Clinical Study of Buthur Labaniyya (Acne vulgaris) and Therapeutic Evaluation of Unani Formulation of Dimad (Paste) in it’s management; An Open-label, block randomized, standard control study.

Buthur Labaniyya (Acne vulgaris) is a self-limiting disorder of teenagers and young adults; although 10-20% of adults may continue to experience some form of the disorder. The Global burden disease (GBD) project estimates the prevalence of acne vulgaris at 9.4%, ranking it as the eighth most prevalent disease worldwide. Acne vulgaris affects both sexes equally but its age of onset is usually earlier in females (16-17 years) than in males (17-19) years. Acne vulgaris is a dermatosis of unknown etiology but androgenic stimulation at puberty is believed to increase the activity of sebaceous glands and sebum production. Sebum flow is impeded because of abnormal keratinization within the pilosebaceous canal, a process that leads to formation of comedones. Bacterial (propiobacterioum acnes) proliferation within the comedones predisposes to rupture of pilosebaceous unit with extravasations into the surrounding dermis, which results in papules, pustules, and cysts. Acne mostly occurs on face and back of neck but can also occur on chest and upper back. In Unani system of medicine, Buthur Labaniyya (Acne vulgaris) is defined as appearance of white papules on face and nose accompanied by discharge of viscous fluids from them. Unani Physicians have explained the cause of Buthur Labaniyya (acne vulgaris) as Madda-i-Sadidiya (suppurative material) which comes to the skin surface due to vapors of the body (bukharat-i-badan) and have also recommended the use of drugs (either orally or locally) having Muhalil (anti- inflammatory), Mujaffif (Desiccative) and Jali (Detergent), Dafi-Taffun (Antiseptic) properties. The allopathic approach for the treatment of Acne vulgaris is either pharmacological (Ilaj bil Dawa) or surgical (Ilaj bil Yad). Pharmacological therapies include; topical application of sulfacetamide, salicylic acid, azelaic acid and retinoid and oral administration of antibiotics (tetracycline, macrolides, clindamycin and dapsone) and anti-androgens (spironolactone, cyproterone), while as surgical procedures includes incision and curettage. Although not life threatening, acne leads to significant morbidity,including depression,anxiety,and psychosocial stress,and is the major cause of psychosocial and psychological impairment for young people triggering anxiety and mood disorders and effecting self esteem. Most of the allopathic drugs are costly, having potential adverse effects and producing only time being relief to the patients. Therefore a clinical trail entitled “Clinical Study of Buthur Labaniyya (acne vulgaris) and Therapeutic Evaluation of Unani Formulation of Dimad (Paste) in it’s management; An Open- label, block randomised, standard control study”is contemplated with the objective to evaluate the therapeutic efficacy of Dimad (Paste) in acne and improve the quality of life. In this regard a Unani formulation as mentioned in classical Unani literature and comprising of Alsi (Linum usitatissimum), Gul-e-Surkh (Rosa damascene Mill), Kalonji’ (Nigella sativa) and Sirka (Vinegar) will be evaluated in the management of acne vulgaris.

The above mentioned ingredients Alsi (Linum usitatissimum),Gul-e-Surkh (Rosa damascene Mill), Kalonji’ (Nigella sativa) and Sirka (Vinegar) have Muhalil  (anti-inflammatory), Dafi-Taffun (Antiseptic), Mukhrij-i-Balgham (Expectorant), Mujaffif (Dessicative), Mufattih (Deobstruent) properties.