E-ISSN:2456-3110

Case Report

Vitiligo

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 4 APRIL
Publisherwww.maharshicharaka.in

Ayurvedic Management of Shwitra (Vitiligo) - A Case Study

Tyagi N1*, Mohan Kumar SS2, Singh NR3, Trivedi AB4
DOI:10.21760/jaims.10.4.52

1* Neha Tyagi, Post Graduate Scholar, Dept of Kayachikitsa, Ch Brahm Prakash Ayurved Charak Sansthan, New Delhi, India.

2 Mohan Kumar SS, Post Graduate Scholar, Dept of Kayachikitsa, Ch Brahm Prakash Ayurved Charak Sansthan, New Delhi, India.

3 Naimish Raj Singh, Professor and HOD, Dept of Kayachikitsa, Ch Brahm Prakash Ayurved Charak Sansthan, New Delhi, India.

4 Atal Bihari Trivedi, Associate Professor, Dept of Kayachikitsa, Ch Brahm Prakash Ayurved Charak Sansthan, New Delhi, India.

Skin is the outer most covering of the body and is the largest organ of integumentary system. In human being, skin pigmentation (affected by melanin) varies among population and skin type can range from dry to non-dry and from oily to non-oily. In Ayurveda Bhrajak Pitta is responsible for Prabha. Any impairment in Bhrajak Pitta and Vata cause skin diseases. All skin diseases come under Kushta and Shwitra is one of them. Like other types of Kushta, Shwitra is caused due to vitiation of Tridoshas and Dhatus like Ras, Rakta, Mamsa and Meda.[1] In Modern system of medicine similar disease is described as Vitiligo. Vitiligo is a chronic auto immune disorder that causes white lesions on skin. This happens when melanocytes are destroyed causing the skin to turn milky white colour.

Keywords: Shwitra, Kustha, Vitiligo, Ayurveda, Skin disorder, Skin Pigmentation

Corresponding Author How to Cite this Article To Browse
Neha Tyagi, Post Graduate Scholar, Dept of Kayachikitsa, Ch Brahm Prakash Ayurved Charak Sansthan, New Delhi, , India.
Email: 		Tyagi N, Mohan Kumar SS, Singh NR, Trivedi AB, Ayurvedic Management of Shwitra (Vitiligo) - A Case Study. J Ayu Int Med Sci. 2025;10(4):339-343.
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https://jaims.in/jaims/article/view/4245/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-03-11 2025-03-27 2025-04-07 2025-04-17 2025-04-27
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© 2025 by Tyagi N, Mohan Kumar SS, Singh NR, Trivedi AB and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2025;10(4)339
Download PDFBack To ArticleIntroductionObjective of studyCase ReportMaterials and MethodsResultsDiscussionConclusionReferences
Neha Tyagi et al. Ayurvedic Management of Shwitra (Vitiligo)

Introduction

In Ayurveda all the skin diseases are categorised under the Kushta. Shwitra is also one of them. The description of Shwitra is available since Vedic literature.

Kushta is included in Astha Maha Gada in Ayurveda.[2] Other names for it include Kilasa, Daruna, Aruna, and Shweta Kushta. Bhrajak Pitta which is situated in the skin is responsible for Chaya and Prabha of Twaka.[3] The Kashyap Samhita states that Shwitra is "Shweta Bhava Michanti Switram," which translates to "white reflection".[4]

According to Sushrut Samhita, Acharya Sushrut called Shwitra as Kilasa ‘Twagtam Eva Aprisravi’ means there is involvement of skin and is Aprisravi i.e., non exudative. Acharya Charak, mentioned various causes of Shwitra that is Viruddha Aahar Sewana, Papkarma etc.[5]

In Modern system of medicine similar disease is described as vitiligo. Vitiligo is an autoimmune disease. Normally, the immune system work throughout our body to fight off and defend our body. But in people with autoimmune disease, the immune cells attack the body’s own healthy tissues. In vitiligo melanocytes are attacked and destroyed causing the skin to turn milky white colour. Treatment of vitiligo in modern system of medicine is topical cream contain corticosteroids, some type of radiations etc.

The psychological damage caused by vitiligo has been shown in numerous research. Vitiligo has a detrimental effect on patients' self-esteem, according to the groundbreaking study by Porter et al. (1979). According to the authors, people with higher self-esteem fared better with the illness than those with lower self-esteem. The detrimental effects of vitiligo on patients' self-esteem and quality of life (QoL) have been repeatedly documented in later international research. Isolation, stigmatization, low self-esteem, melancholy, and self-consciousness are all brought on by vitiligo.[6]

The Ayurvedic approach to autoimmune disease treatment focuses on balancing the Tridoshas and boost immunity. The treatment given like Bakuchi churna, Br Manjisthadi Kwath etc. are well known for the treatment of Shwitra and given in our classical books.

Objective of study

To assess the efficacy of Ayurvedic treatment in Shwitra as mentioned in classical Ayurvedic texts.

Case Report

A 52 year old patient [Female] OPD reg no. 76660 residing in Palam has visited in Kayachikitsa OPD in Chaudhary Brahm Prakash Ayurved Charak Sansthan on 20/09/2022 presented with multiple whitish discoloured patches on face. The lesions were varied in shape, no discharge or itching present over it.

History of present illness

Patient was asymptomatic 2.5 years ago but she gradually got some blackish discolouration on her face which she ignored and gradually white lesion appears on her face she took ayurvedic medication from local pharmacist but didn’t get relief. After few months, she noted that size of lesion was gradually rising & she also observed multiple white patches on her face. With these complaints, she came in Kayachikitsa OPD of CBPACS.

History of past illness

1. History of hypothyroidism (since 35 years): patient is on modern medication (100mcg Thyroxine-1OD)
2. No history of above skin complaints before 2.5 years
3. No history of DM/HTN/ or other systemic disorder.

Family history

According to patient, her mother and maternal grandmother also have Shwitra (Vitiligo)

Personal history

  • Bowel - 1 time/day Normal
  • Bladder - 4-5 times/day, 1time - night
  • Sleep - Normal
  • Diet - Non-Vegetarian
  • Occupation - Teacher
  • Addiction - Nil
  • Appetite - Good intake
  • Allergies - Not any

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Neha Tyagi et al. Ayurvedic Management of Shwitra (Vitiligo)

General Examination

  • Pallor - Absent
  • Icterus - Absent
  • Cyanosis - Absent
  • Clubbing - Absent
  • BP - 130/80mmhg
  • Pulse - 78bpm

Asthavidha Pariksa

  • Nadi - 78 bpm (Pitta Vataj)
  • Mala - Clear 1 time/day (Nirama)
  • Mutra - 4-5 times/day, 1 time/night
  • Jihwa - Clear
  • Sabda - Spasta
  • Sparsha - Samsheetushna
  • Drika - Prakrit
  • Aakriti - Prakritik

Local Examination

  • Site of lesion - Both side on face
  • Distribution - Symmetrical
  • Character of lesion - white coloured grouped and diffused lesion
  • Itching - Absent
  • Inflammation - Absent
  • Discharge - Absent
  • Sensation - Present

Samprapti Ghatak

  • Dosha - Tridosha
  • Dushya - Ras, Rakta, Mamsa , Meda
  • Adhisthana - Twak
  • Srotodushti - Sanga
  • Rogmarga - Bahya

Materials and Methods

Assessment criteria

Subjective criteria: Patient was observed for improvement in hypo-pigmented patches and improvement in general condition.

Grading Assessment[7]

Score0123
Number of patches depending on % of area involvedAbsent1-29%30-69%70-100%
ColourNormal tensity>50% filling with normal tensity<50% of filling with pinkish discolourationWhite patches
ItchingAbsentMildModerateSevere
Hypopigmentation patchesAbsentSolitarySegmentalGeneralised

Objective criteria: Improvement calculated on basis of VASI scoring method.

Chikitsa Vivaran – Shaman Chikitsa was given to patient for 15 months as follows.

SNTreatmentDose and AnupanaDays
1.Bakuchi Churna
Panchnimba Churna
Praval Pishti
Guduchi Satva		30g
30g
10g
10g
Mix all of them and take half tsf TDS with water		15 months
2.Arogyavardhini Vati500 mg with water15 months
3.Br. Manjisthadi Kwatha40ml15 months
4.Tab. Pigmento2BD with water15 months

Results

VASI score formula : ∑All body sites [ Hand units ] * [ Residual Depigmentation ][8]

One hand unit, which encompasses palm plus volar surface of all digits, is approx. 1% of total BSA and used as a guide to estimate baseline % of vitiligo involvement in each body region.

Body is divided into 5 regions : Hands, upper extremities (excluding hands), trunk, lower extremities (excluding feets), feets.

Extent of residual depigmentation

100%Depigmentation, no pigment
90%Specks of pigment are present
75%Depigmented area exceeds pigmented area
50%Depigmented area and pigmented area are equal
25%Pigmented area exceeds the depigmentation area
10%Only specks of depigmentation

VASI score calculation done as below :

Before treatment

VASI : ∑All body sites [Hand units] * [Residual Depigmentation]


J Ayu Int Med Sci 2025;10(4)341
Neha Tyagi et al. Ayurvedic Management of Shwitra (Vitiligo)

= 3*0.75
= 2.25

After treatment

VASI : ∑All body sites [Hand units] * [Residual Depigmentation]

= 2*0.9
= 1.8

CriteriaScore (BT)Score (AT)
Number of patches11
Colour21
Itching00
Hypo - pigmented patch21

jaims_4245_01.JPG
Before Treatment

jaims_4245_02.JPG
After Treatment

Discussion

The progression of vitiligo is rapid, so the management should be taken in proper time to arrest the pathogenesis.

Bakuchi Churna contains constituents like psoralen, isopsorale, bakuchiol, bavchinin, and corylin, all of which possess antioxidant attributes. These constituents not only stimulate melanocytes for the synthesis of melanin but also exert an immune modulatory influence.

It is administered in conjunction with a blend of therapeutic agents, such as blood purifying (Raktashodhak), Kapha-Pitta alleviating (Kapha-Pittahar), and rejuvenating (Rasayana) drugs. This combination includes Praval Pishti, Giloy Satv, Panchnimba Churna.

Panchnimba Churna contains Nimba Panchanga and is used for all types of skin diseases like Kushta, Visarpa, etc.

Br. Manjisthadi Kwath contains herbs exhibiting a range of properties, including Varnya (improving complexion), Kapha Pittashamak (balancing Kapha and Pitta Doshas), Shothahar (reducing oedema), Kushtaghna (treating skin diseases), and Vranropak (wound healing).

Most of these substances possess Tridoshaghna (alleviating all three Doshas) or Kapha Pittahara (mitigating Kapha and Pitta Doshas) characteristics due to their inherent qualities of having Tikta (bitter), Katu (pungent), Kashaya (astringent) taste, Laghu (light), Ruksha (rough) properties, and Ushna Veerya (hot potency), with a Katu Vipaka (pungent post-digestive effect).

Arogyavardhini Vati is having Rakta Dhustihara (blood purifier), Kusthahara (alleviates skin diseases), Srotovishodhana (cleansing channels of body) and Piita Dosha Hara properties and it improves digestion and metabolic activities.

Tab. Pigmento - Bakuchi is the main ingredient. This tablet has multiple actions in vitiligo melanogenic, immune modulator, Anti-inflammatory, and Antioxidant.

Conclusion

The incidence of vitiligo is increasing due to faulty lifestyle, so identifying and eliminating multifactorial agents associated with the disease based on Ayurvedic principles is essential.

Regaining of pigmentation can be achieved in most of patients by following Ayurvedic treatment protocol as mentioned in Shwitra Chikitsa.

Shamana Chikitsa helps to remove the cause of disease by eliminating aggravated Doshas in body, through resulting in overall improvement w.r.t. number of lesions, size of lesions, regaining of normal skin pigmentation.


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Neha Tyagi et al. Ayurvedic Management of Shwitra (Vitiligo)

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