Eczema, often referred to as dermatitis in modern medicine, is known as Vicharchika in Ayurveda. It falls under the broader category of Kushtha (skin diseases). Ayurvedic texts describe Vicharchika as a condition caused by the vitiation of all three Doshas (Vata, Pitta, and Kapha), primarily Pitta and Kapha, along with the involvement of Rakta (blood), Twak (skin), Mamsa (muscle tissue), and Lasika (lymphatic fluid). The accumulation of Ama (toxins) due to impaired digestion (Mandagni) is considered a key underlying factor.

The symptoms of eczema according to Ayurveda can vary based on the predominant dosha:

• Vata-dominant eczema: Dry, flaky, itchy skin with fissures and possibly intense pain.
• Pitta-dominant eczema: Red, inflamed skin with a burning sensation, possibly with pus or fluid-filled eruptions (blisters).
• Kapha-dominant eczema: Oozing, sticky discharge, swelling, thickening of the skin, and intense itching, slow-healing lesions.

Ayurvedic treatment for eczema is holistic and personalized, aiming to:

• Purify the blood and detoxify the body.
• Balance the vitiated Doshas.
• Reduce inflammation, itching, and dryness/oozing.
• Strengthen digestive fire (Agni) to prevent Ama formation.
• Promote healthy skin tissue regeneration.
• Prevent recurrence by addressing root causes.

Here’s a detailed overview of Ayurvedic treatment for Eczema:

I. Shodhana (Panchakarma – Detoxification and Purification Therapies): Panchakarma plays a crucial role in treating eczema by eliminating deep-seated toxins and restoring physiological balance. The specific therapies and their sequence are chosen based on the individual’s dosha imbalance and the stage/severity of the eczema.

1. Snehapana (Internal Oleation):
   • Description: Oral administration of medicated ghee (like Panchatikta Ghrita Guggulu, Tikta Ghrita) for a prescribed period, usually 5-7 days, in gradually increasing doses.
   • Benefits: Helps to soften and liquefy toxins (Ama) from the deeper tissues, making them easier to eliminate through subsequent therapies. It also nourishes the dry skin.
2. Vamana (Therapeutic Emesis):
   • Description: Medically induced vomiting to eliminate excess Kapha and Pitta Doshas from the upper gastrointestinal tract.
   • Benefits: Particularly beneficial for eczema with prominent Kapha symptoms like excessive itching, oozing, and thick, sticky lesions. It helps reduce congestion and inflammation.
3. Virechana (Therapeutic Purgation):
   • Description: Medically induced purgation using herbal laxatives to eliminate vitiated Pitta Dosha and toxins from the small intestine and liver.
   • Benefits: Highly effective for inflammatory skin conditions like eczema, especially when redness, burning sensation, and oozing are present. It purifies the blood and helps in clearing skin lesions.
4. Raktamokshana (Bloodletting/Blood Purification):
   • Description: Therapeutic removal of small amounts of impure blood, usually through local leech therapy (Jalaukavacharana) or venesection (Siravedha).
   • Benefits: Directly cleanses the vitiated blood, which is a key pathological factor in many skin conditions. It helps reduce localized inflammation, itching, and burning sensations. This procedure should only be performed by experienced practitioners.
5. Basti (Medicated Enema):
   • Description: Administering medicated oils (Sneha Basti) or herbal decoctions (Kashaya Basti) into the rectum.
   • Benefits: Primarily for pacifying Vata Dosha, which contributes to dryness, scaling, and intense itching in eczema. It also helps in systemic detoxification and nourishing the body.

II. Bahya Chikitsa (External Therapies):

• Abhyanga (Herbal Oil Massage): Gentle massage with medicated oils like Nimbadi Taila, Karanjadi Taila, Mahamarichyadi Taila, Vranaropana Taila, Jatyadi Taila, or even virgin coconut oil. It moisturizes the skin, reduces dryness, scaling, itching, and inflammation.
• Lepana (Application of Herbal Pastes): Application of pastes made from herbs like Neem, Manjistha, Turmeric, Chandan (Sandalwood), Bakuchi, Karanja, Aloe vera, often mixed with water, rose water, or medicated oils. These help to cool, soothe, reduce inflammation, itching, and promote healing.
• Dhanyamla Dhara: Pouring of warm, fermented medicinal liquid (Dhanyamla) over the affected skin to reduce inflammation and itching.
• Ksheeradhara / Takradhara (Medicated Milk/Buttermilk Pouring): Continuous pouring of medicated milk (Ksheeradhara) or buttermilk (Takradhara) over the affected area or as Shirodhara (on the forehead) for stress reduction. Takradhara is particularly cooling and Pitta-Kapha pacifying, beneficial for inflammatory and oozing eczema.
• Ubtan (Herbal Paste/Powder Bath): Using herbal powders (like those containing Neem, Triphala, Turmeric) mixed with water or milk as a gentle cleanser during baths.
• Avagaha Swedana (Herbal Bath): Soaking in baths infused with herbal decoctions (e.g., Neem leaves, Triphala, Dashamoola) to soothe and cleanse the skin.

III. Shamana (Palliative Therapies & Herbal Medicines): These involve internal medicines to manage symptoms, purify blood, and strengthen the immune system.

• Blood Purifiers (Rakta Shodhana):
  • Neem (Azadirachta indica): Potent blood purifier, anti-inflammatory, anti-bacterial, and anti-fungal.
  • Manjistha (Rubia cordifolia): Excellent blood purifier, detoxifies the lymphatic system, reduces inflammation, and improves skin health.
  • Khadira (Acacia catechu): Blood purifier, anti-inflammatory, and astringent, particularly good for weeping eczema.
  • Sariva (Hemidesmus indicus): Blood purifier, cooling, anti-inflammatory, and anti-allergic.
  • Guduchi (Tinospora cordifolia): Immunomodulator, anti-inflammatory, and helps digest Ama.
• Anti-inflammatory & Immunomodulatory Herbs:
  • Turmeric (Haridra – Curcuma longa): Strong anti-inflammatory, antioxidant, and immunomodulatory properties.
  • Guggulu (Commiphora mukul): Anti-inflammatory, detoxifying, and helps balance doshas.
  • Bakuchi (Psoralea corylifolia): Traditionally used for skin conditions, especially those with discoloration.
  • Chopchini (Smilax china): Used for chronic skin diseases and inflammatory conditions.
• Classical Formulations:
  • Mahamanjishthadi Kashayam/Kwath: A highly effective blood purifier and anti-inflammatory decoction.
  • Kaishore Guggulu: Used for skin diseases, gout, and blood purification.
  • Arogyavardhini Vati: Improves liver function, digestion, and detoxifies the body.
  • Panchatikta Ghrita Guggulu: A medicated ghee formulation beneficial for various skin disorders, especially those with Pitta-Kapha involvement.
  • Nimbadi Churna/Vati: Based on Neem, useful for skin conditions.
  • Triphala: A gentle detoxifier, helps regulate bowel movements and eliminate Ama.
  • Haridra Khandam: A classic preparation for allergic skin conditions.