Eczema

Eczema (Ec-out,Zeo=Oozing) literally means boiling out or breakout of the skin. It is a non contagious acute or chronic inflammatory condition with erythema (redness), scaling , oedema (swelling),  vesiculation and discharge alone or in combination.

A specific type of allergic cutaneous manifestation of antigen antibody reaction in the body. In fact allergies are nothing but hypersensitivity reactions of the body to a foreign protein in the body (Antigen or vijatiya dravya i.e ‘Ama’ in Ayurveda) which have not undergone proper digestion after entering into the body. Thus resulting in forming ‘Ama’.

               It is seen in practice that most of the Eczematous skin disorders are chronic with frequent relapses due to accumulation of toxins (so called ‘Ama’ in Ayurveda) in the body. In modern medicine there is no complete cure of Eczema and steroids used for treatment, have severe side effects in long course. On other hand Ayurvedic medicines and panchakarma therapy eliminates the root cause of the disease without side effects.

Causes of Eczema:

      1) External causes or Exciting cause:

             Factors from outside the body. Irritation, allergic contacts, reactions on exposure to certain micro organisms, chemicals plants, clothing’s, cosmetics, medicaments, drugs, diet, infections etc.

      2) Constitutional or Predisposing causes:

             Factors  within the body or Eczema caused by genetic and psychological factors.

  The general predisposing causes for Eczema are:

• Age: Eczema in infancy, at puberty and at the time of menopause in a woman.
• Familial Predisposing: Familial sensitiveness is an important factor .There is usually a personal or family history of allergy viz; Asthama, Eczema, hayfever etc.
• Genetic predisposing : It is responsible for occurrence of Eczemas in certain families and their absence in others
• General physical debility: It predisposes to eczema by lowering the resistance of the individual against diseases.
• Climatic extremes : Factors like heat, dampness and sever cold and  psychological stresses.
• Local factors: Like xeroderma ( dry skin), Greasy skin, excessive perspiration, etc.

Sign – Symptoms of Eczema :

Acute Eczema :

• Intense itching on the affected part of the skin.
• Eruptions on the skin ( papules, pustules, macules etc)
• Blackish discolouration of the affected skin
• Swelling and redness.
• Discharge.
• Cracking and scaling on the affected site.

         — These features are basically present in wet type of Eczema.    

Chronic Eczema :

• Above features may be present but there is no discharge.
• Thickening of the skin ( dry leathery thickening due to rubbing & scratching)
• Fissures and scratch marks.
• Hyperpigmentation.
• Roughness and dryness on the affected site.

     — These features are found basically in dry type of Eczema.

According to Ayurveda

In the Ayurvedic texts it is mentioned as Vicharchika under eleven types of kshudra kushthas (skin diseases).

In Ayurvedic texts following causes of Eczema ( Vicharchika  in Ayurveda) are mentioned:

• Viruddhahara i.e. intake of incompatible diet.
• Vegadharana i.e. suppression of natural urges.
• Physical exercise after meal and exposure to heat after meal.
• Food during indigestion or when previous meal is not digested.
• Improper advocation of panchakarma.
• Excessive use of cereals, curd, fish, salt &sour substances.
• Performing sexual act during indigestion.
• Disobedience to honorable and elderly persons.
• Sinful acts etc.

Recurrence of Eczema:  

Because of use of unwholesome food materials (fast food, spicy, salty and sour substances & food materials having preservatives & insecticides etc. ), incompatible food materials taken together ( like milk with salty& or sour substances etc.), pachakagni (digestive fire) becomes weaker due to vitiation of the vata, pitta and kapha doshas resulting in production and collection of ‘Ama’( toxins or antigens) in the body against which antibodies are formed. Due to the interactions of ama in the body , allergic cutaneous manifestation in the form of Eczema occur. Once the skin has been irritated and sensitized, it becomes sensitive to further insults. Scratching, chemical trauma, climatic variations and psychogenic stress keep the process going with the result  that dermatitis or Eczema becomes chronic.

Ayurvedic management of eczema:

            Ayurveda stresses on the elimination of the root cause of the disease and  there are two principles of therapy:

Purificatory measures:

            It is advised in Ayurvedic texts that the patients of skin diseases and leprosy should be treated with drug after proper purificatory measure. It is called panchakarma therapy (i.e. five fold therapy) which includes

1. Vaman ( to expel out the doshas (toxins) through mouth)

2. Virechana (to expel out the doshas (toxins) through anal passage)

3. Vasti – Enema with medicated decoctions, oils etc. 

4. Nasyam – Inhaling medicated oil, juice of fresh herbs etc.

5. Raktamokshana      ( blood letting).

Any of the above panchakarma or combination of few will be done depending on dosha associated, intensity of roga, strength of rogi (diseased ), location of roga. It take more time to do combined cleansing. In patients of Eczema we have applied Vaman & Virechana Karma and got excellent results. If the intensity of ama is more or vitiated dosha has spread deeper tissues, the preparatory therapy like Sneha panam (drinking medicated fat), and swedanam ( inducing sweat) should be done until body is ready to eliminate them. Repeated elimination help to reduce the morbid doshas and reduces the intensity of symptoms.

Some other ayurveda therapies

1. Kashaya dhaara

The herb that reduces the pitta and ama are selected and boiled in water. This medicated kashayam will be poured aver the effected part in luke warm. This helps to clean the lesions, provide anti oxidants, to promote healing.

Amla, Haritaki, nimba, sigru, kottam, manjishta etc are most commonly used herbs

2. Lepam

The herb that help in healing the lesion, reduces the symptoms like oozing, irritations, pain, itching etc are grinded into paste. This is applied on the effected area for certain period. Vrana ropana dravya, chandanaadi lepa, aguru etc are commonly used

3. Bandage

If the lesion is too big, bandage with herbs that help in wound healing is done. And the wound is cleaned daily. Jatyadi, murivenna are commonly used.

Pacificatory measures – Drug therapy:

             There are various herbal preparations mentioned in Ayurveduic texts. By taking correct herbal medicines the remaining doshas can be subsided.

Kashayam – like – Mahatiktakam, Tiktakam, Aragwadadi, Guggulu Tiktakam etc

Khanda lehyam – Haridra khanda: It is specially indicated in sheeta pitta and some other skin disorders associated with allergies.

Ghee – Panchatikta Ghrita &  Panchatikta Ghrita Guggulu

         These two preparation are indicated in eczematous disorders,psoriasis and in urticaria.It is found that above preparation have good antibactirial property.

Vati – Kaisora guggulu, Kutaja Ghanavati, etc It is indicated in all type of skin disorders including Eczema.

For Local Application:

Triphalaadi choornam, Gandhaka Ghrita, Mahatiktakam ghee etc

Special care for eczema

• Avoid scratching.  The affected areas may have sever itching.  But if you try not to scratch it will help to prevent aggravation and flaring.
• Keep the skin well moisturized with regular applications of any mild unscented oils like Olive oil, Neem (Margosa) oil, coconut oil,  or ghee (clarified butter).
• Use warm water for shower.
• It would be a good idea to avoid contact with harsh solvents, soaps, detergents and synthetic products.  
• Try using natural products as much as possible on your skin.
• Try to control Stress and anxiety.  Do yoga, pranayama and meditation to stay calm and at peace.  
• Avoid exposure to dry climates or cover up when you’re outside – that way you can avoid contact with dust and pollen too.
• Clothing – light, soft and breathable cottons are the best. Make sure they’re clean and try to avoid tight, thick clothes where your skin can’t breathe.  If you sweat a lot change your clothing frequently.
• It would be a good idea to avoid spicy and deep fried food.  
• Also avoid curd/yoghurt and certain pulses like Urad Dal for example.