INTRODUCTION
Psoriasis is a deadly chronic skin disease of auto-immune nature. In modern days, due to increased stress & altered diet & unhealthy lifestyle, cases of psoriasis increase and the prognosis is very poor. The social stigma caused by this long-term skin disease is still on the high. Psoriasis causes an important role in the cosmetic aspect, especially in children and youngsters. The most reason for considering this disease as a curse, is that it has no effective & permanent cure or prevention. The scaly skin lesions which are the most obvious sign, may reduce or change site but they can not be permanently cured. Usually, the disease affects the whole body but the lesions are predominantly seen in joints, back of thighs or such areas. 45 to 56 percent of people living with psoriasis have scalp psoriasis. It can affect the scalp, hairline, forehead, back of the neck and skin around the ears. Scalp psoriasis may be an indicator of psoriatic arthritis (Psoriatic arthritis), as many people have both.
SIGNS AND SYMPTOMS
Psoriatic lesions on the scalp are usually asymmetrical and sharply demarcated, and exhibit silvery‐white scales with pain, itching, or bleeding resulting the person in feelings of embarrassment, and restricting clothing choices.
CAUSES
Exact cause is unknown. Following factors are considered to play a role in the development of psoriasis.
- Family history
- Obesity
- Stress
- Viral and bacterial infections
PATHOPHYSIOLOGY
The skin cells on the scalp grow too quickly and make powdery or thick scales called plaques. The areas around them can be red and itchy. The pathogenesis of psoriasis is characterized by increased production of inflammatory cytokines that cause hyperkeratosis. Briefly, interleukin (IL)‐23 and IL‐12 are produced by myeloid dendritic cells, and these cytokines activate naïve T cells to differentiate into Th1, Th17, and Th22 cells, which then produce cytokines responsible for the development of psoriatic plaques such as IL‐17, IL‐22, tumor necrosis factor‐α, and interferon‐γ.
DIAGNOSIS
Clinical examination
Skin biopsy
TREATMENTS
Common treatment options for patients with scalp psoriasis include topical agents such as vitamin D analogs, corticosteroids, and coal tar.
PROGNOSIS
Scalp psoriasis can be difficult to treat. It may take time to find a treatment that works well because everyone responds differently to treatments.
COMPLICATIONS
Scalp psoriasis affects individuals differently. Some people have an occasional flare-up while others deal with the condition frequently.
Disease & Ayurveda
Ekakushtha/ ekakushtha
Nidana
Unwholesome diet with opposite potency
Improper routine and behaviour
Teasing and humiliating other good people
Theft
Bad deeds which cause emotional stress factors like repentance/fear/anxiety
Kapha- Vaatadoshakopanidana – causes for vitiation of the kapha dosha and Vaatadosha
Purvaaroopa
Absence of sweating
Loss of tactile sensation
Samprapti
Due to the causative factors, vitiated doshas (mainly kapha) vitiate rasadhatu and reaches skin and develop into scaly rashes.
Lakshana
Absence of sweating
Big lesions resembling scales of fish
Lesions are scattered all over the body or head
Skin resembles the skin of elephant
Divisions
Not mentioned
Prognosis
Yaapya in most cases
Asaadhya in chronic & complicated cases
Chikithsa
Treatment of eka/charmakushtha is alleviating the vitiated Kapha and Vaata doshas. It should be done accordingly in each case. If the lesions are wet/oily and swelling is present, kaphadoshahara treatment should be done. If the lesions are dry & flaky, with dark discolouration, Vaatadoshahara treatment should be administered. Other factors like body constitution, age, physical and mental strength of patient, digestion, season etc. also should be considered while treating the kushtha.
Samana
kshalana – washing with kashayas like aragwadhadikwatha or triphalakwatha
lepana – applying external medicines like kasamardalepa, chakramardadi lepa, aragwadhadi lepa etc.
Sodhana
Vamana with madanaphalakwatha
Virechana with erandatailam, or avipathi choornam
Kashayavasti
Snehavasti
(VAsti is especially beneficial in psoriatic arthritis)
Commonly used medicines
Aragwadhadi kwatham
Mahathikthakam ghrutham
Avipathi choornam
Nimbamruthadi erandam
Vajrakam Kashayam
Manjishtadi Kashayam
Gandhak Rasayan
Rasagandhi Mezhu
Arogyavardhini Vati
Brands available
AVS Kottakal
SNA Oushadhasala
Vaidyaratnam oushadhasala
AVP Coimbatore
Home remedies
No home remedy is there to completely cure psoriasis. But herbs that can help the discomforts of the disease includes the following:
Turmeric
Aloe vera
Neem
Apple cider vinegar
Baking soda
Tea tree oil
Epsom salt
Oatmeal
Diet
Pathya
Light meals and easily digestible foods
Green gram, soups, buttermilk boiled with ginger, turmeric, curry leaves etc.
Freshly cooked and warm food processed with cumin seeds, ginger, ajwain etc
Maintain a regular food and sleep schedule.
Apathya
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products other than buttermilk- Cause indigestion, increase Kaphadosha, can lead to obstruction in channels and respiratory problems.
Curd – causes vidaaha and thereby many other diseases
Red chilli and other pungent, hot and spicy food items.
Behaviour
Better to avoid exposure to excessive sunlight wind rain or dust.
Avoid stress.
Avoid sedentary lifestyle as it is one of the main causes of rheumatoid arthritis.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Yoga
Salabhasana
vajrasana
Nadisudhi pranayama
Bhujangasana
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
doi: 10.1111/jdv.13780. Epub 2016 Jul 13.
Aretrospective cohort study demonstrated the efficacy of infliximab and ustekinumab in addition to etanercept and adalimumab.
doi: 10.1016/j.jaad.2017.05.033. Epub 2017 Aug 2
A placebo‐controlled, double‐blind trial demonstrated the superiority of secukinumab compared with placebo after 12 weeks of treatment on moderate-to-severe scalp psoriasis.
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
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