E-ISSN:2456-3110

Case Report

Vitiligo

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 5 MAY
Publisherwww.maharshicharaka.in

Management of Shwitra (Vitiligo) through the Holistic Approach of Ayurveda

Trigunayat A1*, Bhende P2
DOI:10.21760/jaims.10.5.33

1* Aabha Trigunayat, Post Graduate Scholar, Department of Rognidan Evum Vikriti Vigyan, Government Ayurved College, Nagpur, Maharashtra, India.

2 Pranali Bhende, Associate Professor, Department of Rognidan Evum Vikriti Vigyan, Government Ayurved College, Nagpur, Maharashtra, India.

Vitiligo is a chronic skin disorder characterized by the progressive loss of melanocytes, leading to the formation of depigmented patches on the skin. Ayurveda describes in detail the etiology, symptoms and management of Vitiligo under the disease named Shwitra. While conventional treatments often focus on symptom management, Ayurveda, offers a holistic approach to restoring skin pigmentation and addressing the root causes of the disorder. The disease results from increased oxidative stress brought on by chronic inflammation, which in turn causes greater melanocyte destruction. By examining both classical Ayurvedic texts and contemporary clinical studies, this research highlights the potential benefits of personalized Ayurvedic treatments in promoting skin pigmentation, improving immune function, and managing oxidative stress. This is a case study of 17yr old male patient who came to the OPD with the complaints of white patches on face (below both eyes), lips, neck, extensor aspect of right forearm and left-hand palm region since 2 years. The patient was given Shaman Chikitsa, Nidan Parivarjan, dietary modifications and lifestyle adjustments. Patient started regaining normal pigmentation of skin and is still under follow up for further treatment and for Apunarbhav Chikitsa.

Keywords: Vitiligo, Shwitra, Oxidative stress, Nidan Parivarjan, Apunarbhav Chikitsa

Corresponding Author How to Cite this Article To Browse
Aabha Trigunayat, Post Graduate Scholar, Department of Rognidan Evum Vikriti Vigyan, Government Ayurved College, Nagpur, Maharashtra, India.
Email: 		Trigunayat A, Bhende P, Management of Shwitra (Vitiligo) through the Holistic Approach of Ayurveda. J Ayu Int Med Sci. 2025;10(5):221-225.
Available From
https://jaims.in/jaims/article/view/4269/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-04-10 2025-04-26 2025-05-07 2025-05-17 2025-05-27
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 12.34

© 2025 by Trigunayat A, Bhende P 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(5)221
Download PDFBack To ArticleIntroductionCase ReportMaterials and MethodsObservations and ResultsDiscussionConclusionReferences
Aabha T et al. Management of Shwitra (Vitiligo)

Introduction

Vitiligo is a chronic skin condition characterized by the loss of pigment in certain areas of the skin, leading to the development of depigmented patches. This occurs when melanocytes, are destroyed or stop functioning due to a combination of genetic, autoimmune, and environmental factors. Vitiligo can affect people of all ages and skin types, and its appearance can vary widely. It can be co-related with Shwitra disease in Ayurveda due to the identical signs and symptoms which are; non-exudative white, red or coppery-red colored patches, roughness, dryness, itching, burning sensation of the patches, loss and discoloration of the hair. While vitiligo itself is not harmful and doesn't typically affect overall health, it can have significant psychological and emotional impacts due to changes in appearance. Ayurveda states that Shwitra originates from by being untruthful, ungrateful, disrespecting God and Guru, sinful acts, misdeeds of past life and intake of Viruddha Ahar. Other causes may be Chhardi Vega Dharana, Atisewan of Amla-Katu-Ushna-Lavan Madhur Aharsewan, Atimatra Bhojan along with Navanna Sevan and Dadhi Sevan. In Charak Samhita while explaining the Nidana of Shwitra, Acharya Charak has explained Viruddha Aharvihar (unbeneficial food) and Paap Karma (bad deeds) as the main cause of Shwitra.[1]

Above etiological factors produce the imbalance of Doshas (body humours) like Vata, Pitta Kapha specially Bhrajak Pitta which helps in the formation of and maintain the color of skin. These Doshas are vitiated along with Rasa, Rakta, Mamsa and Meda Dhatus.[2] By considering the above-mentioned factors it can be noted that Vitiligo results due to faulty eating habits, faulty lifestyle and unawareness of same according to Ayurveda. Hence not only medicinal treatment but holistic approach is the need of hour to treat Vitiligo.

Case Report

A 17 year old male patient came to OPD of Rognidan & Vikruti Vigyan on 5th July 2024, with the complaints of white patches on face (below both eyes), lips, neck, extensor aspect of right forearm and on left hand palm region since 2years but is increasing now for 4 months. No itching, burning, roughness or discolouration of hair was present.

History of present illness

Patient has history of small white patch on chest region, which appeared once during childhood and even disappeared after a few months. Two years ago, a small white patch appeared on neck and face region which started spreading slowly but has now been spreading rapidly since last four months. Hence patient’s parents got concerned and then he was brought to hospital to seek Ayurvedic treatment. His appetite, bowel evacuation and urine are normal. He joined gym 6months ago and since then the intake of incompatible foods has increased and was also taking pre workout meals (having boiled black chick peas in morning and working out in gym after half an hour).

Past Medical History

  • No/H/O - Bronchial Asthma/Pulmonary Tuberculosis/COPD/Emphysema/Covid-19.
  • No/H/O - HIV1/HIV2/Hepatitis B.
  • No/H/O - other major illness.
  • No surgical history found.

Personal History

  • Ahara
  1. Virudhha Ahar (incompatible foods like milkshakes, eating tomato chutney and having milk immediately after that, powder of black chick peas with milk (as a source of protein)]
  2. Adhyashan (habit of overeating while trying to gain weight, over feeding of food and milk by parents since childhood)
  3. Katu, Amla and Lavan Rasa dominant Ahar
  • Vihar - Diwaswap - 1-2 hrs, Ratrijagaran - Yes, Vyayam after having food
  • Manasik Hetu - No
  • Addiction history - No
  • Occupation -

Ashtavidha Parikshan

  • Nadi (pulse) - 82/min.
  • Mala (stool) - Malavastambha (1time/alternate day)
  • Mutra (urine) - Ishat Peet (Pale yellow)
  • Jeehva (tounge) - Saam (Coated)
  • Shabda (speech) - Prakrut (Normal).

J Ayu Int Med Sci 2025;10(5)222
Aabha T et al. Management of Shwitra (Vitiligo)

  • Sparsh - Anushna Shit
  • Druka (eyes) - Prakrut
  • Akruti - Madhyam (Medium) BMI – 21.2kg/m2

Local Examination

SiteNo. of PatchesDimensionsColour
FaceBelow Right Eye3cmx5cmx4cmMilky White
Below Left Eye2cmx3cmx3cmMilky White
Lower Lip2cmx2cmMilky White
NeckAnterior aspect5cmx3cm, two other small patchesMilky White
Right handElbow (extensor aspect)Multiple small irregular patchesMilky White
Left handPalm3cmx1cmMilky White

Systemic Examination

  • Blood Pressure - 120/70 mm/Hg.
  • Pulse - 82/min
  • SPO2 - 98% O2
  • S1S2 - Normal

  • Respiratory rate - 19/ min
  • Temperature - 98.2°F

Samprapti Ghatak

  • Dosha - Pachak Pitta, Saman Vayu, Apan Vayu, Kledak Kapha.
  • Dushya - Rasa Dhatu, Rakta Dhatu
  • Strotas - Annavaha Strotas, Raktavaha Strotas
  • Strotodushti - Sang
  • Agni - Agnimandya
  • Adhishthana - Twak
  • Sadhyata - Krichhasadhya

Materials and Methods

Table No. 1 shows the Therapeutic intervention given to the patient.

Treatment was continued upto 3 months.

Table 1: Therapeutic Intervention

DateAushadhiMatraAnupaanKaal
05/07/2024Bakuchi Churna3gm Twice a dayKoshnodak (Lukewarm water)Vyanodane (After meal)
Aarogyawardhini Vati2tab (250mg each) Twice a dayKoshnodak (Lukewarm water)Vyanodane (After meal)
Kumariasav3 tsp (15ml) Twice a day3 tsp Koshnodak (Lukewarm water)Vyanodane (After meal)
Avipattikar Churna3 gm twice a dayKoshnodak (Lukewarm water)Apane (Before meal)
Bakuchi Churna & Chitrak ChurnaBoth in equal quantityMixed with GomutraLocal Application

Observations and Results

No. of PatchesDimensionsColour
BTATBTAT
Below Right Eye3cmx5cmx4cm1cmx2cmx3cmMilky WhiteReddish colour
Below Left Eye2cmx3cmx3cm1cmx1cmx3cmMilky WhiteSkin colour
Lower Lip2cmx2cm1cmx1cmMilky WhitePale White with reddish spots in between
Anterior aspect of neck10cmx5cm, two other small patches10cmx5cm, two other small patchesMilky WhitePale White with red spots in between
ElbowMultiple small irregular patchesMultiple small irregular patchesMilky WhitePale White
Palm (left hand)3cmx1cm2cmx1cmMilky WhitePale White with red spots in between

Discussion

Ayurveda says that the first step for the treatment of Nidan Parivarjan (Avoiding the causative factors). As mentioned earlier patient was taking Katu Rasa (spicy) and Lavan Rasa (salty) dominant Ahar, Viruddha Ahar (incompatible food combination) and Adhyashan (overeating). All these causes lead to Rakta Dushti (vitiation of blood) and vitiation of Tridosha. Bhrajak Pitta which resides in the skin and is responsible for Chaya and Prabha of Twacha (skin) is main Dosha to be vitiated.

The treatment was designed in accordance with Koshtha Shuddhi (clearing out gut toxins), which would improve Dhatu’s nutrition and clear blockages in the Strotas (channels) to allow Vyan Vayu and Bhrajak Pitta to flow properly. Thus, improving the skin colour and pigmentation.

Mode of action of the drugs used are given as follows

Bakuchi Churna - It contains psoralen, isopsorale, bakuchiol, bavchinin, bavachin and corylin which have antioxidant properties,


J Ayu Int Med Sci 2025;10(5)223
Aabha T et al. Management of Shwitra (Vitiligo)

help in stimulating melanocytes for Melanin synthesis, Immuno-modulatory effect and inhibitory against antigen induced granulation[3,4] They also increase the rate of synthesis and amount of melanin and hence encouraging skin to recover from a vitiliginous state.[5]

Arogyavardhini Vati - It Raktadhushtihara (blood purifier), Kushtahara (alleviates skin disease), Sroto Vishodhana (cleansing channels of body) and Pitta Doshahara (alleviates Pitta) properties. And it improves digestion and metabolic activities[6] It performs Bhedan activity, is hepatoprotective and hence used for Kostha Shodan (clearing out gut toxins).

Kumariasava - It facilitates the flow of Achha Pitta from Liver to intestine thereby maintaining healthy digestion and keeps Pachak Pitta in check. Also, liver plays an important role in regulation of melanin production so using hepatoprotective drugs like Kumariasava maintains the normal functioning of Liver.

Avipattikar Churna - As the patient had Malavibandh, Avipattikar was choice of drug because it contains Trivrutta and Triphala both of which help in relieving Vibandha[7,8] with subsidiary effect on Pitta.[9]

Lepa of Bakuchi Churna and Chitrak Churna- The treatment protocol as per the classics for any Kushtha is Shodhan, Shaman followed by Lepa on the lesions[10] Bakuchi promotes local blood circulation, which nourishes the cells there and aids in the proper development of Bhrajak Pitta in the skin. Chitrak being Ushna (hot in potency) with Katu Rasa and Katu Vipaka helps in Pachan (digestion) of the Rasagat Samta at the level of skin through local application. Patient was advised to apply this Lepa and sit under morning sunlight. The UV rays from sunlight reacts with the Lepa contents and helps in promoting the growth of melanocyte, its migration and stimulates proliferation.[11]

Conclusion

This case study has shown encouraging results for the treatment of vitiligo just by using Shaman Chikitsa and within a short span of time. This was accomplished because Nidan Parivarjan (Ceasing the intake of the causative factors) was the primary emphasis.

The study's findings and observations support the notion that, when correctly implemented, Ayurvedic principles produce positive, rapid benefits.

jaims_4269_01.JPG
Figure 1: Before Treatment

jaims_4269_02.JPG
Figure 2: After Treatment

jaims_4269_03.JPG
Figure 3: Before Treatment


J Ayu Int Med Sci 2025;10(5)224
Aabha T et al. Management of Shwitra (Vitiligo)

jaims_4269_04.JPG
Figure 4: After Treatment

References

1. Shukla R, Tripathi R. Agnivesha Charaka Samhita (Hindi translation). Chikitsa Sthana. 7/174. Delhi: Choukhamba Sanskrit Pratishthan; 2009 [Crossref][PubMed][Google Scholar]

2. Shukla R, Tripathi R. Agnivesha Charaka Samhita (Hindi translation). Chikitsa Sthana. 7/3. Delhi: Choukhamba Sanskrit Pratishthan; 2009 [Crossref][PubMed][Google Scholar]

3. Vagbhata. Astanga Samgraha. Chikitsa Sthana. 19/97. Translated by Srikantha Murthy KR. Varanasi: Chaukhambha Orientalia; 2001 [Crossref][PubMed][Google Scholar]

4. Xu J. Effects of Fructus psoraleae on tyrosinase activation. Chin Herb Med. 1991;22(4):169. [Crossref][PubMed][Google Scholar]

5. Wu CS, et al. Effect of psoralen plus ultraviolet A irradiation on cultured epidermal cells in vitro and patients with vitiligo in vivo. Br J Dermatol. 2007 Jan;156(1):122–9. [Crossref][PubMed][Google Scholar]

6. Patil S, Ashwini SG. Ayurvedic management of Shwitra (vitiligo): a case study. J Ayurveda Integr Med Sci. 2022;5:139–45. [Crossref][PubMed][Google Scholar]

7. Bhavamishra S. Bhavaprakasha Nighantu. Commentary by Chunekar KC, edited by Pandey GS. Revised & enlarged ed. Varanasi: Choukamba Bharati Academy; 2010. p. 39–40 [Crossref][PubMed][Google Scholar]

8. Bhavamishra S. Bhavaprakasha Nighantu. Commentary by Chunekar KC, edited by Pandey GS. Revised & enlarged ed. Varanasi: Choukamba Bharati Academy; 2010. p. 166 [Crossref][PubMed][Google Scholar]

9. Gadad GG, et al. Clinical evaluation of Vitiligo and its treatment in Ayurveda. Int J Pharmacogn Phytochem Res. 2021;22(2):301–11. [Crossref][PubMed][Google Scholar]

10. Gavali KA, Gavali PK, Londhe DJ. Ayurvedic management of Shwitra (vitiligo): a case report. J Res Ayurvedic Sci. 2019;3(4):152–6. [Crossref][PubMed][Google Scholar]

11. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancer, and cardiovascular disease. Am J Clin Nutr. [cited YYYY MMM DD]; Available from: https://ajcn. nutrition.org/content/8016/16785 [Crossref][PubMed][Google Scholar]

Disclaimer / Publisher's Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of Journals and/or the editor(s). Journals and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.


J Ayu Int Med Sci 2025;10(5)225