E-ISSN:2456-3110

Case Report

Atopic Dermatitis

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 5 MAY
Publisherwww.maharshicharaka.in

An Ayurvedic approach in the management of Kashyapokta Charmadala (Atopic Dermatitis) in Children: A Case Study

Gupta S1*, Divyasri RA2, Sudheer BR3
DOI:10.21760/jaims.10.5.35

1* Suryana Gupta, Post Graduate Scholar, Dept of PG Studies in Kaumarabhritya, Sri Sri College of Ayurvedic Science and Research, Bengaluru, Karnataka, India.

2 Divyasri RA, Professor and Guide, Dept of PG Studies in Kaumarabhritya, Sri Sri College of Ayurvedic Science and Research, Bengaluru, Karnataka, India.

3 Sudheer BR, HOD, Dept of PG Studies in Kaumarabhritya, Sri Sri College of Ayurvedic Science and Research, Bengaluru, Karnataka, India.

Atopic Dermatitis (AD), commonly known as eczema, is a chronic relapsing skin disorder affecting 10-30% of children worldwide. It is characterized by intense pruritus, erythema, scaling, serous oozing, and occasional blister formation.[1] Children diagnosed with AD may also present with asthma and allergic rhinitis, which are the common comorbidities of AD in infancy and/or in early childhood. Ayurveda describes a similar condition as Charmadala in Khila Sthana of Kashyapa Samhita, attributing it to the vitiation of all three Doshas and presents with symptoms such as redness, itching, pustules, pain and cracks in the skin and tenderness.[3] This case study highlights an Ayurvedic intervention that successfully managed AD in a 14-year-old girl through a combination of Panchakarma therapies and Shamana Aushadhis. The outcome demonstrated significant symptomatic relief and skin rejuvenation, with no relapse observed during follow-ups.

Keywords: Kashyapa Samhitha, Charmadala, Shamana Aushadhis, Atopic Dermatitis

Corresponding Author How to Cite this Article To Browse
Suryana Gupta, Post Graduate Scholar, Dept of PG Studies in Kaumarabhritya, Sri Sri College of Ayurvedic Science and Research, Bengaluru, Karnataka, India.
Email: 		Gupta S, Divyasri RA, Sudheer BR, An Ayurvedic approach in the management of Kashyapokta Charmadala (Atopic Dermatitis) in Children: A Case Study. J Ayu Int Med Sci. 2025;10(5):231-235.
Available From
https://jaims.in/jaims/article/view/4359/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-04-12 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 11.52

© 2025 by Gupta S, Divyasri RA, Sudheer BR 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)231
Download PDFBack To ArticleIntroductionCase ReportObservations and ResultsDiscussionConclusionReferences
Suryana G et al. Management of Kashyapokta Charmadala (Atopic Dermatitis) in Children

Introduction

The skin, body's largest organ, plays a vital role in protection, thermoregulation, and immune response. In children, dermatological conditions such as AD contribute significantly to paediatric consultations.[4] AD presents as a chronic inflammatory skin disorder with severe itching, redness, and scaling, often linked to asthma and allergic rhinitis. From an Ayurvedic perspective, AD correlates with Charmadala, a disorder described in Kashyapa Samhita, characterized by itching, pustules, skin cracking, and tenderness due to Tridoshic involvement. Unlike conventional management, Ayurveda employs a holistic approach through Shodhana and Shamana therapies, aiming at long-term relief and rejuvenation.

Case Report

A 14-year-old female patient presented with maculo-papular lesions, erythematous in nature, affecting various body areas, including face, neck, and limb flexures. The lesions were associated with severe itching, burning sensation, scaling, and persistent dryness for over a year. The patient had a h/o asthma since age of four and had been using nebulizers/antibiotics for symptomatic relief. She experienced frequent lip cracking, which progressed into dry, flaky, erythematous rashes accompanied by pain and itching. The condition later spread to scalp, elbows, eyebrows, and limb flexures, with mild oozing from some affected areas. Symptoms worsened with spicy food intake and cold weather, significantly disrupting her sleep due to intense nocturnal itching. Consultation with an allopathic doctor led to long-term use of topical and systemic steroids, resulting in complications such as eyebrow and eyelash loss. Concerned about these side effects, patient sought Ayurvedic treatment at Sri Sri College of Ayurvedic Science Research and Hospital, Bengaluru for holistic management.

History of Past Illness: K/C/O Asthma since 4 years of age.

Drug History: Antihistamine - Syrup Cetirizine (2-5mg) (SOS)

Family History: Her grandmother and paternal uncle have H/O Asthma

General Examination:

Built : Moderately built
Height : 145 cm
Nourishment : Well- nourished 
Weight : 35 kg
B.P : 110/80 mm of Hg 
Temperature : 97°F.
Respiratory Rate : 20cpm 
Pulse : 84 bpm

Growth and Development

All milestones attained as per age

Integumentary System:

Table 1: Examination

NatureMaculo-papular lesions present especially in flexor region.
DistributionAll over the body, present especially in flexor region.
SizeLess than 5 mm
ShapeCircular
ColorErythematous
BordersWell defined
Secondary changesLichenification +
DischargePresent
Burning sensationPresent
Itching over lesionPresent +++
TendernessPresent
Surface textureRoughness ++
Dryness ++

Investigations:

IgE: 1253.7 IU/ml (07/02/23)


Before Treatment:
jaims_4359_01.JPG


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Suryana G et al. Management of Kashyapokta Charmadala (Atopic Dermatitis) in Children

Treatment Protocol:

Table 2: Timeline of the treatment during hospital stay

Date of VisitPanchakarma Treatment/Medicines UsedDischarge Medications
(16/03/2023 – 27/03/2023)
(First IP Visit)		1.  Sarvanga Abhyanga: Panchatiktaka Ghrita[5] - 11 days Followed By
2.  Sarvanga Avagaha: Lodhra + Sariva + Lajjalu + Pooga Kwatha -3 days
3.  Sarvanga Pichu: Prunilol cream+ Narikela jala + Panchavalkala lepa + Lajjalu - 11 days
  • Khadirarista[6]
  • Panchatiktaka Ghrita Guggulu[7]
  • Yashtimadhu Ghrita Pichu[8]
  • Panchavalkala Ointment
(18/05/2023 – 22/05/2023)
(Second IP Visit)		1.  Snehapana: Mahatiktaka Ghrita[9] (75 ml, x 1 day)
2.  Sarvanga Abhyanga: Tungadrumdi Taila (2 days) followed by Bashpa Sweda (2 days)
3.  Virechana: Trivrt Lehya + Triphala Kashaya + Draksha Kashaya
  • Khadirarista + Sariva Kalpa
  • Panchatiktaka Ghrita Guggulu
  • Yashtimadhu Ghrita + Aragwadhadi Mahatiktaka Ghrita
  • Capsule Tiktamrutam
(16/11/2023 – 24/11/2023)
(Third IP Visit)		1.  Snehapana: Mahatiktaka Ghrita (for 3 days)
2.  Sarvanga Abhyanga: Panchatiktaka Ghrita followed by Bashpa Sweda (2 days)
3.  Virechana: Trivrt Lehya + Amalaki Swarasa + Katuki Choorna		Same as before
(08/02/2024 – 1 day) (Fourth IP Visit)1.  Sarvanga Abhyanga: Karpuradi Taila followed by Bashpa Sweda
2.  Sadhyo Vamana: Yashtimadhu Kwatha + Saindhava Jala		Shataputi Abhraka Bhasma + Hinguvachadi Choorna + Swasakutara Rasa + Yashtimadhu Choorna with honey

Table 3: Follow-Up and Outcome

FeaturesDistributionDischargeTendernessBurning sensationItching over lesionSurface texture
1. Roughness
2. Dryness
16/03/23
(First IP Visit)		Maculo-papular rashes present all over the body.PresentPresentPresent+++1. ++
2. ++
10/04/23
(First Follow-up)		Maculo-papular rashes reduced over face and neck, persists over flexor region.MildPresentPresent++1. ++
2. +
18/05/23
(Second IP Visit)		Maculo-papular rashes reduced all over the body.MildAbsentAbsent+1. +
2. +
30/09/23
(Second Follow-up)		Maculo-papular rashes reduced all over the body.AbsentAbsentAbsent+1. Mild
2. +
16/11/23
(Third IP Visit)		Few lesions present all over the body.AbsentAbsentAbsent+1. Absent
2. +
08/02/24
(Fourth IP Visit)		Very few Maculo-papular lesions present over flexor region.AbsentAbsentAbsentMild over few areas1. Absent
2. Mild
11/04/24
(Fourth Follow-up)		No Relapse seenAbsentAbsentAbsentAbsent1. Absent
2. Absent

First Follow-Up:
jaims_4359_02.JPG


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Suryana G et al. Management of Kashyapokta Charmadala (Atopic Dermatitis) in Children

Second Follow-Up:
jaims_4359_03.JPG

Fourth Follow-Up:
jaims_4359_04.JPG

Observations and Results

Over four admissions and follow-ups, the patient experienced:

  • Reduction in erythema, dryness, and maculo-papular lesions
  • Decreased itching, burning sensation, and oozing
  • Improved skin texture and elasticity
  • Normalization of IgE levels
  • No relapse observed during follow-ups

Discussion

AD is a chronic relapsing disorder, necessitating a treatment approach that minimizes flare-ups and extends disease-free periods. Here, we have seen chronic case of Tridoshaja Charmadala with vitiation of Rakta showing frequent exacerbations. For treatment of Charmadala, drugs alleviating Vata, Pitta, Kapha Doshas, which have Kandughna (antipruritic), Kushtaghna (alleviates skin lesions) and Rakta Shodhaka (Blood purifier), as well as possessing, Katu (pungent), Tikta (bitter) Rasa and Ushna Veerya (hot in potency) were selected. Though the patient exhibited Tridoshaja Charmadala with Rakta vitiation, showing frequent exacerbations requiring systematic detoxification,

treatment was aimed at reducing dryness and pruritis which caused much of discomfort to patient attributed to Vata and Kapha Dosha. Hence, Bahirmarjana Chikitsa was primarily performed, helping to reduce Prakupita Doshas. Internal medicines and external procedures useful in skin diseases were chosen in this case. Ayurvedic treatment incorporated Shodhana Chikitsa to eliminate accumulated toxins or Utklishta Doshas from body, followed by Shamana Chikitsa to pacify remaining Doshas or Seshadoshas. After completion of treatment, it led to symptomatic relief and considerable improvement was recorded with noticeable reduction of symptoms along with appearance of healthy skin.

Conclusion

AD, a chronic relapsing disorder, requires an approach that not only controls flare-ups but also ensures long-term skin health. Kashyapa’s approach to Charmadala - an Utpaata Vyaadhi emphasizes targeted Dosha management through sequential Panchakarma therapies. If coupled with Shamana Aushadhis and Pathya Ahara-Vihara it significantly reduces symptoms and prevent recurrence and further manifestation of new symptoms. This case study highlights the efficacy of Ayurvedic treatments in achieving sustained remission without side effects associated with long-term steroid use.


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Suryana G et al. Management of Kashyapokta Charmadala (Atopic Dermatitis) in Children

It also, suggests that Kashyapokta Charmadala with the involvement of Tridoshas and multiple Dushyas is Sadhya when approached with a specifically designed protocol. Further clinical trials are warranted to substantiate these findings and promote Ayurveda’s role in dermatological care.

Declaration of patient consent:

Obtained as per ICMR National Ethical Guidelines

Patient Perspective:

Before treatment, my condition severely impacted my daily life and academics. Ayurvedic therapy not only improved my skin but also restored my confidence and well-being.

References

1. Reid MC, Eccleston C, Pillemer K. Management of chronic pain in older adults. BMJ. 2017;356:j1321. doi:10.1136/bmj.j1321 [Crossref][PubMed][Google Scholar]

2. Prasher B, Pandey R, Tiwari P, et al. Molecular correlates of Ayurvedic principle of Prakriti (human constitution) and its implications for personalized medicine. J Transl Med. 2017;15(1):1–12. doi:10.1186/s12967-017-1206-6 [Crossref][PubMed][Google Scholar]

3. Kashyapa. Kashyapa Samhita, Vrddhajivakiya Tantra. In: Tewari PV, Kumar N, Sharma RD, Kumar A, editors. Varanasi: Chaukhamba Visvabharati; p. 621. Khila Sthana, Chapter 15: Charmadala Adhyaya [Crossref][PubMed][Google Scholar]

4. Medscape. Understanding the mechanisms of pain: how do we classify pain? [Internet]. 2011 [cited 2025 Feb 9]. Available from: https://www. medscape.org/viewarticle/743529 [Crossref][PubMed][Google Scholar]

5. Govinda Das. Bhaishajya Ratnavali, 58-Visphotachikitsa Prakarana, verse 20. Varanasi: Chaukhamba Sanskrit Sansthan; 2022. . [Crossref][PubMed][Google Scholar]

6. Govinda Das. Bhaishajya Ratnavali, 54-Kushtha Prakarana, verses 365–370. Varanasi: Chaukhamba Sanskrit Sansthan; 2022. . [Crossref][PubMed][Google Scholar]

7. Vagbhata. Ashtanga Hridaya, Chikitsa Sthana, Chapter 12, Verses 13–15. Varanasi: Chaukhamba Sanskrit Sansthan; 2021. . [Crossref][PubMed][Google Scholar]

8. Acharya JT. Charaka Samhita, Chikitsa Sthana, Chapter 14, Verse 44. Varanasi: Chaukhamba Krishnadas Academy; 2016. . [Crossref][PubMed][Google Scholar]

9. Acharya JT. Charaka Samhita, Chikitsa Sthana, Chapter 14, Verse 43. Varanasi: Chaukhamba Krishnadas Academy; 2016. . [Crossref][PubMed][Google Scholar]

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