Therapeutic evaluation of Topical Unani Formulation Dhimad of Kafe Dariya (Cuttle fish bone) and Haldi (Turmeric Curcuma Longa) in Buthur Labaniyya (Acne Vulgaris)

Acne vulgaris, or Buthur Labniya in Unani medicine, is a common dermatological disorder primarily affecting adolescents. It results from irritation of the pilosebaceous unit, leading to increased sebum production, abnormal keratinization, and colonization by Propionibacterium acnes. In Unani philosophy, acne is caused by an imbalance of bodily humors, with suppurative material ascending to the skin due to bukharat (bodily vapors). Globally, acne affects approximately 9.4 percent of the population, with teenagers showing up to 85 percent prevalence, largely due to hormonal changes. Clinically, acne manifests as comedones, papules, pustules, nodules, and cysts, with severe cases potentially causing scarring. Conventional management involves topical treatments like retinoids, antibiotics, and benzoyl peroxide, while moderate to severe cases may require oral antibiotics or hormonal therapy. Isotretinoin is reserved for treatment-resistant cases but carries risks of erythema, peeling, dryness, and other adverse effects. Resistance to antibiotics further limits long-term use, emphasizing the need for alternative therapies. Unani medicine offers effective, oil free formulations for acne management, focusing on blood purification, desiccation, and scar prevention. One such formulation is Dhimad, a homogenous paste made from fine powder of Kafe Dariya (Cuttlefish bone) and Haldi (Turmeric), mixed with Arq e Gulab. Applied topically at night, it targets acne lesions and is left overnight. The control drug in studies is Clindamycin 1% gel, applied similarly. These interventions demonstrate the potential of combining classical Unani remedies with modern therapeutic principles for safe and holistic acne management.