Rekindling Skin Pigmentation: Ayurveda Management of Switra - A Case Report

Vitiligo is a chronic skin disorder characterized by depigmented patches resulting from the loss or dysfunction of melanocytes. In Ayurveda, it closely correlates with Switra, a condition primarily caused by an imbalance of Dosha, especially Pitta. The disturbance of Bhrajaka and Ranjaka Pitta, which are responsible for skin coloration, is considered central to its pathogenesis. Both modern medicine and Ayurveda recognize a multifactorial origin, including genetic, autoimmune, and environmental factors. Vitiligo affects approximately 0.5% to 2.5% of children worldwide.Ayurveda advocates a holistic approach to managing Switra, focusing on internal cleansing and restoration of balance. This includes Shodhana therapies such as Snehapana (oleation) followed by Virechana (therapeutic purgation), aimed at eliminating aggravated Dosha. Additionally, Shamana therapy is used to pacify residual imbalances through internal and external medications. A case of a 13-year-old female with depigmented patches over the knees, shins, and elbows for seven years, accompanied by mild itching, demonstrated the effectiveness of this approach. Previous allopathic and homeopathic treatments had been unsuccessful. The patient underwent Deepana-Pachana, followed by Snehapana and Virechana. Post-detoxification, she received Shamana therapy, including topical application of Bakuchi–Jyotishmati Malahara with controlled sun exposure and internal administration of Bhringaraja Churna with honey or milk.Significant clinical improvement was observed, including reduced lesion size, change in colour from milky white to pink, relief from itching, and stabilization of disease progression. This case suggests that a combined Shodhana–Shamana approach may be effective in managing Switra, warranting further research.