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ACNE

VULGARIS
BY
DR DEEPTI PATIL
INTRODUCTION
One of the inflammatory skin disease.

Acne vulgaris is quite common and affects 85%-


100% of the population at some point in their
lives.

Acne vulgaris or Acne is found to have parity with


the disease Yuvanpidika mentioned in Ayurvedic
texts.

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INCIDENCE
It develops earlier in females than males.

A peak incidence and severity occurs


between 14-17 years in females and 16-19
years in males.

It is not known why acne resolves or why it


is more persistent in females.

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ETYMOLOGY

The word acne is from the Greek word acme


meaning a point, or acne meaning chaff
(seed covering-very itchy when contacted).

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SKIN PHYSIOLOGY
Dynamic organ with multiple function
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Two verities of skin Second level
● Third level
Nails, hairs, sebaceous glands and sweat glands ● Fourth level
● Fifth level
are appendages of the skin

Layers :

Histologically 2 layers

In clinical medicine 3 layers

Microscopically 7 layers- Epidermis(7)+Dermis(2)

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DEFINITION
A chronic inflammatory condition of the
pilosebaceous follicles on the face and upper
trunk.

It is characterized by the development of


comedones (Black heads/white heads),
papules, pustules and cysts which may resolve
to leave pitted scars.

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CAUSES

Heredity

Oily skin or hair

An increased production of male hormones


at puberty

A hormonal imbalance in women

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Conti…

Some medications

Cosmetics that contain chemicals and


vegetable oil

Periods of high stress

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SYMPTOMS
Skin rash or lesion on the face, truck (chest) neck,
back, or other area

Comedones (whiteheads or blackheads)

Pustules

Cysts

Papules

Nodules
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Conti…

Redness (erythema) of the skin lesions or skin


around a lesion

Inflammation around the skin eruptions

Crusting of skin eruptions

Scarring of the skin

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PATHOGENISIS OF ACNE

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ACNE GRADING

MILD ACNE: Less than 10 lesions

MODERATE ACNE: 10-25 lesions

SEVER ACNE: More than 25 lesions

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TYPES OF ACNE
1. Nodulocystic acne

2. Acne excoree

3. Acne medicamentosa

4. Acne cosmetica

5. Acne conglobata

6. Acne neonatrum
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YUVANA-PIDAKA

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ETYMOLOGY
Yuvan And Pidika.

(1) Yuvan : derived from 'Yu dhatu' by using 'Kanin


Pratyaya' with it. The word Yuvan is used in the
sence of adult or young.

(2) Pidika : derived from 'Peed Dhatu' by using "Dvul


+ Tap Pratyaya" with it. "Peed" Dhatu is used in the
sense of pain.The meaning of Pidika is a painful
eruption.

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DEFINITATION
ÉÉsqÉsÉÏ MühOûMüMüÉUÉ CirÉÉÌSlÉÉ rÉÑuÉÉlÉ
ÌmÉÌQûMüÉÈ |

rÉÔlÉÉqÉÉlÉlÉÇ rÉÑuÉÉlÉlÉÇ, iÉxrÉ ÌmÉÌSMüÉ rÉÑuÉÉlÉ


ÌmÉÌQûMüÉÈ||

(xÉÑ.ÌlÉ.13/36) lrÉÉrÉ cÉÎlSìMüÉ OûÏMüÉ

Yuvan Pidika is like “Salmali kantaka”.

The face of a young is called Yuva Anana

and its pidika is Yuvan Pidika


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SYNONYMS

Yuvan Pidika

Mukhadusika

Anana dusika

Tarunya Pidika

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NIDANA OF YUVAN PIDIKA

Svabhava - Bhava Prakasha (Bh.Pr.Utt.


61/31)

Sukra Dhatu Mala - Sarangdhara


(Sa.S.Pr.Kh. 5/13-15)

Vata, Pitta, Kapha and Rakta produce the


disease 'Yuvan Pidika'.
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Conti..
AHARAJA VIHARAJA MANASIKA KALAJA

Katu Vegavidharana Atisoka Vasanta


Guru Jagarana Ksobha Grisma
Madhura Nidra Viparyaya Krodha Mid day
Atisnigdha Upavasa Santapa Sarata Kala
Dugdha Atapa Sevana Svabhava
Drava Chardi vegadharana (Avasthika Kala)
Dadhi
Amla
Usna

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SIGNS

Salmali Kantaka Kara pidika

Saruja

Ghana

Medogarbhi

Yuna Mukhe

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SAMPRAPTI

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NIDANA SEVANA

Dosha Dushya Agnimandyak


Prakopaka Daurbalyakara ar
Vat Pitt Kaph Rakt Me Twa Swed Ama
a a a a da k a
Kha vaigunya in
swedavaha & Raktavaha
srotas (sebaceous
gland)
Kaphadhi
kya
Sanga in swedavaha &
Raktavaha srotas
Shushkata in kapha &
meda
Rakta dusti, sammurchhana
Srotodusti 2222
Pidika with medogarbhita

Pittaja Vataja Kaphaja

BHEDA

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TYPES

VATAJA: Vedana, Rukshata, Krishanata.

PITTAJA: Paka, daha, Srava, Vaivarnya,


Usnata.

KAPHAJA: Kandu, Snighadata, Kathinata.

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TREATMENT
To control the lesion and to prevent the
scarring.

Counseling the patient, as it causes sever


stress in young people.

Prolonged treatment may be necessary.

Acne management includes both tropical and


systemic treatment.

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TROPICAL DRUGS FOR ACNE

Comedolytics: Act by removing follicular


obstruction

Antibiotics: Decrease the bacterial


population; have anti inflammatory effect

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SYSTEMIC DRUGS FOR ACNE
Antibiotics: Decrease the bacterial population;
have anti inflammatory effect

Retinoids & Isotretinoin: removes the follicular


obstruction, sebostatic effect and anti-
inflammatory effect

Antiandrgoens: decrease the sebaceous


activity by decreasing androgens

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Action of Drugs in Acne
Decreasing bacterial population

Decreasing follicular keratinization

Decreasing sebaceous secretion

Controlling inflammation

Decreasing hormone secretion.

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Conti..
Shodana Chikitsa
Vamana
Virechana
Raktamokshana
Nasya
Shamana Chikitsa
Bahya
Abyantara
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Conti…

Bahya Chikitsa:

Lepana

Mukhabyanga followed by swedana

Utsadana

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Conti…
Abyantara Chikitsa:
● Rakta shodaka and rakta Prasadaka kashayas
Rajapravartini vati
Arogyavardini
Varunadi Kashaya
Rasa medo dhatugata chikitsa.
Arthava/Sukra Doshahara Chikitsa.
Vishagna Chikitsa.

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LEPAS

Lodra+Dhanyaka+vacha

Gorochana+Maricha Churna

Sarshapa+Vacha+Lodra+Saindava

Shalmali Kantaka Lepa

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OTHER FORMULATIONS

Kumkumadhya taila (A.Hru.U.32/27-30,


Ch.Da.121-124)

Kanaka taila (ch.da 113-114)

Manjistadya taila(ch.da 110-112)

Dwiharidradi taila

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PRECAUTIONS
Wash the skin as often as needed to control oil, to remove
the dirt and make up

Maintain dandruff free condition of the scalp.

Comb or pull hair back out of the face.

Don't squeeze, scratch, pick, or rub lesions. These activities


can increase skin damage.

Wash hands before and after caring for skin lesions to


reduce the chance of infection.

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Conti…

Don't rest the face on hands. This irritates the skin


of the face.
Identify and avoid anything that aggravates acne.
Though no substance is proven to cause acne in
everyone, triggers may include foods, lotions,
make-up, Etc.
Avoid greasy cosmetics or creams, which can
aggravate acne.

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COMPLICATIONS
Cysts

Skin abscess

Permanent facial scars

Keloids

Changes in skin color

Psychological damage

Side effects of other medications

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DISCUSSION

Though it is a adolescent problem, first


occurs in females

Snigda padarthas are one of the causative


factor, - mukhabyanga followed by sweda
has very good result in Acne.

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CONCLUSION
Being an Kshudra Roga it takes long duration for
complete cure, some times persistent for life time

Sukra Dhatu mala as one of the Nidhana is more


suitable.

Scarring is the main reason for Psychological


upset in patients.

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SUMMARY
Acne occurs due to change in the
pilosebaceous unit secondary to increased
androgen at puberty

Occurs due to follicular obstruction

Presents with comedones, pustules, cysts, and


scars over the face, chest, & trunk.

Treatment includes tropical and systemic.


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REFERENCES
Su.Sam.Ni 13th chapter & Chikitsa 20th chapter.
A.Hru U.32
B.P. Utt 61st chapter Kshudraroga Chikitsa
Sa. Sam.Pr.Kh.5th chp
Ch.Da
Bai.Rat 60th chapter
Dermatological diseases by Venkataram mysore.

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THANK YOUSecond level
● Third level

● Fourth level

● Fifth level

“A man in love mistakes a pimple


for a dimple.”- Japanese proverb
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