Clinical evaluation of the efficacy of Shvitrahara kashaya and lepa in vitiligo

Vitiligo is a progressive, idiopathic, pigmentation disorder of the skin, characterized by hypopigmented white lesions. PUVA therapy is the treatment of choice in the modern system of medicine. In Ayurveda, Shvitra or Kilasa is the term employed to describe hypopigmentation disorders of the skin. Shvitra is caused by various dietic and behavioral factors which aggravate the tridoshas, especially the Kapha dosha vitiating the Meda dhatu. Many Ayurvedic drugs are well known for the regeneration of melanocytes, among which Bakuchi is one. The present study was planned to study its efficacy in the regeneration of melanocytes. The outcome of treatment in 50 cases of Shvitra vis-à-vis vitiligo receiving Shvitrahara kashaya and Shvitrahara lepa was analyzed and compared. Group I (n = 25) patients were treated with Shvitrahara kashaya and Shvitrahara lepa; Group II (n = 15) patients received Shvitrahara lepa only; and the remaining 10 patients of Group III used both (Western medicine) oral psoralens and UV-A therapy. Assessment was done after 6 months with bi-monthly follow-ups. Out of 25 cases in Group I, 17 showed 80% improvement (t = 7.65; P < 0.01) in the surface area, number of lesions, pigmentation and associated symptoms like itching; out of 15 patients in Group II, 10 showed partial repigmentation, i.e. 50% (t = 5.72; P < 0.01) response was observed. In Group III, 90% response (t = 6.14; P < 0.001) in repigmentation and number of lesions as well was noted but eight patients developed adverse effects like sunburn, severe itching and gastric upset on taking oral psoralen. On the basis of results and observations, it can be concluded that Ayurvedic formulation containing Bakuchi is efficacious and has no untoward effects when compared to oral psoralens and UV-A therapy.