Darunak or commonly known as dandruff, is a disorder that affects the scalp. Dandruff causes white, dry flakes of dead skin cells to shed from the scalp. Although dandruff rarely causes baldness and hair loss, the itchiness of this condition may most certainly be a cause of concern. If white flakes persist for a long time, the person may experience symptoms of seborrhea, psoriasis, or eczema. According to Ayurveda, Darunak is a Vatakapha predominant tridoshaj disease. According to Acharya  Sushrut , Madhav  and Yogratnakar , Darunak have symptoms like Itching, White scales like structures, Dryness in the scalp. Along with aforesaid symptoms of Acharya Vagbhatta also considered Hair loss and Numbness of scalp. The Adhisthan (place of origin) of this disease is the keshbhumi (Scalp). 

Over time, proponents of Ayurveda have conducted various researches on this disease, trying to find out an effective solution when it comes to dandruff related problems. 

Prolonged Treatment for Wet or Oily dandruff: 

The scalp skin produces sebum (Kapha), which is an oily substance. This sebum helps in keeping your scalp and hair hydrated. It is a natural process, without which your hair may turn dry and frizzy. However, when this sebum (kapha) is over produced due to certain reasons, you may suffer from problems of the scalp. Over production of sebum (kapha) causes oily scales to appear on the scalp, which may cause severe itching and may also result in infection. Therefore, wet dandruff requires prolonged treatment, whereas it is easier to treat dry dandruff. 

Impurity in the blood: 

According to Ayurvedic system of medicine, dry dandruff is caused because of  Vata Pradhan Kapha dosha . On the other hand, wet dandruff is caused because of  Kapha Pradhan Vata dosha . As per Acharya Videha Pitta and Kapha are involved in causing darunak i.e. Dandruff. The vitiation of Vata and Pitta in the body leads to vitiation of Raktadhatu(blood) thus giving rise to impurities in the blood. This in turn leads to poor nourishment of the scalp. In such cases, detoxification of blood is also required to get rid of dandruff. 

Ayurvedic View

Ayurveda places the problem of dandruff in the category of Shudra Roga, which appears due to an imbalance of all three doshas (Ayurvedic humor). The primary doshas involved are Kapha and Vata.Kapha is an Ayurvedic humor which symbolizes Softness, Stickiness, provides nourishment & lubrication. Vata is dry and rough in nature. In an aggravated state, both doshas as per their predominance cause the production of specific impurities in scalp, which are dry and sticky in nature. These impurities accumulate in the deep tissues of the scalp and contaminate them. Contamination of the deep tissues and aggravated Vata-Kapha Dosha causes itching and flaky patches on the scalp. Due to these factors, the scalp sheds larger than normal amounts of dead epidermal cells, which leads to the problem of dandruff. 

The Ayurvedic line of treatment is to generally pacify Kapha and Vata through herbal medicines, as well as a tailor-made diet and lifestyle plan. Also, special herbs are administered to cleanse the body of accumulated digestive impurities. 

The Ayurvedic system of treatment for wet or oily dandruff, in particular, is briefly mentioned here: 

According to Ayurveda, dandruff could be caused due to prolonged intake of cold water, Excessive usage of foods that taste salty, Chronic Rhinitis,  Irregular Sleeping Habits, Excessive Exposure to UV of sun, Suppressing Natural Urges, Excessive consumption of alcohol, Excessive sweating , Improper maintenance of Hair and using very less or no hair oil for massaging Head and Scalp.
Ayurveda suggests both topical and internal medicines for the treatment of wet or oily dandruff. The topical medicines are intended to manage dandruff and also provide relief from itching and infection, if any. The internal medicines are intended to detox the blood and also improve immunity, nourish the skin and thereby help in improving the quality of hair.
If dandruff is caused due to psoriasis and eczema, then there are exclusive medicines to combat the infection, detox the body and nourish the skin and hair.
Ayurveda suggests that foods like coconut, Indian gooseberry ( Amla), Raisins etc. help in preventing dandruff.
In addition to these, Ayurveda also suggests various home remedies for effective management of both wet and dry dandruff, like washing your hair with decoction prepared with Neem Leaves or Take powder of Mustard seeds and licorice, make them into paste by adding milk to it and leave it on head for 20min and wash later with water.
Taking Panchkarama detoxification procedures like Nasyam, Raktamokshnam, Shirobasti, Abhyanga Swedanam under the guidance of expert can also play very important role in the management of both the types of dandruff. 
Accumulated hair and dandruff scales can be made returned to the healthy scalp from unclean combs and brushes. This may irritate the scalp and causes flare of dandruff again. Combs and brushes are the tools for the care of your hair; they should be properly made and well cared to accomplish this purpose. Neem wood combs can work wonder but they should also be regularly cleaned and changed every six months. It can be easily deduced that wet dandruff can be effectively managed and treated by undergoing treatment under Ayurvedic system of medicines. 
However, you should avail such treatment under the supervision of an experienced doctor specialised in Ayurvedic medical science.

Dandruff (Oily & Wet) and its Management With Ayurveda 

Cellulitis is a common contagious bacterial skin infection marked by redness and swelling of the skin that feels tender and hot. It usually occurs when bacteria penetrate through a crack or a cut on the skin s surface. Although cellulitis can develop anywhere over the face or the body, it is your lower legs that are affected the most. It damages the tissues beneath the skin, spreading to the bloodstream and the lymph nodes. If left untreated, the infection might get aggravated and turn fatal.  


Prevention:
In case of a recurrence, preventive antibiotics may be recommended by the doctor. Adopting the below mentioned precautionary measures can help: 
1. Gently rinse the wound with soap and water on a daily basis, whenever you go in for a shower.
2. Apply an antibiotic ointment or a cream over the wound to get adequate protection.
3. Use a bandage to dress your wound and change it daily.
4. Watch out for signs of infections such as pain and redness and accordingly go for medical help.
5. People with diabetes often suffer from poor blood circulation. They require extra precautions in order to prevent any skin injury:
Minutely check for signs of injury, failing which you might be even more susceptible to infections. 
Moisturize and lubricate your skin daily to prevent peeling and cracking.
Trim your toenails and fingernails carefully so that they do not injure the ambient skin.
Wear appropriate gloves and footwear to protect your feet and hands.
Treat any infection developing on the skin surface at the right time because they might be contagious.


5 Tips to Prevent Cellulitis

Burning your skin is a very traumatic experience and can leave behind scars that remind one of the traumatic incident. Scarring caused by burns may fade a little with time but are usually permanent. Apart from affecting your appearance severe burns can also affect the functioning of the body. Burns can make a person withdraw socially by making him or her afraid of how people will accept them with their scars as well as make them depressed about their appearance.

Burn repair surgery can be categorised under two headings: Acute and Reconstructive

Acute repair surgery happens immediately after the burn and deals with large burns and deep burns that affect critical areas. The focus here is to aim for saving of life of burn patient with earliest wound healing with various surgical means.
Reconstructive burn surgery addresses the deformities & scars after the initial burn wounds have healed. The goal here is to improve the appearance of the scars and ensure improvement of functioning. 
There are many types of reconstructive surgeries for burns and the type of surgery best suited to a patient is based on the location of the scar, the extent of scarring and the patient s personal goals.

Skin grafts: This involves the removal of healthy skin from one part of the body and transplanting it to the burn site. This split thickness skin graft include only a few outer layers of skin & full thickness graft involve the entire dermis. This is used in cases of deep burns where full thickness of dermis is affected. Also skin grafts are used for defects following release of burn contracture . 
Flaps: These are thick skin tissues with its own blood supply, used to cover exposed vital structures like vessels , tendons, nerves, bones, etc especially in deep electrical burns of extremities. 
Free flap procedure: In this Microvascular Surgery , muscle, bone or skin is transferred from one part of the body to another to reconstruct huge defects after contracture release or for cosmetic improvement of ugly burn scars. 
Tissue expansion: This involves the insertion of a balloon expander under the skin near the burn scars & deformities. As the balloon is filled with saline, the skin stretches and grows. Once the skin has stretched enough, the expander is removed and the skin can then be used to replace the burn scars & deformities.
This procedure has many advantages as the skin colour and texture are a near perfect match thus reducing scarring to a large extent. However, it is a very slow procedure and can take a few months.

Burn Repair Surgery - How Can It Help To Reduce Deformities & Scars?

6 face washing mistakes that are damaging your skin, everyday!

Face-washing may be a simple everyday task that requires no great effort on your part. But when it?s not done right, it causes significant harm to your skin, each day. The mistakes that you may make while washing your face could lead to issues like irritation, dryness and even wrinkles. Read on to find out how you can avoid making these common errors, and save your skin from blemishes, ageing and lustreless look.

1. Using the wrong cleanser

The use of the wrong cleanser can throw your ph levels out of balance. The optimal ph balance of your skin is 5.5ph. This is the ideal level at which the thin protective layer on the surface of the skin (called acid mantle) can function to keep germs, toxins and bacteria at bay. You should therefore be picking your cleanser based on your skin type as it would come with the right ph balance. 

2. Not cleaning your hands before touching the face

Always clean the germs and dirt of your hands first before moving onto your face. Ignoring this crucial first step can cause you to transfer all the bacteria and dirt of your hands on your face, giving rise to common skin problems such as acne, pimples and blackheads.

3. Using a pre-used washcloth

To avoid the filth from clogging your pores, always clean the washcloth that you use with an antiseptic to keep germs and bacteria at bay. Once you're done washing your face, don't rub the cloth all over your face but pat dry it.

4. Washing face using with hot water

When it comes to the water that you splash on your face, you should always use lukewarm or room temperature water. This is because hot water leaves your skin dry as it washes away the skin's essential oils; and cold water can break the capillaries (fine blood vessels) of your skin. In contrast, mildly lukewarm water will keep your skin hydrated and healthy.

5. Not washing the face twice a day

Just as you shouldn't ignore this important skin care habit that keeps your skin clean, you also shouldn't go overboard with it. Excessive face-washing can hamper the natural oil production of your skin, giving rise to dryness and irritation as a result. Your skin requires the natural oil it produces to keep it smooth and supple. Ideally, you should wash your face twice daily - once in the morning for removing the bacteria and dirt that clogged your pores, and again at night before going to bed.

6. Rushing through the routine

Lastly, don't rush through your cleansing routine. Make sure to properly rinse your face of cleanser completely, otherwise the residues would cause your skin to dry up later on, leading to skin irritation.

It is therefore very important to pay attention to all the little details that make up your face-washing routine. By doing it right, you get to achieve the clear and blemish-free skin that you always wanted.

If you would like to consult with me privately, please click on consult.


6 Face Washing Mistakes that are Damaging Your Skin, Everyday!

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 

Dry skin is a condition caused by the lack of moisture in skin. Fine lines and wrinkles are just some of the conditions, which may be caused due to dry skin. Dry skin can also be very uncomfortable. The condition is mostly caused by environmental factors such as exposure to harsh weather conditions or getting soaked in hot water.

People at risk:
1. Age: People who are older than 40 years of age tend to be more at risk of dry skin than people who are younger than 40 years.
2. Climate: As mentioned earlier, weather conditions play a pivotal role in causing dry skin. Therefore, people who live in areas where the climate is either very hot or very cold tend to get dry skin more often than people who live in temperate climates. Low humidity is another factor which causes dry skin.
3. Profession: Some professions, such as nursing or hairstyling requires frequent usage of hot water all through the day, which can also lead to dry skin.
4. Swimming: Swimming is one of the major causes of dry skin. This is especially true in pools, which have chlorine. This is because chlorine increases the itchiness on your skin.

Treatments:
1. Lifestyle changes: Usually, lifestyle changes such as avoiding long, hot showers and putting moisturizers are good enough to make sure that dry skin goes away.
2. Lactic acid: Creams with lactic acid and urea can be prescribed by your doctor, if the dryness of your skin does not go away with moisturizers. These creams are usually over-the-counter medications.
3. Prescription creams: Prescription creams are given, only when conditions such as dermatitis, psoriasis or ichthyosis are present.
4. Wet dressing: Wet dressing is given only when dermatitis has set in, as it mostly help in preventing the infection.
4. Oiling: Oiling your body, especially with fish or flaxseed oil, ensures that your body does not succumb to dry skin.
5. Hand sanitizer: Normal hand sanitizers tend to make your hands dry. Thus, dermatologists recommend hydrating hand sanitizers that allow your hands to maintain their moisture. Therefore, whenever you are using a hand sanitizer, use a hydrating one.

Risks and Treatment of Dry Skin

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