31-Year-Old Female Patient Recovered from Chronic Seborrheic Dermatitis

Abstract

Background: Seborrheic dermatitis is a chronic inflammatory disorder commonly involving seborrheic areas of the body and presenting with pruritus, erythema, and scaling. In Ayurveda, a closely comparable condition is described as Darunaka, which is categorized under Kapalagata Roga and Kshudra Roga, and attributed mainly to the vitiation of Vata and Kapha Doshas. Classical descriptions highlight manifestations such as Kandu (itching), Rukshata (dryness), Twak-Sphutana (scaling or cracking), and Keshachyuti (hair fall), which align with modern clinical features of seborrheic dermatitis. Seborrheic dermatitis is a chronic, relapsing inflammatory dermatosis of seborrheic areas, comparable to Darunaka described under Kapalagata and Kshudra roga in Ayurveda.

Objective: To evaluate the effect of an integrated Ayurvedic protocol, including external procedures and internal treatment (Chikitsa), in a chronic case of seborrheic dermatitis (Darunaka).

Materials and Methods: A 30-year-old female with a 4-to-5-year history of pruritic and scaly lesions over the scalp and seborrheic body areas was evaluated at IAFA on 18^th January 2023. Management included external applications like IAFA E-5 Cell Repair Oil, IAFA Skin Fresh Bar, and IAFA 333 Shampoo, along with internal therapy using Bhoomi Amla and Makoye Swaras, Pitpapra capsules, and IAFA Skin Detox tablets, along with individualized dietary advice. Clinical parameters such as flaking, itching, dryness, and lesion extent were retrospectively graded over four weeks.

Results: Progressive clinical improvement was observed across the four weeks, with a reduction in scalp flaking, i.e., retrospectively graded 3 to 1, itching intensity VAS approximately 8 to 3, and dryness scoring from 3 to 1. No new seborrheic lesions were noted after the third week. The patient also reported improvement in acne activity. Treatment was well tolerated, and no adverse effects were recorded.

Introduction

Seborrheic dermatitis is a common, chronic, relapsing inflammatory skin disease that predominantly affects sebaceous gland–rich areas such as the scalp, face, and various body folds, and typically presents with erythematous, scaly plaques, greasy crusting, and pruritus. Its prevalence in adults is reported between approximately 1–3% in the general population, and higher in specific groups such as individuals with HIV infection or neurological disease.

Dandruff, considered a mild, non-inflammatory form of the same disease spectrum confined to the scalp, affects up to half of the adult population worldwide and shows frequent relapses. Beyond physical discomfort, seborrheic dermatitis can significantly affect quality of life due to visible lesions, chronicity, and psychosocial impact. The pathogenesis of seborrheic dermatitis is multifactorial and not yet fully elucidated.

Current research models highlight an interplay between sebaceous lipid production, overgrowth or qualitative changes of Malassezia spp. on the skin, alterations in the cutaneous microbiome, epidermal barrier dysfunction, and an abnormal or exaggerated host immune response. Malassezia yeasts metabolize sebum lipids and release free fatty acids and other metabolites that can act as irritants and immune triggers, leading to inflammation in susceptible individuals.

Recent work also implicates activation of innate immune pathways, including mast cells, γδ T cells, and the NLRP3 inflammasome, and emphasizes the contribution of skin barrier impairment and microbiome imbalance in disease expression and relapse. Standard management relies mainly on topical antifungals, e.g., azoles, anti-inflammatory agents such as low-potency corticosteroids or calcineurin inhibitors, and medicated shampoos. However, long-term control may be suboptimal, relapses are frequent, and concerns about chronic steroid use remain.

In Ayurveda, conditions closely resembling seborrheic dermatitis and dandruff are described under Darunaka, classified as a Kapalagata Roga, i.e., the disease of the scalp, by Acharya Vagbhata and Sharangadhara, and as a Kshudra roga (minor disease) by Acharya Sushruta, Bhavaprakasha, and Madhava.

Darunaka is attributed primarily to the vitiation of Vata and Kapha doshas and is characterized by Kandu (itching), Rukshata (dryness), Twak-Sphutana (cracking or scaling of the scalp skin), and Keshachyuti (hair fall), features that closely resemble seborrheic scalp disease clinically. Along with this, Ayurvedic literature correlates dandruff and seborrheic dermatitis with Darunaka and highlights the role of faulty diet and lifestyle, excessive use of chemical hair products, and neglect of appropriate oiling and scalp care in precipitating Vata-Kapha aggravation and recurrence.

On this basis, Ayurvedic management of Darunaka generally aims to normalize Vata and Kapha, support Rasa-Rakta-Mamsa Dhatu balance, restore scalp health, and reduce recurrence through a combination of internal formulations, external applications, i.e., medicated oils, shampoos, and pastes, and Pathya-Apathya (dietary and lifestyle) regulation.

Several clinical and conceptual studies have proposed Ayurveda-based treatment protocols for Darunaka with reference to seborrheic dermatitis, but systematically documented case reports with clearly defined outcome parameters remain limited. Documenting individual cases using integrative outcome measures can therefore contribute to the emerging evidence base for Ayurvedic approaches in seborrheic dermatitis and help generate hypotheses for larger controlled studies.

Case Presentation

A 30-year-old female presented with a chronic history of skin rashes and pruritic lesions involving seborrheic regions, including the ears, eyebrows, forehead, neck, breasts, and abdomen, along with persistent scalp flaking and dryness. Symptoms were present for approximately 4-5 years with fluctuating severity and occasional acne formation. The patient reported itching, dryness, and visible scaling that affected cosmetic appearance and caused discomfort during flare-ups.

Clinical evaluation suggested Seborrheic Dermatitis with associated dandruff, which correlated with Darunaka as described in Ayurveda due to Vata-Kapha predominance. No significant medical comorbidities were mentioned at the time of the consultation. Ayurvedic therapy was initiated at IAFA, and progressive clinical improvement was observed over the following weeks.

1) Patient Details

Age/Sex: 30-year-old / Female

Date of first visit: 18^th January 2023

2) Chief Complaints

Skin rashes with itching
Dryness involving the ears, eyebrows, forehead, neck, breasts, and abdomen
Scalp flakes with itching
Acne

3) Diagnosis

Modern Diagnosis: Seborrheic Dermatitis with dandruff

Ayurvedic Diagnosis: Darunaka -Kapalagata or Kshudra Roga, i.e., Vata-Kapha Pradhana

4) Triggers and Exacerbating Factors

Dryness of the skin and scalp aggravated itching and flaking
Cold and dry seasons are associated with the worsening of seborrheic symptoms
Possible Kapha-aggravating dietary factors and lifestyle patterns
Cosmetics and hair products may irritate the scalp and worsen scaling
Stress and seasonal variations may contribute to flare-ups

Materials and Methods

1) Intervention Protocol

Ayurvedic treatment was initiated after consultation on 18^th January 2023 at IAFA, with a focus on the management of Vata-Kapha vitiation, normalization of scalp integrity, Kleda Shoshana, Rakta-Mamsa support, and reduction of inflammatory and scaling tendencies. Treatment included external applications and internal treatment, along with dietary modifications intended to minimize Kapha aggravation and dryness of the skin and scalp.

2) Ayurvedic Diagnostic Framework

Table 1. Ayurvedic Diagnostic Analysis (Samprapti Ghataka)

Samprapti Ghataka	Analysis
Dosha	Vata- Kapha Pradhana
Dushya	Rasa and Rakta predominance, with Mansa involvement at the scalp and skin
Strotas	Rasavaha and Raktavaha Strotas, Twaka-gata involvement
Strotodushti	Sanga (scaling and obstruction), Rukshata, and mild local inflammation
Udbhava Sthana	Kapalagata (scalp region)
Vyaktasthana	Scalp, eyebrows, ears, face, upper trunk, and abdominal region
Roga Marga	Bahya Roga Marga (skin and scalp)
Adhishthana	Twak (skin) and Kapala (scalp)

3) Ayurvedic Treatment Protocol

The therapeutic plan focused on reducing Vata-Kapha derangement in the body, improving scalp barrier, mitigating inflammatory response, and modulating microbial imbalance. External therapy consisted of IAFA E-5 Cell Repair Oil, IAFA Skin Fresh Bar, and IAFA 333 Shampoo, intended for skin repair, anti-inflammatory action, anti-scaling support, and reduction of itching.

Internal therapy included Bhoomi Amla Swaras, Makoye Swaras, Pitpapra capsules, and IAFA Skin Detox tablets, supporting detoxification, anti-allergic action, blood purification, and reduction of itching and dryness. Together, these internal and external treatments are aimed at restoring scalp health, reducing recurrence, normalizing dryness, preventing cracking, and improving overall dermatological comfort without adverse effects.

4) Treatment Progression and Formulations

Table 2. Formulations Used with Dose, Frequency, Route, and Duration

Formulation	Dose	Frequency	Route	Duration
IAFA E-5 Cell Repair Oil	The 10 ml formulation is mixed in 10 ml of extra virgin coconut oil	Once or twice daily	Topical	Continuous
IAFA Skin Fresh Bar	As directed	Once daily	Topical	Continuous
IAFA 333 Shampoo	As directed	Once daily or as needed	Topical	Continuous
Bhoomi Amla Swaras	30 ml of water	Twice daily	Oral	Continuous
Makoye Swaras	30 ml of water	Twice daily	Oral	Continuous
Pitpapra Capsule	1 capsule	Twice daily	Oral	Continuous
IAFA Skin Detox Tablet	2 tablets	Twice daily	Oral	Continuous

5) Phased Therapeutic Strategy

The treatment was given in phases according to symptom response and tissue healing requirements. Initial care emphasized controlling itching, scaling, and dryness. Subsequent weeks focused on stabilizing the inflammatory response, reducing lesion spread, improving barrier function, and preventing recurrence.

Table 3. Phased Ayurvedic Treatment Strategy

Phase	Timeline	Ayurvedic Treatment	Objective	Patient Response
Phase 1: Initial Management	Week 1	External and internal treatment	Reduce itching, scaling, and dryness	Visible reduction in flakes and pruritus
Phase 2: Stabilization	Week 2-3	Continued external and internal treatment	Preventing new lesions and controlling inflammation	No new seborrheic lesions after week 3
Phase 3: Maintenance	Week 4	Same protocol and diet regulation	Maintain barrier function, reduce recurrence	Progressive improvement and tolerance

6) Monitoring and Evaluation Protocol

Evaluation was based on clinical symptoms, scalp involvement, and retrospective grading of response parameters, including itching (VAS), flaking severity (0–3), dryness (0–3), and lesion extent. Overall tolerability and absence of adverse effects were monitored during contact follow-up.

Table 4. Clinical response

Parameter	Baseline	Week 2	Week 4
Flaking (0–3)	3	2	1
Itching VAS	8	5	3
Dryness (0–3)	3	2	1
New lesions	present	occasional	none

Table 5. Clinical Monitoring Approach

Parameter	Assessment Method
Scalp flaking (0–3)	Retrospective grading
Itching VAS (0–10)	Retrospective VAS
Dryness (0–3)	Retrospective grading
New lesion appearance	Clinical observation
Tolerability	Patient feedback

7) Dietary and Lifestyle Measures

Light and easily digestible diet
Bitter and astringent foods
Lukewarm water at intervals
Fruits, millets, and green vegetables
Avoidance of A1 milk, gluten-rich items, fried foods, excess spice, sour foods, fermented items, and seafood

Results

At baseline, the patient presented chronic seborrheic dermatitis involving the scalp and multiple seborrheic regions, characterized by flaking i.e., grade 3, itching in VAS- approximately. 8/10, and dryness of grade 3. Following initiation of the Ayurvedic treatment protocol at IAFA, a progressive improvement was documented across all clinical parameters during the four-week observation period.

Symptomatic reduction was most notable in scalp scaling and itching within the first two weeks, followed by stabilization and absence of new lesions in the subsequent period. By week three, progression of existing lesions ceased, and cosmetic improvement, along with reduction in pruritus, was reported. By week four, flaking reduced to grade 1, itching to approximately 3/10, and dryness to grade 1. Acne activity, initially present along with seborrheic features, also reduced by the end of treatment. No adverse effects or treatment-related intolerance were reported.

Clinical progress was supported further by patient-reported comfort in scalp integrity, decreased visible flakes during hair washing, and improved appearance of previously affected areas such as ears, eyebrows, and forehead. The patient also reported greater social confidence due to better control of scalp scaling.

Graphical Representation

Figure 1. Reduction in Scalp Flaking Severity Over 4 Weeks

Line graph showing progressive decline in flaking score from 3 at baseline to 1 at week 4, demonstrating marked symptomatic improvement and stabilization after week 2. The Y-axis shows Flaking score (0–3), and the X-axis shows Baseline, Week 2, and Week 4.

Figure 2. Itching Severity (VAS) Over 4 Weeks

Patient-reported VAS scores demonstrated a steady reduction from 8/10 at baseline to 3/10 at week 4, indicating symptomatic relief. Y-axis showing VAS score and X-axis showing Time (weeks).

Figure 3. Skin Dryness Scores Over Time

Dryness scores improved from grade 3 at baseline to grade 1 by week 4, reflecting improved scalp barrier and moisturization associated with external therapy. Y-axis showing Dryness (0–3) and X-axis showing Time (weeks).

Figure 4. Appearance of New Lesions (Presence vs Absence)

Bar graph illustrating reduction from present at baseline to none by week 4, indicating control and suppression of exacerbations.

The Ayurvedic treatment demonstrated clinical benefit across various parameters, including flaking, itching, dryness, and lesion propagation, with marked symptomatic relief achieved by week 4 and no adverse outcomes. Absence of new lesions from week three onwards signifies disease stabilization, while concurrent improvement in acne activity suggests systemic modulation rather than purely topical effect. These results indicate the potential therapeutic utility of Ayurvedic external and internal treatment in chronic seborrheic dermatitis (Darunaka).

Discussion

Seborrheic dermatitis is an inflammatory dermatological condition with an etiology involving Malassezia overgrowth, altered skin lipid metabolism, epidermal barrier dysfunction, and immune-mediated inflammation. As per Ayurveda, it can be correlated to Darunaka, primarily characterized by Vata-Kapha vitiation with symptoms such as Kandu (itching), Rukshata (dryness), Twak-Sphutana (scaling), and Keshachyuti.

The chronicity and recurrence observed in modern dermatology parallel the classical descriptions of repeated scalp irritation due to disturbed Kapha and dryness of Vata. The therapeutic objective in this case, therefore, emphasized Dosha Samyata, Kleda Shoshana, Rakta-Mamsa support, removal of subtle Aama (toxins), and restoration of scalp barrier integrity. The treatment strategy applied combined external and internal Ayurveda-based formulations in alignment with Samprapti Vighatana, i.e., breaking pathogenesis.

External agents, including IAFA E-5 Cell Repair Oil, IAFA Skin Fresh Bar, and IAFA 333 Shampoo, collectively aimed to reduce inflammation, improve epidermal barrier, normalize scalp moisture, and decrease microbial load. Internal medications such as Bhoomi Amla Swaras, Makoye Swaras, Pitpapra capsules, and IAFA Skin Detox tablets were selected due to their known anti-allergic, anti-inflammatory, and blood-purifying properties, with an objective of detoxification and Rakta-Mamsa Dhatu support.

1) Ayurvedic Pathophysiological Understanding

In Darunaka, the fundamental pathology arises from Vata-Kapha vitiation within the Kapala and Twak, where Vata creates excessive dryness, roughness, and scalp cracking, while Kapha leads to coating, inflammation, itching, and recurrent flaking. The presence of Ama (toxins) further obstructs the microchannels, weakens local immunity, and sustains chronic episodes of irritation.

The formulations used in this case directly counter this Samprapti through coordinated actions, i.e., external applications rich in Pongamia, Berberis, Wrightia, Psoralea, Cassia fistula, and coconut-based emollients, etc., soothe inflammation, reduce Kapha-derived scaling, and restore Snigdha Guna to correct Vata-induced dryness, thereby repairing the scalp barrier.

Internal therapy with Bhoomi Amla, Makoye, and Pitpapra Swaras provides Raktashodhaka and Daha-shamana effects, reducing irritative heat and pruritus, while Pitpapra offers classical Kusthaghna action to calm chronic skin reactivity.

The Skin Detox Tablet, containing Khadira, Tinospora, Triphala, and Karanja, promotes Aama-Pachana, Kapha-Vata Shamana, and Twak- Strotoshodhana, improving tissue metabolism and preventing further obstruction. Together, these formulations balance the Doshas, cleanse inflammatory metabolites, nourish the scalp tissues, and restore normal Twak physiology, effectively breaking the pathogenesis of Darunaka and supporting sustained symptom resolution.

Table 6: Formulations, Key Ingredients, and Their Actions

Formulation	Key Ingredients	Ayurvedic Actions	Modern Pharmacology
IAFA E-5 Cell Repair Oil	Pongamia glabra, Albizia lebbeck, Berberis aristata, Cassia fistula, Cocos nucifera	Kandughna, Vranaropana, Keshya, etc.	Antifungal, anti-inflammatory, antioxidant, barrier-repair emollient
IAFA Skin Fresh Bar	Sveta Kutaj, Neelini, Kumari, Lodhar, Nimba, Chakramarda, Almond oil, Avocado oil, Coconut oil	Twachya, Krimighna, Shothahara, Raktaprasadana	Antimicrobial, anti-allergic, antioxidant, moisturizing lipid support
IAFA 333 Shampoo	Aloe barbadenis, Acacia concinna, Trigonella foenum, Hibiscus rosasinensis, Wrightia tinctoria, Psoralea corylifolia, Triphala, Cassia fistula, Pongamia glabra, Cassia tora, Indigofera tinctoria, Berberis aristata	Kandughna, Keshya, Kapha-Vata Shamaka, Tvak-Shodhaka	Antifungal, keratolytic, anti-inflammatory, scalp microbiome modulation
Bhoomi Amla Swaras	Phyllanthus niruri	Raktashodhaka, Dahashamaka, Kandughna	Anti-inflammatory, hepatoprotective, antipruritic
Makoye Swaras	Solanum nigrum	Dahashamana, Shothahara, Kandughna	Anti-inflammatory, antipruritic, soothing effect
Pitpapra Capsule	Fumaria indica	Kusthaghna, Daha-Shamana, Trishnahara	Antioxidant, anti-inflammatory, and skin disease supportive
IAFA Skin Detox Tablet	Adathoda vasica, Melia azedarach, Solanum surattense, Trichosanthes dioica, Tinospora cordifolia, Pongamia glabra, Triphala, Mahamanjistadi Kwath	Rakta-Shodhana, Krimighna, Kandughna, Ama Pachana, Dosha-Shamana	Anti-inflammatory, antimicrobial, immunomodulatory, detoxifying

Happy Note

Source:- https://g.co/kgs/UQxwCG

Conclusion

This case showed that using a combination of Ayurvedic internal medicines and external applications helped reduce itching, flaking, dryness, and new lesion formation in a patient with chronic seborrheic dermatitis (Darunaka). The treatment was well-tolerated, and no side effects were reported.

Consult Online with Dr. Sahil Gupta (B.A.M.S., M.H.A.)

The improvement suggests that Ayurvedic management aimed at balancing Vata and Kapha, supporting the skin barrier, and reducing inflammation may be useful in similar cases. However, this is a single case, and more studies with longer follow-up and larger numbers of patients are needed to confirm how effective this approach is in the long term.

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