Management of Shwitra (Vitiligo) With Virechana Karma and Avalgujadi Lepa: A Case Report

Background: Shwitra is described in Ayurveda as a variety of Kilasa and is regarded as a Tridoshaja disorder involving Rakta, Mamsa and Meda Dhatu. It is characterised by Shweta Mandala (white patches) and is comparable to vitiligo, an acquired depigmentary disorder affecting about 1–2% of the world population, with marked cosmetic and psychological impact. Case presentation: A 40-year-old male labourer presented with a depigmented patch over the forehead of 6 months' duration. Intervention: After Deepana–Pachana with Chitrakadi Vati and Snehapana with Panchatikta Ghrita, Virechana Karma was performed with Trivrit Avaleha (100 g) and warm milk, followed by Samsarjana Krama. Avalgujadi Lepa mixed with Gomutra was applied locally on alternate days for 21 days. Results: Aruna Varnata reduced from grade 2 before treatment to grade 1 after treatment and grade 0 at the 21s day follow-up. The pigmented-spot score improved from grade 3 to grade 2, indicating the appearance of new perifollicular pigmented spots. No adverse effects were observed. Conclusion: Virechana Karma combined with Avalgujadi Lepa may be an effective approach in the management of Shwitra. Larger controlled studies are needed to confirm these findings.