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A CONCEPTUAL STUDY OF VYANGA (MELASMA) IN AYURVEDA W.S.R SAUNDARYA OF SKIN
CLINICAL TYPES
According to the Doshas predominance
disease may be categorized into four sub-
types:
Vatika: Blakish colour and rough in nature.
Paittika: Blue coloured in center and copper
colour in periphery.
Kaphaj: Whitish in colour and itchy nature.
Raktaj: In center copper and on periphery
blood coloured associated with burning and
tingling sensation.
AYURVEDIC MANAGEMENT
Ayurvedic management mainly comprises of the
followings.
1. Nidanparivarjan. 2. Shodhan chikitsa- Shiravedan,
Manjisthadisaeha, Kumkumadi tailam, Kasisadi ghritam,
Sarshap oil, Nasya. 3. Samanchikitsa- For internal use:
Somaraji churna, Avalgujaadi gutika, Khadiroudak. For
external use: Eladi Gana, Arjunatvagaadi lepa,
Manjishthadi lepa, Kanak tailam, Shalmali lepa, Masoor
Lepa. 4. Udvartan- Shirish, Lamajjak, Naagkeshar, Lodhra.
TREATMENT OF VYANGA AS ILLUSTRATED BY VARIOUS
ACHARYAS ON THEIR CLASSICS
REFERENCES
Astang Hridyam edited by Dr. Bramanand Triphathi, Chaukhamba Sanskrit Pratishthan, Dehli, reprint 2014,
Uttarasthana, Chapter-31.
Charak Samhita edited by Pandit kashinath shastri, Dr. goraknath chaturvedi, chaukhambha Sanskrit
sansthan, Varanasi, reprint 2012, Sutrasthan.
Achar A, Rathi SK. Melasma: A clinico-epidemiological study of 312 cases. Indian J Dermatol
2011;56:380e2
Sushrut Samhita edited by Kaviraj Ambikadutta shastri, Chaukambha Sanskrit sansthan, Varanasi, part-1,
reprint 2014, Uttartantra chapter 1.
Chakradatta edited by Dr. Indradev, Chapter 55.
Bhaisajya Ratnavali edited by Prof. Siddinandan mishra, First edition 2005, chapter 60.
MATERIALS AND METHODS
The materials is based on review of Ayurvedic texts and
research papers. Materials related to Vyanga and melasma
have been collected from Ayurvedic brihatriyi, laghutriyi.
Samprapti:
As Acharyas says, prakupitvata due to anger and hard work
along with pitta dosha in combined form suddenly came to
facial region and produce blakish colour's thin patches on
face.
Causative factors:
Mainly anger and excessive hard work.
Samprapti Ghatak:
Dosha: Vata-Pitta. Dushya: Ras, Rakta.
Adhisthan: Mukhagat Tavak. Vyadimarga: Bhahya.
Srotodustiprakar: Sang.
ABSTRACT
Vyanga is one of the kshudraroga, characterized by the presence of painless, bluish-black patches on face. It is one of the must common diseases as regards the face is concerned. On the basis of clinical features, it can
be compared with Facial melanosis, one of the hyperpigmented disorders. Facial melanosis or Melasma is a common skin problem. The condition causes dark, discoloured patches on skin. It's also called chloasma, or the
"Mask of Pregnancy", when it occurs on pregnant women.Melasma causes patches of discoloration. The patches are darker than the usual skin colour. It typically occurs in the face and symmetrical, with matching marks on
both sides of the face. Other area of the body that are often exposed to sun can also develop melasma. According to ayurveda it occurs due to excessive anger and hard work. So, as the results vitiated dosha mainly pitta
along with vata produce blackish patches in the face which is called Vyanga. Vyanga is rakta pradoshaj vikarand in its doshas involved is udan vyau, Bhajrak pitta and Dushya rasa and rakta dhatu, as this condition disturbed
our mental and physical state. A good physical appearance and natural colour shows us beauty called as Saundarya in ayurvedic literature. In modern medical science, topical steroids have been described in the management
of facial melanosis. However, the topical steroids are not completely free from adverse effects such as irritation, rashes. Apart from this, generally the topical steroids are expansive and sometimes poor patients cann't afford
this treatment. Hence, there is a need to search better methods of management in facial melanosis considering the above drawbacks. Ayurveda mentions a good number of medicine for skin care. Massage with oils,
application of paste of medicines etc., makes the face smooth, soft and glowing. In addition to this, bloodletting is also described. Drugs having Kusthaghna, Kandughna, Raktashodhaka, Twakprasadaka and Varnyakara
properties eg. Arjuna, Nimba, Manjistha are helpful in management and can produce cutaneous depigmentation that remove the blakish discoloration of skin.
Key words: Melasma,, Vyanga, Kshudraroga.
MODERN CONCEPTS OF MELASMA
Melasma is a most common acquired pigmantery disorders
that manifests as symmetric hyperpigmented macules and
patches that mainly affects the face. It is brownish coloured
appearance. This form of facial pigmentation is sometimes
called chloasma, but its mean green coloured skin, so for
this condition term melasma is preffered.
Epidemiology:
The prevalence of malasma is varies between 1.5% and
33.3% depending on the population. Melasma is more
common in women than in men. Its prevelance in women is
around 50%-70% in pregnancy stage and 8%-29% of women
on o.c.pills. In men prevelance between 20.5%-25.38% of
the cases. In men malar pattern is more common than the
centrofacial and mandibular patterns.
Etiology:
There are many factors implicated in etiology. These are
Genetics backgrounds, UV radiations, Pregnancy, OCP's,
Cosmetics and Drugs such as phenytoin.
Classifications of Melasma:
Epidermal- appears light brown in colour.
Dermal- Bluish gray in colour.
Mixed- Dark brown in colour.
Clinical features:
Sanche et al classified melasma into three groups-
Centrofacial: 63% cheek, forehead, upper lip, nose and chin.
Malar: 21% malar area on face.
Mandibular: 16% ramus of mandible.
Pathogenesis:
Darkening of the skin due to the over-production of melanin
by overactive pigment cells called melanocytes. however,
various factors can provoke melanocytes to go into
overdrive, and these different root causes are what
distinguish the different types of brown spots. epidermal
melanin deposition causes a brownish appearance, and
dermal melanin appears bluish. Combined epidermal and
dermal melanin deposition appears gray
INTRODUCTION
Melasma is a common, acquired and symmetrical
hypermelanosis characterized by more or less
dark brownish maculae, with irregular contour,
but clear limits, on photoexposed areas,
especially the face , forehead, temples, and more
rarely on the nose, eyelids, chin and upper lips.
Even minor changes in the cellular environment
affect melanosomes and pigmentation.
Numerous intrinsic and extrinsic factors are
responsible for a whole range of responses in
melanosome structure and distribution under
different type of stress.
Ayurveda has mentioned the melasma as Vyang
in Kshudraroga by all Acharyas. The etiological
factors, pathogenesis of Vyanga are explained in
Ayurveda. In Vyanga vata and Pitta dosha is
mainly involved. They along with each other due
to causative factors suddenly produce Vyanga on
face region.
Prepared By:
Dr. Kiran Paudel, P.G. Scholar
Dept. of Dravyaguna Vigyana.
National Institute of Ayurveda,
Jaipur.
Guided By:
Prof. Dr. A. Rama Murthy
Dept. of Dravyaguna Vigyana
National Institute of Ayurveda,
Jaipur
S.N. Classics Procedure
recommended
Chapters
1
.
Sushruta
Samhita
Siravedha
, Pralepa
Chikitsha Sthan, Kshudraroga
chikitsha (20/33
-36)
2.
Astanga Hridya
Siravedha
, Lepa
Uttar Sthan Kshudraroga
Pratishedha(32/15
-32)
3.
Astang Sangraha
Pana
, Abhyanga, Navan,
Pralepa
, Vaman,
Virechana
Uttar Sthan, Kshudraroga
Pratishedha (37/23
-33)
4.
Bhav Prakash
Siravedha, Pralepa,
Abhyanga
Chikitsha
Prakarana
Madhyam
Khanda
Kshudraroga Adhikar
(61/39)
5.
Yoga Ratnakara
Siravedha, Pralepa,
Abhyanga
Uttar
Sthan Kshudraroga
Chikitsha
(1-12), 14
6.
Chakradatta
Siravedha
, Pralepa,
Abhyanga
Kshudraroga
Chikitsha
prakarana
55/40,43,44,48,49
7.
Bhasajya
Ratnawali
Siravedha
, Pralepa, Lepa
,
Abhyanga
Kshudraroga
Chiktisha
adhyaya
60/37, (40-43), (90-
92)