A Randomized Comparative Clinical Study to Evaluate the Efficacy of Ashoka Tvak Lepa and Arjuna Tvak Lepa in the Management of Dushivishajanya Vyanga With Special Reference to Melasma

Background: Vyanga is an Ayurvedic Kshudra Roga characterized by facial discoloration and is clinically comparable with melasma. The present study evaluated two topical Ayurvedic bark preparations in Dushivishajanya Vyanga with special reference to melasma. Objective: To compare the efficacy of Ashoka Tvak Lepa and Arjuna Tvak Lepa in patients with Dushivishajanya Vyanga. Materials and Methods: This randomized comparative clinical study was conducted in the outpatient department of Agad Tantra, Institute for Ayurved Studies and Research, Kurukshetra. Fifty-four patients aged 18–50 years meeting the diagnostic criteria were enrolled; 10 withdrew and 44 patients completed the study, with 22 patients in each group. Group A received Ashoka Tvak Lepa and Group B received Arjuna Tvak Lepa, applied locally twice daily for 28 days. Assessment was performed using graded clinical parameters—Shyavata, Mandala, Rukshata and Snigdhata—and the Melasma Area and Severity Index (MASI). Within-group changes were assessed using the Wilcoxon signed-rank test and between-group differences using the Mann–Whitney U test. Results: Both groups showed statistically significant improvement in all assessed parameters. Mean MASI decreased from 10.43 to 6.20 in Group A (40.54% improvement; p<0.0001) and from 10.60 to 3.25 in Group B (69.31% improvement; p<0.0001). Between-group comparison showed a significant difference in MASI (U=141.5, p=0.0182), favouring Arjuna Tvak Lepa. Arjuna Tvak Lepa also showed greater improvement in Shyavata and Mandala, whereas between-group differences for Rukshata and Snigdhata were not statistically significant. No adverse effects were reported during the study period. Conclusion: Both topical interventions improved clinical features of Vyanga; however, Arjuna Tvak Lepa produced greater improvement in overall disease severity as measured by MASI and was superior to Ashoka Tvak Lepa for hyperpigmentation and lesion size in this study.