Management of Charmakeela (Scalp Wart) With Kshara and Agnikarma – A Case Report

Background: Warts are caused by the Human papilloma Virus (HPV) which enters the skin through small cuts or cracks. It will make the skin cells to grow faster and leading to the formation of benign skin lesion characterized by rough, raised finger like projection over the skin surface. Ayurveda correlates it with Charmakeela. Acharya Sushruta and vagbhta mentioned it under Kshudra Roga and are caused due to the vitiation of Vyana Vata and Kapha doshas. Sushruta mentioned Ksharakarma and Agnikarma in the treatment of Charmakeela. In contemporary science, the treatment includes topical keratolytics, cryotherapy, electrocautery and laser therapy. Clinical findings: In the present case report, a 29-year-old male patient was presented to the Shalakya OPD with small painless growth over the scalp since 1 year which was gradually increasing in size and it is associated with irritation, mild burning sensation and itching while combing hairs. Based on the detail history and thorough local examination it was diagnosed as Scalp wart. Intervention: By considering the broad base of the wart Ksharakarma was performed first because performing Agnikarma first may leads to more pain and bleeding. 3 sittings of Apamarga kshara application and one sitting of Agnikarma with Panchaloha shalaka was performed. Outcome: After 51 days of treatment Significant reduction in wart size was observed after 3 sittings of Ksharakarma. Complete removal from the base was achieved following one sitting of Agnikarma. Healthy granulation tissue developed, and complete healed skin was observed after Agnikarma. No complications such as infection, scarring etc were noted, and no recurrence was observed during follow-up. Conclusion: The present case study suggest staged approach of Apamarga Kshara application followed by Agnikarma leads to controlled wart size reduction and base destruction. This ordered para-surgical intervention proved safe, effective and beneficial in preventing recurrence of scalp wart.