An Open Labelled Randomized Comparative Clinical Study to Evaluatethe Efficacy of Vatapatradi Lepa and Lodhradi Lepa with Manjisthadi KwathIn Mukhadushika With Special Reference to Acne Vulgaris

Mukhadushika is explained under kshudrarogas.It is characterized by shalmali kantak sadrush pidika on face due to vitiation of kapha , vata , rakta dhatu. It corelates to acne vulgaris explained in modern science.Acne is estimated to affect 9.4% of the global population making it 8th most prevalant disease worldwide.Peak severity is seen in late teenage years but acne may persists into 3rd decade and beyound.

Acne vulgaris is a follicular disorder affecting susceptible pilosebaceous follicles.The condition commonly manifest with papules,pustules and nodules.Pathologic events originates in the sebaceous follicle that are predominantly found on the face ,neck and upper trunk.In pathogenesis of acne many different factors play a role altered abnormal status with increased androgens in men and increased androgen properties of progesteron and other hormones in women.Follicular keratization : Hyperkeratotic plugs form in follicle opening. Hyperplasia of sebaceous gland with increased sebum production secondary to hormonal changes.Colonization of follicle by proprionibacterium acnes,which produce lipases splitting free fatty acids and releasing inflammatory mediators.

Treatment needs to be continued for at least 6 weeks to produce effect.The treatment of acne vulgaris may consists of topical therapy ,systemic therapy or combination of both.Topical therapy alone is indicated for mild to moderate lesions.Benzoyl peroxide 5% gel ,topical antibiotics erythromycin,clindamycin are used.In moderately severe cases systemic therapy is given which includes only estrogens ,retinoids ,antibiotics.Using antibiotics for acne treatment for prolonged period results in antibiotic resistance and can have a significant negative impact on gastrointestinal microbiome.

Face is the most  important for reflecting the beauty of person which is affected in mukhadushika.Ayurveda relatively proved to be efficacous in treatment of skin disease.Acharyas mentioned various therapeutic procedures like *Jalaukavacharana , vaman,siravedha,pralepa,abhyanga.*In vatapatradi lepa vata is kashaya and sheeta virya . Malati is kapha pitta shamak.Raktachandan is raktashamak. Kushtha is tridosha shamak.Kaleeyaka is tikta,ruksha,ushna virya.In lodhradi lepa lodhra is kashaya,kaphaghna and sheeta virya. Dhanyaka is kashaya,tikta,madhur vipaka.Vacha is kashaya and ushna virya.In manjisthadi kwath manjistha is madhur ,kashaya alleviates kapha and used in rakta vikaras and ushna virya.

Hence present study is aimed to evaluate and compare the efficacy of vatapatradi lepa and lodhradi lepa with manjisthadi kwath in mukhadushika with spoecial reference to acne vulgaris.