URTICARIA AND AYURVEDA

Urticaria is a vascular reaction of the skin (Vasodilation and permeability) due to the liberation of histamine from mast cells predominately. Urticaria, affects about 20 percent of people at some time during their lives. It can be triggered by many substances or situations and usually starts as an itchy patch of skin that turns into swollen red welts.

Urticaria is a heterogeneous group of disorders characterized by production of ‘wheals’, (also called as hives), i.e. itchy, transient, erythematous, or pale, edematous swelling of the superficial layers of the dermis which blanch on pressure; each individual lesion is short lived, lasts for few minutes to several hours, seldom more than 24 hours; episodes may recur daily or several times each day for days, or years.

Wheals are rounded, oval or ill defined closely placed lesions which may coalesce to form various shapes and sizes from a few millimeters to few centimeters. Any part of body may affect, trunk being more commonly involved than extremities or face.

TYPES OF URTICARIA

1) Acute Urticaria:

Typically, lesions lasting less than 6 weeks are referred to as acute Urticaria.

2) Chronic Urticaria:

If Urticaria lasts six weeks or more.

3) Physical Urticaria

In physical urticaria, the characteristic wheals can be reproduced by a physical stimulus such as cold, heat, pressure, vibration, sunlight, water, exercise, and increases in core body temperature.

a) Dermographism:

Urticaria, wheals and flares occur in response to simple rubbing of the skin.

b) Pressure urticaria:

This type of urticaria can occur right way, precisely after a pressure stimulus or as a deferred response to sustained pressure being enforced to skin.

c) Vibratory urticaria:

It is rare familial condition consisting of erythema and edema following the stretching of skin.

d) Localized heat urticaria:

It occurs when heat is applied locally, results in edema and erythema at the site of heat contact.

e) Cholinergic urticaria:

34% of all the physical urticaria are cholinergic, which occur with exercise, anxiety, sweating, and passive warming.

URTICARIA IN AYURVEDA

Urticaria is correlated with Sheetapitta in Ayurveda. The proper references for Sheetapitta are not found in Brihatrayies but explanation about Udarda, Kotha, Utkotha are mentioned. Acharya Madhavakar gave description about Sheetapitta, Udarda and Kotha. It is a Tridoshaja disorder having predominance of Pitta and Vata with Rasa, Rakta as main Dushya. Acharya Madhavakar quoted that Shitapitta having Vata dominancy while Udarada having Kapha dominancy.

SYMPTOMS

Sheetapitta is a skin disorder characterized by inflamed lesions having symptoms like:

• Varati Danshvata Kandu (wasp sting itching) and may be associated with
• Toda (pricking sensation)
• Daha (burning sensation)
• Chardi (vomiting)
• Jwara (fever).

TREATMENT

SHODHANA CHIKITSA (PANCHAKARMA)

• Vamana (therapeutic emesis): Emesis should be given with decoction of Patola and Arishtaka.

•  Virechana (therapeutic purgation): Purgation should be given with decoction of Triphala, Guggul Pippali. 

SHAMANA CHIKITSA (PALLIATIVE TREATMENT)

Accodring to Acharya Charaka

• Udarda Prashamana Mahakashaya
• Katu Taila
• Mustadi Churna

Accodring to Acharya Sushruta

• Use of Eladi Gana Dravya

Accodring to Bhavaprakasha

• Navakarshika Guggulu
• Use of Trikatu, Sharkara Yavani, Vyosha, Yavakshara
• Use of Aardraka Rasa with Purana Guda
• Yavani with Guda
• Amalaki with Guda   
• Nimba Patra Amalaki with Ghrita
• Ardraka Khanda

Accodring to Chakradatta

• Visarpokta Amritadi Kwatha
• Agnimantha Moola Churna with Ghrita
• Shushka Pakva Gambhari Phala after boiling with milk

Accodring to Bhaishajya Ratnavali

• Yashtyadi Kwatha
• Goghrita, Maricha
• Haridra Khanda
• Brihat Haridra Khanda
• Lepa of Durva and Haridra
• Udwartana with Siddhartha, Rajani, Kustha, Prapunnada, Tila, Katu Taila
• Abhyanga with Katu Taila

According to Yogaratnakar

• Use of Vardhamana Pippali and Vardhamana Lasuna.