E-ISSN:2456-3110

Case Report

Reversing Vitiligo

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 5 MAY
Publisherwww.maharshicharaka.in

Reversing Vitiligo through Ayurveda: A Clinical Case Study

Nande EV1*, Valhekar N2, Joglekar P3, Jadhav V4
DOI:10.21760/jaims.10.5.45

1* Eshwar V Nande, Post Graduate Scholar, Dept of Agadtantra, Tilak Ayurved Mahavidyalaya, Pune, Maharashtra, India.

2 Neelam Valhekar, Associate Professor, Dept of Agadtantra, Tilak Ayurved Mahavidyalaya, Pune, Maharashtra, India.

3 Priyadarshan Joglekar, Professor and HOD, Dept of Agadtantra, Tilak Ayurved Mahavidyalaya, Pune, Maharashtra, India.

4 Vishvnath Jadhav, Vaidya, Shri Vishvbodh Ayurved Chikitsalay, Solapur, Maharashtra, India.

All skin conditions are categorized under the Kushta Roga category in Ayurveda. Which include Shwitra. White, discoloured spots on the body are the classic sign of Shwitra, a disorder brought on by the participation of the Sapta Dravyas, which include Vata, Pitta, Kapha, Rasa, Rakta, Mamsa, and Meda. Tamra, the fourth tier of Twacha, is primarily regarded as Shwitra's ideal position. It can co-relate to vitiligo. A hypopigmentation dermatological condition, vitiligo affects 1% of people globally since modern science has limitations and adverse effects, several safe and efficient medications are anticipated from Ayurveda, hence an effort was made to treat 46-year-old female patient suffering from Shwitra since past 3 years, through Ayurvedic approach. She was given Shaman chikitsa and Panchakarma like Vaman and Virechan were performed. The treatment was given for 6 months and significant improvement was seen in patient’s condition. The VETI Score reduced from 54 to 24. Hence Ayurvedic medicines offers an effective approach to manage Shwitra.

Keywords: Ayurveda, Shwitra, Vitiligo, Panchakarma, Virechana, hypopigmentation, leukoderma, Case Report

Corresponding Author How to Cite this Article To Browse
Eshwar V Nande, Post Graduate Scholar, Dept of Agadtantra, Tilak Ayurved Mahavidyalaya, Pune, Maharashtra, India.
Email: 		Nande EV, Valhekar N, Joglekar P, Jadhav V, Reversing Vitiligo through Ayurveda: A Clinical Case Study. J Ayu Int Med Sci. 2025;10(5):288-293.
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https://jaims.in/jaims/article/view/4302/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-04-07 2025-04-26 2025-05-06 2025-05-16 2025-05-26
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 12.54

© 2025 by Nande EV, Valhekar N, Joglekar P, Jadhav V 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].

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Download PDFBack To ArticleIntroductionObjective of the StudyCase ReportResultDiscussionConclusionReferences
Eshwar VN et al. Reversing Vitiligo through Ayurveda

Introduction

Between 0.5 and 25% of people worldwide suffers with vitiligo, sometimes referred to as leucoderma, which is the most prevalent depigmenting skin disorder in both adults and children. It is distinguished by a selective loss of melanocytes in the skin’s affected regions, which dilutes the pigment. The usual lesions are non-scaly white patches and have clear edges. This condition is called Shwitra in Ayurveda. In addition to abnormalities in metabolism, oxidative stress, and cell detachment, it is classified as an autoimmune illness with both environmental and genetic origins. In Ayurveda, the vitiation of Tridoshasas and Dhatus like Rasa, Rakta, Mamsa, and Meda causes Shwitra, a type of Kustharoga. Various Acharyas have described Shwitra in their Samhitas Acharya Charak has described the types, symptoms, treatment and Nidan of Shwitra in Chikitsa Sthan.[1] Acharya Sushrut has mentioned Shwitra as a different form of Kustha.[2] He has also classified it’s types based on Dosha predominance.[3] Acharya Vaghbhat has given brief difference between Kustha and Shwitra, according to Acharya Vagbhat Shwitra is more severe than Kustha as it soon arrives in a condition akin to a house on fire.[4]

Objective of the Study

To assess the therapeutic effectiveness of an Ayurvedic treatment regimen in managing Shwitra.

Case Report

A 46 yr. old female came with complaints of white discoloration over her neck, upper back, lower back and hand region associated with itching. She was diagnosed with Shwitra and Ayurvedic management was done.

Past History: She presented above symptoms from past 3 years; however, her symptoms had aggravated from past 1 year. She had no history of any systemic disease.

Family History: All were in good generalised condition, there was nothing significant in their medical history. Shwitra was not found in her family history.

Personal History: She was farmer, had both veg & non-veg diet, belong to Hindu family. She had loss of appetite with normal bowel & normal micturition.

She had history of dist. sleep due to family stress. She was not allergic to any food or medicines.

History of Previous Treatment: Patient had taken allopathic medicines prior to this but discontinued the treatment due to no significant result.

Dietary Habits: She was consuming 1-2 times food in 24 hrs.

  • Commonly consumed food – Non-Veg 3-4 times / week [fish, chicken]
  • Agni status - Vishama Agni

Asthavidha Pariksha

  • Nadi [Pulse] - 86/min
  • Mala [Stool] - 1-2 time/day
  • Mutra [urine] - 4-5 times a day
  • Jivha [tongue] - Alpa Saam
  • Shabda [Speech] - Spastha
  • Sparsh [touch] - Anushnsheet
  • Drik [eyes] - Prakrut
  • Akriti [Appearance] - Madhyam

Rupa (Signs)

  • Whitish discolored patches over the Neck region, Upper back, and Lower back.
  • Hand associated with mild Itching, with no burning sensation since past 3 year.
  • All these symptoms said to have aggravated from last yr.

O/E Of Skin

  • Site of lesion - Neck region Upper and lower back and hand
  • Lesion - Epidermal
  • Distribution - Symmetrical
  • Character of lesion - Macules
  • Colour - White
  • Arrangement - Non-Segmental
  • Itching - Mild present
  • Discharge - Absent
  • Superficial sensation on lesion
  • Pain - Absent
  • Swelling - Absent
  • Paresthesia - Absent

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Eshwar VN et al. Reversing Vitiligo through Ayurveda

  • Aggravating factors - Rainy season

Hetu (Causes)

Modern science says that it is an Autoimmune disorder but according to Ayurveda there are various reason of Vitiligo, some possible reason found in this Patient was eating stale food for breakfast from past 10-15 years, having tea and Indian bread [ roti] 3-4 times a week, Non veg 3-4 times /week and family stress. The diet that she was consuming from many years was Kleda Vardhak and Virudhha Aahar, which slowly turned into Dushivisha. Dushi Visha is a component of Sthavara, Jangama, or Kritrima Visha that cannot be eliminated from body; rather, it becomes less potent after digestion or counteraction of antidotes (Prativisha), remains in body for a long time, and gradually vitiates it. [5] According to Chakrapani, Dushivisha is “Kalantara Prakopi Visham Dushi Visham,” which indicates symptom appears later.[6] Dushi Visha is poison that vitiates Dhatus during day due to elements like Desh, Kal, Aahar, and Nidra.[7] Because of its low potency and long half-life due to its Kapha-covering properties, it is not lethal.[8] All Dhatus are gradually affected by Dushivisha, a low-potency toxin that progresses slowly. It causes toxicity in Raktavah Srotas when it enters Rakta Dhatu, it results in various forms of Kustha (Twak Vikara), Kitibh, Kandu, Arunshika, and Kotha.[9] Hence diet of patient was one of major reasons of Shwitra.

Samprapti (Aetiology)

Samprapti of Shwitra can be explained from given below flowchart.

jaims_4302_01.JPG

Ayurveda treatment protocol

1. Deepana Pachana
2. Vaman Virechana
3. Shamana Aushadha.

Deepan Pachan Chikitsa

DateManagementImprovement
7/12/23 to 13/12/23Pachan Churn - Shunthi + Musta + Triphala Churna with warm water.Appetite was improved and digestion problems were relieved

Vamana Protocol

Vamana
Sneha Pana (Panchtikta Ghrita) 13/12/23 to 19/12/23.
1st day 30ml, Increase 30ml every day, on 7th day Snehsidhhi Lakshana was developed.
Vaman Yoga - Madanphal 2tsf + Pippali ½ tsf + Vacha ½ tsf + Madhu 15ml
Vaman Kadha - Yasthimadhu Kwath [8 lit], Dugdha [1 lit]
Vaman Vega - 8 Uttama Vega, 3 Madhyam Vega, 2 Heena Vega
Sansarjan Krama was given for 7 days
DateManagementImprovement
13/12/23 to 29/12/23Vaman KarmaReddish colour appearance on white patches, mild itching

Virechana Protocol

Virechana
Sneha Pana (Panchtikta Ghrita) 30/01/24 to 5/01/24
1st day 30ml, Increase 30ml every day, on 5th day Snehsidhhi Lakshana was developed.
Virechan Yoga - Trivrutta Awleha 30 gm
Abhyadi Modak - 2 tab (250 mg)
Manuka Phant -1 Lit [During Virechan]
Virechan Vega - 14 Uttam Vega , 5 Madhyam Vega
Sansarjan Krama was given for 5 days.
DateManagmentImprovement
30/12/23 to 12/01/24Virechan KarmMore Improvement was seen,

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Shamana Chikitsa Protocol

DateManagementImprovement
13/01/24 to 13/02/241. Dushivishari Agad - 125mg BD After meal with Luke warm water.
2. Udayaditya Ras - 125 mg BD After meal with Luke warm water.
3. Bakuchi Ghan Vati - 250 mg BD After meal with Luke warm water.
4. Arogyavardhini Vati - 125 mg BD After meal with Luke warm water.
5. Khadirarishta - 15 ml with equal amount of water.
6. Sarivadyasava - 15ml with equal amount of water BD.
7. Local Application - Bakuchi Taila - BD
After half an hour, expose the area to the mild sunlight for 15-20 minutes.
8. At night Avipattikar Churn 1tsp with 10ml of warm water.		Spreading of White patches over body decreased, no new white spot was observed, itching decreased
14/02/24-14/03/24Continue with same treatment - For Lepa Chakramarda Beej Churna, Bakuchi Beej Churna in equal amount mix with Gomutra apply once a dayProminent Black spots were seen in white patches, no itching.
15/03/24- 15/04/24Continue with same treatment.Black spots increased in number thus covering the white patches, no itching Most of the skin became normal.

Result

Veti Score

VETI score formula: (Percentage of head involvement x grade of tensity) + (Percentage of trunk involvement x grade of tensity) 4+ (Percentage of upper limbs involvement x grade of tensity) 2+ (Percentage of lower limbs involvement x grade of tensity) 4+ (Percentage of genitalia involvement x grade of tensity) 0.1

Stage 0Normal Skin
Stage 1Hypopigmentation (including trichrome & homogeneous lighter pigmentation)
Stage 2Complete depigmentation with black hair and with perifollicular pigmentation
Stage 3Complete depigmentation with black hair and without perifollicular pigmentation
Stage 4Complete depigmentation with compound of white and black hair with/without perifollicular pigmentation
Stage 5Complete depigmentation plus significant hair whitening

Percentage of involvement = Area Score
0 = 0%
1 = 1-9%
2 = 10-29%
3 = 30-49%
4 = 50-69%
5 = 70-89%
6 = 90-100%

VETI Score before treatment

VETI: [Ph*Th] + [Pt*Tt] 4+ [Pu*Tu] 2+ [Pi*Ti] 4+ [Pg*Tg] 0.1

= [0*0] + [3*3]4+ [3*3]2+ [0*0]4+ [0*0]0.1=54

VETI score after treatment

VETI: [Ph*Th] + [Pt*Tt] 4+ [Pu*Tu] 2+ [Pi*Ti] 4+ [Pg*Tg] 0.1

= [0*0] + [2*2]4+ [2*2]2+ [0*0]4+ [0*0]0.1=24

jaims_4302_02.JPG

jaims_4302_03.JPG

jaims_4302_04.JPG


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Discussion

Shwitra can be managed very well in Ayurveda by both Shodhana & Shamana Aushadis, if treatment can be initiated in early stages, we can observe satisfactory results. In this case patient presents with whitish discoloured patches on neck, upper and lower back, Shamana Aushadis helped white patches to turn into pinkish colour. Gradual filling of depigmented area with normal skin tensity enhanced after 1st follow up. After 2nd follow up 50% improvement was observed. The total improvement is evaluated as per VETI score. Drugs given and probable mode of action are as follow-

DrugsIngredientMode of Action
Pachan churnShunt, Mustha, TriphalaHelps to digest the Aam in the body due to its Ushna, potency, Shoshak effect.
Dushivishri AgadPippali, Dhyamaka, Jatamamsi, Lodra, Ela, Suvarchika, Kustha, YAsthimadhu, Chandan, GairaikRaktshodhan, Vishaghna, Kusthanga and Kandughan properties.
Arogyavardhini VatiShuddha Parad, Shuddha Gandhaka, Lauha Bhasma, Abhraka Bhasma, Tamra Bhasma, Triphala, Shuddha Shilajatu, Shuddha Guggulu, Bark of Chitrakmool, Kutki.Kushthanasaka, Tridosha Jwaranashaka. It has properties of Deepana,Pachana,Medonashaka, Malashuddhikari,
Bakuchi Ghan VatiBakuchiStimulate melanocyte formation as it contains Psoralen.
Udayaditya RasShuddha Parad, Gandhak, Grutkumari, Chitrak, Triphala, Vidang, BakuchiIt has cell rejuvenating properties, prevent toxin buildup, blisters caused due to Chitrak helps with discoloration, it has hot potency drugs which helps in pacification of Kapha and Vata Dosha.
Khadiraristhacontains mainly Khadira, Devdaru, Bakuchi, Daruharidra, TriphalaActs as blood purifier, Khadir removes toxins from blood and clears skin and lymph.
SarivadyasavaSariva, Mustha, Lodra, Pippali, Kustha, Usher, Yavani Guduchi, Amalaka, Ela, Kutaki,It has properties of anti-oxidant, anti-inflammatory, depurative [blood purifier]
Chakramarda seedChakramardaPacifies Pitta and Vata Dosha, helpful in other skin disorders like Dadru, Sidhma Kustha, Krumi
Avipattikar ChurnaShuntha, Marich, Pippali, Vidang, Trivrut, Triphala, Lavang, Ela, Patra, Sharkara.Regulated the normal functioning of digestion and has laxative property.

Conclusion

The increasing prevalence of vitiligo, which is frequently attributed to lifestyle choices, emphasises the necessity of using Ayurvedic principles to diagnose and treat the disease’s complex origins. Following the Ayurvedic therapy guidelines described in Shwitra Chikitsa can help many patients to achieve effective control and noticeable depigmentation. Shodhana (Detoxification therapies) and Shamana Chikitsa (palliative treatments) work together to eradicate exacerbated Doshas and address the underlying cause of the illness. This all-encompassing method minimises the chance of recurrence while promoting the restoration of normal skin pigmentation and reducing the number of patches and size of lesions.

References

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