Ayurvedic management of mukhadushika (acne vulgaris) through vamana karma and shamana chikitsa: A case study

Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit, most common in adolescents and young adults, and is characterised by comedones, papules, pustules, nodules and post-inflammatory scarring. In Ayurveda it is correlated with Mukhadushika (Yuvanpidika), a Kshudra Roga described by Acharya Sushruta, in which Shalmali-kantaka-sadrusha Pidaka (thorn-like eruptions) appear on the face due to vitiation of Kapha, Vata and Rakta. Modern management with topical and oral agents provides relief but is often limited by recurrence, side effects and scarring. The present case study describes a 23-year-old female student with a 9–10-month history of painful, itchy, pus-forming facial pimples, associated with faulty dietary and lifestyle habits and Jatharagni mandya. She was managed on Ayurvedic principles: Deepana–Pachana and Rakta-prasadana Shamana Chikitsa (Arogyavardhini Vati, Mahamanjishtadi Ghan Vati, Avipattikar Churna and Mukha Lepa), followed by Abhyantara Snehapana with Panchatikta Ghrita, Sarvanga Abhyanga–Swedana with Tila Taila, and Vamana Karma with Yashtimadhu Kwatha, Madanaphala Phanta and milk, with Samsarjana Krama. Shamana therapy with Ananta–Manjishtha Phanta and Avipattikar Churna was continued for 30 days. Comparison of clinical photographs before and after treatment showed a reduction in inflammatory lesions and redness. The case suggests that a sequential approach of Shamana, Shodhana and Pashchat Shamana may be an effective and safe option in Mukhadushika.