Ayurveda and Lichen Planus
By Dr. Sajimon George BAMS. AAA. ATMS
Lichen planus is a common, chronic recurrent skin or mucosal rash with gradual or sudden onset. It is very rare in young and very old. In some, condition may limit itself within months or years. Prevalence rate is less than one. Real cause is not discovered. Since this is considered as an immunologically mediated disease complete cure is difficult. Only rare cases of lichen planus become severe. But continuity and worsening of symptoms or change in appearance of lesions of skin and mouth deserve attention and medical intervention. Many lichenoid skin lesions resemble lichen planus and biopsy confirmation may be required for the accurate diagnosis. This helps to make differential diagnosis of persistent vaginal or oral lichen planus from precancerous whitish plaques called leukoplakia.
Exact cause is unknown. But it may be present with many conditions of immunological compromise such as vitiligo, primary biliary cirrhosis, exposure to certain chemicals and alopecia areata.
- Lichen planus can manifest symptoms on skin, mucous lining, genitalia, nails and scalp.
While affecting mucosal lining, it may produce symptoms on mouth such as bluish white spots on the sides of the tongue, gums and inside of the cheek.
When skin is affected, lesions will be itchy and single or clustered. In appearance it will be shiny or scaly with sharp border.
Ayurveda and Lichen Planus (Ayurvedic approach)
This condition is considered as a variety of Kushta(skin disease) resulted from dooshi visha or accumulated toxins. Regular exposure to unwholesome food, activities, chemicals and other toxins gradually affect proper functioning of digestive fire or Agni. Result of impaired digestion is the production of Ama or partly digested food. This achieves toxic nature and accumulates in the body. Toxic Ama is absorbed and transported through subtle channels of body or Srothas. Due to the less potency this toxins doesn’t result in immediate death of the person. After getting accumulated in some part of the body it manifest in to symptoms when favorable factors are available. Toxins get covering by Kapha and thus it can resist from body mechanisms of digestion or excretion. In the case of lichen planus , Ama get deposited in the skin or mucous membrane .Gradually this affect Vatha, Pitha and Kapha components of skin and gradually manifest in to symptoms. Even though all the three Doshas involve in the pathogenesis, Pitha and Kapha dominate in Lichen planus. Due to the treatments or other factors, this disease may subside for some time. Practice of unwholesome food, activities etc will again trigger pathogenesis and finally resulting in the new episode of the disease.
Success of a holistic treatment greatly depends on the total cooperation of the patient. Ayurveda being a holistic treatment modality it deserve same cooperation for good results.
Treatment mainly aims purification of the body, achieving healthy digestive fire, cure of symptoms remaining and rejuvenation of body.
- To detoxify the system by Sodhana or Panchakarma procedures.
After assessing signs and symptoms, health and digestive power of the patient either Vamana (medicated vomiting) or Virechana (medicated purgation) or both may be given. Selection of formulation for both the procedures is made only after careful evaluation. Ayurveda suggest oral administration of medicated ghee or oil only in certain skin diseases before purification procedures .Sweating also is not required in most of the cases.
- To correct functioning of Agni and thus to prevent further generation of Ama .
Progress of the disease and the purification procedures weakens Agni or digestive fire. Gradual use of light to digest food along with medicines will be required to regain normal power of Agni.
- To pacify the symptoms (Samana oushadhas or medicines of alleviation)
Gargling (Kabala) or washing (dhara) with suitable herbal decoction is useful in appropriate conditions.
Internal administration of herbal decoctions, pills, arishtas (preparations with self-generated alcohol), and medicines for external application are also used here.
- Rasayana or Rejuvenating medicines
After all treatment procedures, body tissues or dhatus require rejuvenation. Rejuvenating medicines specifically useful to skin is used here. These medicines provide strong immunity power to prevent further vitiation of Dosha and dhatus and maintain health.
Dos and Don’ts
Diet should contain turmeric, tulsi, ginger, cumin, curry leaves and cardamom.
Always avoid heavy to digest food which can impair Agni or digestive fire. Avoid regular use of sweet, oily, heavy milk products such as curd and cheese. Avoid fast foods and refined sugars. Avoid fermented and sour foods.
Sleep:Good sleep is necessary for normal functioning of digestive fire and immunity.
Mental health:Practicing yoga and meditation can help to reduce stress. Stress also influences immunity.
Hygiene and clothing
In warm and humid climate keep skin dry. Wear cotton clothing and cotton bed clothes.
Following herbs may be used in different conditions of Lichen planus.
In Vatha predominant conditions (Prominent Dry skin lesions)
Herbs of Dasamoola, Tuvaraka(Hydnocarpus laurifolia),Pata (Cyclea peltata),Bala(Sida rhombifolia),Aswagandha(Withania somnifera)
In Pitha predominant conditions (Where inflammatory changes and burning sensation is prevalent)
Brahmi (Bacopa monnieri), Mandookaparni (Centella asiatica) , Manjishta (Rubia cordifolia) , Liqorice (Glycirhiza glabra)
In Kapha predominant conditions (Where itching and white patches are present)
Vacha(Acorus calamus),Triphala (Emblica officinalis, Terminalia chebula,Terminalia bellerica), Mustha(Cyperus rotundus),),Bitter gourd(Momordia charentia),Patola (Tricosanthes dioica)) ,Arka(Calotropis gigantia), Guloochi (Tinospora cordifolia) , Neem (Azadirachta indica) and Aragwatha(Cassia fistula),Turmeric (Curcuma longa), Katuki(Picrorhiza currora).
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