Psoriasis is a chronic dermatosis characterised by an unpredictable course of remissionn & relapse. It is an non-infectious skin disaease chracterised by scaly, silvery patches mainly on the scalp and extensior surface of the body. Its exact cause is unkown. In ayurveda, it is closely resembles with ekakushta. The features of ekakushta explains in ayurveda classics resembles with the symptoms of psoriasis. Psoriasis is the challenge for modern science. There is no definite treatment for psoriasis in modern science till today. The drug available in the market use to treat psoriasis are not very effective and have local and systemic effects.

In ayurveda, vata pitta and kapha dosha is the main contributory factor for the disease. Due to vitiation of three dosha, the disease manifest and main line of treatment for psoriasis is panchkarma and internal medicine. It is considering the best approach for skin disorder in ayurveda. A case report of 42-year old male, presented with well demarcated red scaly, silvery patches mainly on both legs, hands, scalp, chest and back with itching, and also nail and joint involvement has been presented in this article.

Etiology of Psoriasis: 

Unknown but many factors have been associated-

Genetic: may be autosomal dominant

Triggers: physical trauma ,infection and drugs.

Biochemical change: like increase level of arachidonic acid and Cgmp.

Immunological factors: helper T cells PLAY A KEY ROLE.

Epidemiology: 

Roughly, 1% of population is affected. Can occur at any age and affected both sex. Most patients as worse in winters.around 7 million people are affected in developed country.

Histopathogenesis:

Increased epidermal cell proliferation.

Retention of nuclei in stratum corneum.

Proliferation of fibroblast.

Dilated and tortous capillary loops.

Shortened epidermal turnover time from normal of 60 to 10 days.

Clinical features: Usually chronic indolent lesions which persist for month. Lesions are mildly papule or plaque.erthematous plaque lesions with characteristic slivery, large, loose scales. The patients of psoriasis may also suffer from depression and low self-esteem.

In a patients with psoriasis always check for nail and joint involvement.

Nail: 10 to 15% of the patients have nail involvement. Pitting, nail plate thickening, subungual debris, discolouration of nail plate and oil spot seen in the nails.

Joints: 10% patients have joint involvement.

Sites: Scalp, pressor points & extensor. Sometimes generalised.

Chronic recurrent psoriasis is difficult to treat. Modern science treat with PUVA and corticosteroids but these drugs having local and systemic side effects like liver and kidney failure etc. So, it is the time to find out the effective and safe treatment for Psoriasis. Medicines which are used in ayurveda are safe and practised since many years. A huge numbers of drugs are prescribed in ayurveda for the treatment of kushta.

Case details: A 42-year old male patient, hindu brahman by religion, presented on 10 april 2016 with well demarcated raised red scaly, silvery patches on chest, back and both legs and hands. He complained of itching all over the body and on scraping, white powder like substances fall down and leaves a bleedy surface. On history, patients had complaints since 20 years and diagnosis of psoriasis by allopathic physician. Since 20 years he has been taking allopathy and homoepathy patients from various practioners of U.P and delhi. He is brahman and lives in well known temple of delhi and visit homes of peoples for religious ceremony. He is afraid that if the disease is spreading continously, then he is unable to work as priest because people neglect him due to disease. The disease is spreading all over his body and also involves nail and joint. Destruction of nail plates of hand and legs was also developed. For this, patients took allopathic treatment for such a long time but do not get relief.

The patients visit our clinic for the first time. He told use that his problem not solves since 20 years and spreading continuously. So, he is unable to trust us. So, we first give him counselling because reassurance and emotional support are invaluable. Physical and mental rest enhance the effects of the treatment. It is also important to tell him that the disease is not contagious and is benign.

SYMPTOMS OF THE PATIENTS :

Itching all over body

Silvery patches, especially, on legs ,chest ,back but now spreading in his hand and scalp.

Destruction on nail plates

Swelling and pain in left middle fingers and flexor deformity in proximal interphalangeal joint

Swelling in right middle metatarso phangeal joint and pain

Some blood test of the patients were done like CBC, LFT, KFT, SR, URIC ACID to assess outcome.

His general health was good and both physical and all blood test were within the normal limts.we advise patients for panchkarma and oral medication but patients refuse for panchkarma so we start his oral or internal medication. 

Investigation Done :

CBC(Complete Blood Count)

LFT(Liver Function Test)

KFT(Kidney function Test)

Sr. Uric Acid

Investigation was done to rule out any other pathology. Investigation were within normal limit.

Internal Medication :

Medication are given into two phase. In First Phase, we are given panchsakara churna - one spoon two times daily for anulomana and pachan, Panchnimba churna- one spoon two times daily with luke water, panchtikta ghrita gugulu - two tab two times daily, and one oil for local application containing jyotishmati,bakuchi, and chakramad for five days. We told patient to apply the oil firstly only on legs for 5 days. Patient taking the same for 5 days and come on 5th day, we see the fabulous result, the rashes which are developed within 4 to 5 months just disappear and other rashes are also subsiding.

After 5 days, in second phase, we continue the same treatment and also added haridra khand - one spoon two times daily, gugulu tiktam kashaya - three spoon two times daily (one hour before food for 15 days). The patient came back on 20th day, with great result, the rashes were almost 60 % subsiding and pain and swelling in finger and ankle also reduce to great extent. Now, patient is not taking any pain killer for pain. Patient also get improvement in nails of legs.

We prescribe the same medicine for one month that time and ask him to do some physiotherapy additional for finger deformity. After that patient came with 70 to 75 % relief in symptoms and patients also tell that during the treatment, he will not develop any additional rashes.

During the treatment, we also told the patients to follow some dietary changes and live according to the rules of Ayurveda.

Result: Psoriasis is a disease with unkown etiology and triggered by many factors. In modern science, treatment of psoriasis is a challenge. They do not have any safe and proper medicine for psoriasis. But, ayurveda treatment gives satisfactory results as well as the quality life to the patients. Ayurveda removes toxin out of the body and corrects the formation of aama. Ayurveda gives the prevention as well as the treatment. So, by following the dietary and lifestyle change we prevent the reoccurrence of the disease.

Ayurveda For Psoriasis 

All ayurvedic treatments have their roots in hundreds of years of research and thus are extensive. The philosophy followed by these treatments is that every human being in governed by three doshas of forces - vata (air), pitta (fire) and kapha (earth). Depending on the force that is in highest proportion in an individual, all his psychological and physical attributes are determined. Hair loss is attributed to the pitta dosha which is concentrates on metabolism and digestion. The various methods to treat premature loss of hair, according to ayurvedic principles are:


	Balancing the pitta dosha:&nbsp;pitta dosha can be managed by eating less salty, fried and spicy food, consuming limited amount of alcohol, coffee and meat and reducing smoking habits. Certain herbs can curb excess pitta like shatavari or asparagus and bitter vegetables.
	Ayurvedic oil and shampoo: an effective remedy is oil made by boiling a cup of neem (margosa) leaves in 4 cups of water. The mixture is then strained and stored. If applied at night and rinsed off in the morning, hair loss can be prevented and your hair gets healthier. An ayurvedic shampoo can be made at home by preparing a mixture of methi (fenugreek), green bean (mung dal), soapberries, lemon juice and curry leaves which need to grinded well together before applying on the scalp.
	Ayurvedic diet plan:&nbsp;ayurveda believes that a well-balanced diet is the preventive measure to most ailments, including hair loss. Consuming vegetables with high protein and iron content like cauliflower, kale, pumpkin leaves, spinach, salsify, lentils, beet greens, string beans, dandelion greens, raisins, soybeans etc. Proves to be helpful in this regard. This diet can also help to combat systemic diseases like alopecia which may causes loss of hair and sizeable bald spots.
	Ayurvedic medicines:&nbsp;four ayurvedic medicines are used extensively for the purpose of combatting hair loss. These are thikthakam kashayam, thikthakam grisham (regulates metabolism), chyavana prasam and narasimha rasayanam, which improves the strength and quality of hair).
	Combating other problems that cause hair loss:&nbsp;using herbs like brahmi (to manage stress), shilajita and jatamansi (for thyroid imbalance), cardamom (for chronic problems) and ashwagandha (for immune system disorders) can indirectly help when hair loss is a symptom or side effect of another disease.



Combating Hair Loss And Ayurveda

Any surgery that requires an incision will involve sutures or staples as the last step of the procedure. This helps close the incision and keep out infections. Taking care of your stitches can help limit scarring and discomfort and speed up the healing process. Here are a few things to keep in mind.

Keep it clean and dry: For the first few days, use a washed wet cloth to clean the incision site. After a few days, you may start washing the area with soap and water unless advised else wise by your doctor. Ensure that you dry the skin thoroughly after washing it. Avoid baths that involve soaking the area in water. Also, avoid swimming. Do not use any powders, lotions, creams, deodorants etc on the wound site.
Look out for signs of infections: Avoid activities that may involve exposing your wound to dirty water, chemicals, dust etc. This increases your risk of infections. Also look out for signs f infections such as redness, swelling, pus or bleeding, fever or increased pain from the wound. In case you notice such signs, consult your doctor at the earliest.
Do not scratch: As it heals, your skin is likely to turn itchy. However, refrain from scratching so as to reduce chances of infections. Do not try and pull away from the scab but let it fall off on its own. This will also help limit scarring.
Limit contact: Avoid wearing tight clothes or anything that sticks to the skin while your wound is healing. Instead have plenty of loose, comfortable clothes easily accessible. Also, do not take part in close contact sports such as football etc until the stitches have healed completely.
Change your dressing regularly: A dressing should be changed as soon as it gets wet or soaked with blood or other body fluids. Wear clean medical gloves while changing a dressing. When putting on a new dressing do not touch the inside of the dressing or apply any creams on the stitches unless advised so by your doctor. In the case of removable stitches, the doctor will usually remove the stitches after a few days. DO not attempt to pull the stitches out on your own.
Avoid exposing the wound to sunlight: New skin that forms as the incision heals is very sensitive to sunlight and gets sunburnt very easily. Limiting your exposure to sunlight can help reduce the effects of scarring.

Stitches Post Surgery - How You Should Take Care?

The skin is the largest external organ as well as the largest organ in general in the human body. There are many types of skin diseases that can afflict your body and they may appear anywhere. Ayurveda is a potent weapon which can be used to treat many skin diseases effectively. The natural remedies of Ayurveda are being increasingly adopted throughout the world. Let's take a look at a few of the skin diseases that can be easily cured by Ayurveda.

Eczema - one of the most common types of skin diseases, eczema is characterized by the reactions that the skin has. These reactions can manifest themselves in many forms. The most common reaction is swelling of the skin with redness. Other forms may also develop blisters, cracking of the skin, scaling or papules.

Scaly rashes - scientifically known as papulosquamous eruptions, scaly rashes are usually the result of itching which in itself is a reaction to some internal or external factors. These rashes can be mild to severely painful depending on what had caused them. Some factors behind these may be eczema, reaction to drugs, psoriasis and others.

Urticaria - these rashes differ from other ones as they persist for a short period of time and usually result in swellings on the skin. These swellings may be very sensitive and itchy. Some common examples of urticaria are nettle rashes and hives that may develop due to an external factor such as bug bites.

Psoriasis - Ayurveda has great treatments for this disease as its incidence within the population is quite high. This is a non-infectious skin condition where inflammation occurs in the affected parts of the skin and reddish scales form on the body. This problem is usually attributed to excessive cells within the body.

Pruritus or itching - another very common skin affliction which can be caused by a variety of factors, it can be a reaction to something external or be caused by internal issues that may be developing. Mostly caused by the reaction of external nerve endings they may become very painful if over stimulated.

Ayurveda has many remedies for all of the ailments mentioned above along with many other skin disorders and has gained popularity as it completely natural and devoid of side effects encountered with conventional medicine.

Common Skin Diseases That Ayurveda Can Easily Cure

While most people recover from first and second degree burns without fatal consequences, third-degree burns pose a different story altogether.

Third-degree burns occur when the damage to the skin extends beyond the dermis, and perforates deep within the tissues. This sort of injury is the most serious one. For instance, injuries sustained from a fire breakout, acid attack, etc.

Symptoms include-

Charred/black skin
Numbness
The damage to the nerves caused by third-degree burns are so extensive, that the victim may feel very little or no pain.

Complications-
There are several complications associated with third-degree burn injuries, such as the following-

Infection
Sepsis
Scarring
Low volume of blood
Very low body temperature
Joint/bone problems
How Ayurveda heals third-degree burn injuries-
Burn injuries, especially of third-degree, leaves behind ugly, unpleasant scars. Moreover, such distressing marks can be traumatic for the victim as it may bring back horrific memories of the incident. Many times the person may feel hesitant to visit a doctor or go for a therapy. This is when Ayurveda comes to your aid.

Ayurveda uses therapeutic and natural remedies- essential oils, herbs and spices- to relieve pain, and helps you get rid of those burn scars. Some of the natural ingredients used in Ayurvedic treatment include-

Use of herbal oils Lavender and Calendula helps in quick relief from burn injuries.
An ointment prepared from red sandalwood, gairika, tugaksiri, and plaksa extracts can be applied on injuries caused due to third degree burn.
Applying cucumber juice or Jatyadi oil on the affected area with cotton balls offers relief from the pain.
Prepare a paste using mustard oil and henna leaves, and apply the same on burn injuries. This will provide instant relief from irritation.
Prepare an herbal pack using, turmeric, amla, etc. that are rich in anti-inflammatory, antibacterial properties. This can heal burn scars and ease pain.
Apart from these, Ayurveda also suggests following a bland (without spices), healthy diet so that the injury does not aggravate the injury further.

Third-Degree Burn Injuries - An Ayurvedic Approach!

6 Causes of hair loss you didn t know about and how you can combat this problem

In order to have healthy volume of hair on your head, the rate of hair loss and replacement should be in tandem. With age, your hair growth cycle shows signs of slowing down and factors like age, disease, and hormonal changes among others affect the pace at which an individual hair follicle moves through the 3 phases of the hair cycle. A disruption in your hair cycle can give rise to loss of hair that s rapid and unexpected. Hair loss or alopecia can affect both men and women. 
So what can cause your hair to fall at an alarming rate?

The reasons behind hair loss could be many, but here are 6 major ones: 
1. Lack of protein in your diet
When you exclude protein from your diet, your body starts to conserve the protein that it has by altering the growth cycle of your hair. In such cases, your hair enters into the resting stage, resulting in zero hair growth. 
In India, 9 out of 10 people are said to suffer from low amounts of protein in their diet, with 91% vegetarians reporting protein deficiency.

2. Iron deficiency 
Iron plays a very important role in the transportation of oxygen to the different organs of the body. Lack of iron in your diet (which is the principle reason behind anaemia) can give rise to several health problems including hair loss. Your body attempts to direct oxygen to important organs so as to support their functioning. As a result, your scalp witnesses a low supply of oxygen, which causes hair loss. 


3. Vitamin D-3 deficiency
Deficiency of vitamin D-3 gives rise to a type of hair loss called Telogen Effluvium (TE). This is a temporary hair thinning phenomenon that takes place when the all the hair on your scalp enter the resting phase at the same time, subsequently causing you to shed a large amount of hair later on. 

4. Smoking 
Smoking can also affect the health of your hair, especially the rate at which it falls and the number of strands lost in a day. A research carried out by the Harvard School of Public Health has revealed that smoking can cause a rise in a hormone called dihydrotestosterone (DHT).
An increase in DHT level prevents new hair cells from growing and causes hair follicles to reduce in size with each hair cycle. As a result, the area on your scalp that gets affected by DHT experiences a lack of hair growth.  

5. Use of testosterone supplements in gym
Intake of testosterone in the form of supplements and injections to build muscle mass can trigger hair loss in men. This takes place when the testosterone in these supplements gets changed into DHT, thereby affecting your hair loss rate and amount. 

6. Past illnesses (dengue, TB and typhoid)
Falling of hair can also be brought on by illnesses such as typhoid, TB and dengue as the hair growth cycle comes to a stop. Hormonal or metabolic stress that is experienced during the course of such diseases may cause hairfall. 

What are the treatments available to cure hair loss?

1. Hair transplant
Hair transplant is a minimally invasive surgical technique that transfers hair follicles taken from other parts of your body to the balding area. Known by the name of Follicular Unit Transplantation, this hair loss treatment can help to bring back the natural appearance of a fuller head of hair. Hair follicles are harvested using two procedures- follicular unit extraction and strip harvesting. Procedure can vary from 4-8 hours or more depending on the case. 

2. Platelet- Rich Plasma (PRP)
Platelet- Rich Plasma (PRP) is another treatment alternative that can reverse hair loss. It s a simple non-surgical procedure that lasts about 60-90 minutes. In this form of hair treatment, the patient s own blood cells, more specifically blood platelets are injected into the scalp. Usually 8 sittings are required with each sitting being 2 weeks apart for better results.

3. Low Level Laser (Light) Therapy (LLLT)
This form of hair therapy utilises light energy of a specific wavelength and threshold to stimulate cellular activity, thereby promoting hair growth. Various controlled clinical tests have revealed its effectiveness in encouraging hair growth in both the genders.  




 6 Shocking Causes of Hair Loss + How To Combat this Problem

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