Busoor-e- Labaniya (Acne vulgaris)

Acne is one of the commonest skin condition which affects 90% of population sometimes in life. It heals automatically (self-limiting) in most of the cases without leaving any scar. 

It is characterized by seborrhoea, the formation of comedones, erythematous papules and pustules. Less frequently there will be appearance, nodules, cysts, deep pustules or pseudocysts. In some cases, it is accompanied by scars.

It is commonly seen in adolescents or teenagers. An estimated 80–90% of teenagers (8 out of 10) suffer from acne. During puberty in both sexes, acne appears as a result of an increase in androgens such as testosterone. It develops earlier in females than in males.

In some cases acne can affect people even in their forties also. One out of every 20 persons in their fourth decade is likely to have acne. 

The prevalence rates are reported lower in some rural societies. In 2010 alone, acne was estimated to affect 650 million people globally making it the 8th most common disease worldwide. People are generally affected by this problem especially before and after puberty. 

Because of its cosmetic value acne assumes lot of significance in the society.

What is Acne?

Acne is chronic inflammation of pilo-sebaceous follicles characterized by areas of blackheads, whiteheads, pimples, greasy skin, and possibly scarring.

It produces unsightly spots on the face, nose, neck, upper part of chest, back and upper arms/ shoulders and buttocks. 

The sebaceous gland is the site of the problems. These glands produce sebum which, contains cholesterol, fatty acids and waxes. Several things can go wrong with this fairly simple process. For example, if the production of sebum increases or if dead cells clog up the openings of the glands, the flow of the sebum gets disturbed. As a result the pores get blocked and black pimples develop as the sebum spills into the surrounding tissue. These pimples might even get infected. Male hormones, the androgens, are responsible, mainly for the over production of sebum and the consequent development of acne. 

In Unani system of medicine, acne vulgaris is termed as Basoor-e- Labniya, Mohasa or Keel. Busoor-e- Labaniyah which means eruptions of milk due to whitish discharge resembling milk. According to Ibn-e- Sina (Canon of Medicine), these are small white eruptions on the nose and cheeks which resemble condensed drops of milk. 

Causes of Acne

According to modern medicine the exact cause of acne is unknown but several factors such as genetics, hormonal changes, infections, skin cosmetics, certain medications and environmental conditions play important role in causing acne. 

As per Unani classics the cause of acne is suppurative material (madda Sadeediya), which comes to the skin surface due to vapours of the body (bukharat-e- badan) and this material does not get resolved in the skin due to its viscosity.

According to some Unani physicians, the main cause of acne (Busoor-e- Labaniyah) is the hyperactivity of sebaceous glands (Ghudud-e- Dohniya),  which  results  into  increased  production  of oily material. This oily material gets clogged into the openings of these glands. These glands are then inflamed, get suppurated and filled with pus.  

The  yellow pus (madda-e- sadeedi)  reaches  to  the  skin  due  to increased  abnormal  heat (ifraat-e- hararat )  and  does not get resolved easily from the pores. In other words, the yellow pus (madda-e- sadeediyah) originates due to the bukharat-e- badan and later gets shifted towards skin. 

The yellow liquid of acne (busoor-e-labaniyah) is transformed from the body vapours (bukharat-e- badan), which are accumulated in the skin and their light ingredients (raqeeq) get converted into a thick fluid due to the effect of air and these thick materials are not easily resolved, hence the pores get blocked. 

There are many causes which lead to the above described pathogenesis, such as

1. Increased blood volume in the body
2. Use of hot diets
3. Use of alcohol
4. Impurities of the blood
5. Indigestion
6. Constipation
7. Sudden stoppage of haemorrhoidal blood
8. Menstrual disturbances etc.

Signs of Acne

• Blackheads (open plugged pores) 
• Whiteheads (closed plugged pores) 
• Papules (Small red, tender bumps)
• Pustules (Pimples which are papules with pus at their tips) 
• Nodules (Large, solid, painful lumps beneath the surface of the skin)
• Cystic lesions (Painful, pus-filled lumps beneath the surface of the skin)

Symptoms of Acne

Acne can cause more than blemishes. Studies show that people who have acne can have

1. Low self- esteem
2. Depression
3. Dark spots on the skin
4. Scars 

Diagnosis of Acne

Your General physician will be able to conduct diagnosis of acne just by looking at your skin spots. This will involve examining your face, chest, neck and back etc. looking for the different types of spots, such as blackheads or sore, red nodules etc.

Acne is diagnosed mainly by its appearance. Physical examination, medical and personal history are helpful to rule out any other possibilities in the diagnosis of acne.

Preventive Measures

The preventive measures can help the patients mainly to reduce the severity, swollenness and redness of the face. These tips can alleviate the complications arising from acne.

• Avoid touching and scratching of the affected parts repeatedly. Wash your hands regularly with antiseptic lotions and keep them clean. 
• Avoid makeups. If required use only those kinds which are oil free and do not clog up the pores.
• Stay away from sunlight as it can produce more oil glands causing acne. Use sunscreen when you move outdoor.
• Balanced and complete diet should be preferred with more consumption of fresh vegetables and fruits.
• Drink more and more quantity of water (10-12 glasses daily) to flush out the toxins from the body. 
• Avoid drinking of beverages like coffee, tea and alcohol. Also avoid smoking.
• Regular exercise are helpful to expel out the excreta from the body.
• Avoid tight clothes such as caps and scarves.  Wear light and loose clothes.  

Treatment 

As per Unani philosophy the basic principles which are followed for the management of acne are:

• Removal of underlying cause
• Improvement of digestion and correction of hepatic insufficiency
• Medication to improve the quality of blood and if required then minimise the quantity also.
• Use of blood purifiers

The mainstay for the treatment of acne in modern medicine is the use of topical and or systemic antibiotics and retinoids. However long term use of these drugs may produce significant side effects. 

Physicians of Unani system have been practicing many herbo- mineral formulations (both local as well as oral routes) for the treatment of acne, pimples, and scars which are beneficial in the treatment and management of acne vulgaris.

Oral drugs are required when acne is severe and cannot be controlled by local drugs and measures. 

Scars which result from acne require specialized care & management. Unani herbal treatment successfully cures this ailment without any negative effects.

List of Unani single drugs: Out of these some are used orally and some locally

Compound Preparations available in market

Itrifal Shahatra, Majoon Ushba, Habb-e- Qooqaya, Safoof Barg-e- Neem, Habb-e- Musaffi, Sharbat-e- Musaffi and Sharbat-e- Unnab are common unani compound formulations for treating skin problems. And these are beneficial compound formulations in the treatment of acne.

Some useful Preparations and homemade remedies

• Prepare a mixture of 4 gms each of Shaahtara (Fumaria indica), Chiraitah (Swertia chirayita), Sarphuka (Tephrosia purpurea), Globe flower (Trollius europaeus) and Unnab (Zizyphus jujuba) 5 pieces. Boil in about 200 ml. of water. Strain it. Add sugar as required. Consume twice a day i.e. in the morning and before going to bed.
• Apply yellow Indian cucumber juice (Cucumis sativus) on the face. Cucumber juice mixed with lemon juice may also be applied on the pimples to get relief from acne and acne scars.
• Take one apple (Malus sylvestris), grate it, add 1 spoon of honey and mix well. Apply to the face, leave it for 15 minutes and wash with luke warm water. This will help in removing acne and its scar.
• Take 2 spoons of oat meal (Avena sativa) add small amount of honey, water and mix well. Apply to the face. After sometimes remove with likewarm water with a smooth cloth. 
• Take 1 spoon of pineapple juice (Ananas comosus), add 1 pinch of turmeric powder, mix well and apply to the face. Leave it for 15 minutes and wash with cool water. It removes acne and black spots.
• Take some curd, add 1 spoon oats, 4 drops of lemon juice (Citrus limon) and mix well. Apply to the face. After some time remove the mask with cool water, it removes acne. Applying lemon juice alone is helpful to remove acne and its scars.
• Apply honey to the face once in every 3 days. After 30 minutes remove the mask with lukewarm water. 
• Take mint juice (Mentha arvensis) mix with 1 pinch turmeric powder and apply to the face. Even mint juice alone if applied on the face helps to get relief from acne and acne scars. 
• Take rose water (Rosa damascena), mix with 4 drops of lemon juice. By using cotton make a small round ball, dip in to the juice. Place the balls over the spots and remove after 15 minutes. 
• Take sufficient quantity of cuttle fishbone. Rub it on stone by using water. After preparing the paste, use it over the pimples and acne. Continue treatment for one week.
• Prepare a paste of almond powder and castor oil. Apply it on the acne spots with gentle massage. Wash it after 10-15 minutes. 
• Prepare a paste of ground sesame seeds. Mix well with water. Apply it on the affected area. It is also effective in treating skin rashes and allergies.
• Powder of pomegranate skin alone or its roasted paste mixed with lime juice is effective in the treatment of pimples effectively. This mixture could also treat whiteheads, blackheads, and boils.
• Add 1 tsp. of Dalchini safoof (Cinnamomum zeylanicum) and 1 tsp of lemon juice, make a paste. Apply it to the affected area. It is very useful in the management of acne. 
• Take 2 spoons of water thoroughly mix with 1 spoon of olive oil (Olea europaea). Apply to the face, leave it for some time. It is good remedy for the control of acne. It also glows the skin.
• Take kheera juice (Cucumis sativus) mix with honey, store in fridge up to 1 week. Apply this paste to the face with cotton. It is helpful for skin health and controls acne.
• Take white of egg and mix it with honey. Apply it to the face to make a mask, leave it for some time, then wash the face with lukewarm water. It is a good skin tightening agent and removes acne. 
• Take 1 tsp of ground nut oil mix with 1 tsp lime juice, then apply to the face. It prevents formation of pimples.
• Take some pods of cloves (Syzygium aromaticum), fry them without oil and make a fine powder. Then add curd and make a paste, apply it over the pimples.
• Applying papaya milk (Carica papaya) on face helps to remove pimples. Raw Papaya (Carica papaya) paste if applied on the face also helps to cure pimples.
• Make a fine powder of aunf (Foeniculum vulgare), add lemon juice to it to make a paste. Applying this paste on the face daily helps to remove pimples. The face will glow naturally. 
• Sandalwood (Santalum album) paste if applied on the face helps to overcome acne and remove its scars.
• Take neem leaves (Azadirachta indica) boil with water and inhale its steam.  This helps in reducing acne and acne scars. This also removes extra oil from the face and reduces pimples.
• Take gram flour (Besan) and mix with butter milk. Apply it on the affected area. It reduces acne and acne scars. 
• Nutmeg (Myristica fragrans) grinded with milk if applied on the face helps a lot in reducing acne and acne scars. 
• Powdered dry orange skin (Citrus sinensis) if applied as a paste or its skin alone if rubbed on the face helps to remove acne scars.
• Gheekwar (Aloe vera) is best medicine for pimples or acne. Aloe vera leaf if rubbed on the face removes acne and acne scars.
• Ajwayin seeds (Ptychotis Ajowan) grinded with curd applied on the face also helps to get rid of acne or pimples.
• Menthi (Trigonella foenum-graecum) paste also helps in getting rid of acne and its scars. Also basil leaves (Tulsi) if rubbed on the face is good remedy to remove acne scars. 
• Fresh leaves of fenugreek crushed and ground to form a fine paste could be applied on the face. Allow it to remain overnight and wash off in the morning.
• Wash your face with tender coconut water as it is a good remedy to overcome acne scars and preventing acne.
• Dhania powder (Coriandrum sativum) if mixed with lemon juice and applied on the face also removes acne and its scars.
• Take six gms each of dried rind of orange (Citrus sinensis), egg shell, tragacanth gum (Astragalus gummifer), barley, gram, lentil ((Lens culinaris), starch, kernel of almond and kernel of sweet melon seeds (Cucumis melo). Make a fine powder of all ingredients and prepare a paste with water. Apply it before going to bed and wash it with lukewarm water in the morning. This procedure helps in removing acne and pimples.
• Cupping therapy is very useful for the treatment of acne, as it removes out toxins and harmful substances from the body which is very beneficial in acne.

Note: Should be taken under the advice of the qualified Unani physician.The patients are required to follow strict Unani regimen for optimum results.