti
-
inflammatory
14
Vedanasthapana
Analgesic
15 Caksusya Improves vision
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Volume-III, Issue-II
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Cite this article as: Vandana Meena, Anand K Chaudhary.
Manjistha (Rubia Cordifolia) - A helping herb in cure of Acne,
J of Ayurveda and Hol Med (JAHM).2015;3(2):11-17.
Source of support: Nil, Conflict of interest: None Declared.