It may begin with a little itching. Then a reddish patch appears, followed by dryness, irritation, scaling or a burning sensation. For many people, eczema begins quietly but gradually becomes difficult to ignore.
The itching may become particularly troublesome at night and can interfere with sleep. Repeated scratching can make the skin thicker, rougher or darker. In some cases, cracks may develop, while certain forms may also show moisture or oozing.
In modern medicine, eczema is a broad term used for several inflammatory skin conditions. These include atopic dermatitis, contact dermatitis, dyshidrotic eczema and other forms.
In Ayurveda, several features of eczema are correlated with Vicharchika, a condition described among the skin disorders. Classical descriptions of Vicharchika include features such as itching, small eruptions, discoloration and discharge. However, modern eczema and Ayurvedic Vicharchika should not automatically be considered identical in every patient. Proper assessment of the individual presentation remains important.
What is Eczema?
Eczema is a skin condition that may cause dryness, itching, redness, irritation, small eruptions and scaling.
Some people mainly experience very dry skin, while others may develop moist or oozing lesions. When itching continues for a long time, repeated scratching can cause the skin to become thick and rough.
Eczema may also fluctuate. Symptoms can settle for a period and then become active again when certain triggers are present.
Common Symptoms of Eczema
Symptoms vary depending on the type of eczema and the area of the body involved.
Common features include:
- Persistent or recurrent itching
- Excessive dryness
- Redness or changes in skin colour
- Small eruptions
- Scaling
- Burning or irritation
- Cracks in the skin
- Bleeding after scratching
- Moisture or oozing
- Thickened skin over time
- Darkening or other changes in skin colour
In children, eczema may commonly affect the face, arms, legs or other areas, while adults may experience it on the hands, neck, around the elbows, behind the knees and other areas.
Why Does Eczema Occur?
Eczema does not have one single cause. Several factors may contribute, including weakness of the skin barrier, immune responses, genetic tendency and environmental influences.
In some individuals, symptoms may become worse with:
- Harsh soaps
- Laundry detergents or other chemicals
- Fragranced skin-care products
- Perfumes
- Excessive heat
- Sweating
- Very cold or dry weather
- Rough or irritating fabrics
- Repeated rubbing of the skin
- Stress
- Individual sensitivity to a particular substance
However, not every trigger applies to every person.
Eczema and Vicharchika in Ayurveda
Ayurveda describes various skin disorders under the broader category of Kushtha, within which Vicharchika is also described.
Classical descriptions of Vicharchika include features such as:
- Kandu — itching
- Pidika — small eruptions
- Shyavata — dark or dusky discoloration
- Srava — discharge or oozing
These features may resemble some manifestations of modern eczema. Therefore, the Ayurvedic concept of Vicharchika can be useful when understanding certain eczema-like presentations from an Ayurvedic perspective.
However, it is not appropriate to assume that every case of eczema is automatically Vicharchika. Ayurvedic assessment may consider the individual’s constitution, dosha status, digestive capacity, diet and lifestyle, duration of the condition, skin findings and associated symptoms.
Eczema from the Dosha Perspective
From an Ayurvedic perspective, Vicharchika may involve predominantly Kapha and Pitta, while Vata may also contribute in certain presentations.
Kapha-predominant presentation
There may be more:
- Moisture
- Discharge
- Stickiness
- Thickened skin
- Heaviness
Pitta-predominant presentation
There may be more:
- Redness
- Burning
- Warmth
- Swelling
- Irritation
Vata-predominant presentation
There may be more:
- Marked dryness
- Roughness
- Cracking
- Tightness
- Itching
In real clinical presentations, features of more than one dosha may occur together. Therefore, dosha assessment should not be based on a single symptom.
Understanding Eczema Through Nidana Panchaka
Ayurveda uses Nidana Panchaka to understand disease more comprehensively.
Nidana
Identifying factors that may contribute to or aggravate the condition.
Purvarupa
Early or subtle symptoms that may appear before the condition becomes fully developed.
Rupa
The characteristic manifestations such as itching, eruptions, discoloration, dryness, scaling or discharge.
Upashaya and Anupashaya
Understanding what provides relief and what makes the symptoms worse.
Samprapti
Understanding the Ayurvedic process through which aggravated doshas interact with the relevant tissues and contribute to the skin disorder.
This approach looks beyond the visible skin lesion and considers the person as a whole.
Diagnosis in Modern Medicine
Eczema is often diagnosed through clinical examination and medical history. If the presentation is unclear or does not respond as expected, a dermatologist may recommend further evaluation.
Several other skin conditions can resemble eczema, including:
- Fungal infections
- Psoriasis
- Scabies
- Contact dermatitis
- Other inflammatory skin disorders
Therefore, persistent or recurrent eczema-like symptoms should be properly assessed rather than treated only on the basis of appearance.
Ayurvedic Approach to Eczema — A Safer Treatment Perspective
Treatment of eczema should not be reduced simply to “taking a medicine.” A more appropriate approach begins with identifying aggravating factors, maintaining healthy skin care and then choosing treatment according to the individual’s presentation.
1. Nidana Parivarjana
Identifying and avoiding factors that aggravate symptoms is an important part of Ayurvedic management.
This may include:
- Avoiding harsh soaps
- Avoiding irritating fabrics
- Reducing excessive heat and sweating
- Discontinuing a personal-care product if it consistently aggravates symptoms
- Reducing repeated scratching
However, when the trigger is uncertain, unnecessarily eliminating many foods or everyday items is not advisable.
2. Skin Care
When eczema is associated with dryness, maintaining skin moisture is particularly important.
- Avoid very hot water.
- Keep bathing time reasonably short.
- Avoid rubbing the skin vigorously.
- Apply an appropriate moisturiser after bathing.
- Prefer fragrance-free skin-care products.
- Keep fingernails short.
If a cream, oil or topical preparation increases burning or itching, it should not simply be continued without appropriate advice.
Ayurvedic Medicines
Classical Ayurvedic literature and traditional practice describe several formulations used in the broader management of skin disorders. These include formulations such as Panchatikta Ghrita, Khadira-based preparations and Manjistha-based preparations.
However, this does not mean that every person with eczema should take one of these medicines.
Selection of an internal Ayurvedic medicine may depend on factors such as:
- Individual constitution
- Dosha involvement
- Digestive capacity
- Severity and nature of the condition
- Whether the skin is dry or exudative
- Age
- Other medical conditions
- Current medications
Classical formulations such as Panchatikta Ghrita, Panchatikta Ghrita Guggulu, Khadirarishta or Manjistha-based preparations may be considered by an Ayurvedic physician in an appropriate patient, but they should not be self-started solely on the basis of this article.
Additional caution is important during pregnancy, breastfeeding, childhood, older age, liver or kidney disease, concurrent medication use or suspected skin infection.
The modern scientific evidence for Ayurvedic medicines is not equally established for every eczema presentation. Classical textual use and modern clinical evidence should therefore be understood separately.
External Treatment
Any topical Ayurvedic preparation should be selected according to the current condition of the skin.
A very dry skin presentation and a moist or oozing presentation may not require the same approach.
Ayurvedic practice includes traditional use of various medicated oils, ghee-based preparations and topical applications. However, these are not automatically appropriate for every patient.
Particular caution is required when:
- There is active discharge
- There are open skin lesions
- Infection is suspected
- Burning or irritation increases after application
In such situations, a topical preparation should not be started independently without appropriate clinical advice.
Panchakarma
Ayurveda describes Shodhana therapy in the management of selected conditions. In an appropriate patient, an Ayurvedic physician may consider procedures such as Virechana after proper assessment.
Raktamokshana is also described traditionally in relation to certain skin disorders.
However, Panchakarma is not required for every person with eczema.
Before considering any Panchakarma procedure, factors such as:
- Age
- Physical strength
- Digestive capacity
- Disease status
- Other medical conditions
- Current treatment
should be assessed.
Panchakarma should not be performed at home or by an inadequately trained person.
Integrating Modern Treatment with Ayurveda
Maintaining skin moisture and appropriate skin care are also important parts of modern eczema management.
When required, a dermatologist may prescribe topical medicines or other treatments to control inflammation and itching.
If a person is already receiving modern medical treatment, prescribed medicines should not be stopped independently simply because Ayurvedic treatment is being started.
When combining Ayurvedic and modern treatment, it is safer to inform both healthcare professionals about all current medicines and treatments.
Diet for Eczema
A strict identical diet is not necessary for every person with eczema.
From an Ayurvedic perspective, a diet that is suitable for the individual and easy to digest may be preferred.
In general:
- Choose fresh, easily digestible meals.
- Include seasonal vegetables and fruits.
- Maintain adequate hydration.
- Take grains and pulses in appropriate quantities.
- Reduce heavily fried foods.
- Avoid excessive use of very spicy foods.
- Limit frequent outside food and highly processed foods.
If a particular food repeatedly appears to aggravate symptoms, it can be discussed with a qualified healthcare professional.
Simply because someone has eczema, it is not appropriate to permanently eliminate milk, curd, ghee, grains, fruits or multiple other foods without a clear reason.
Lifestyle
Small daily habits can also make a meaningful difference in eczema care.
What to do
- Keep fingernails short.
- Get adequate sleep.
- Avoid excessive overheating.
- Prefer soft cotton clothing.
- Keep the skin adequately moisturised.
- Work on reducing stress.
- Avoid repeated scratching when itching occurs.
What to avoid
- Repeated scratching
- Very hot showers
- Harsh scrubs
- Unidentified “instant relief” creams
- Long-term self-use of steroid-containing combination creams
- Assuming every itchy rash is fungal and self-starting antifungal medicines
Yoga and Pranayama
Yoga is not a direct treatment for eczema, but it may form part of a lifestyle approach that supports stress management and healthy sleep.
Depending on individual capacity, practices may include:
- Nadi Shodhana Pranayama
- Bhramari Pranayama
- Shavasana
- Gentle meditation
- Gentle yoga practice
If a practice causes excessive heat, sweating or friction against the skin, it should be modified.
Case Study
Case Study 1 — Dry and intensely itchy eczema
A 35-year-old person presented with long-standing dryness of the hands and legs along with increased itching at night. Repeated scratching had made the skin rough and thick.
In such a presentation, initial attention would be given to maintaining skin moisture, identifying aggravating factors and confirming the diagnosis. From an Ayurvedic perspective, assessment of dosha status and digestive capacity may help the physician decide whether an appropriate Shamana approach should be considered.
Case Study 2 — Moist and oozing eczema
A person developed eruptions with moisture and discharge around the flexural area of the hand. The person had also been applying several different creams independently.
In such a situation, it is important to determine whether this is eczema alone or whether an infection is also present. The condition of the skin should be assessed before deciding on internal or external treatment.
Case Study 3 — Recurrent eczema
A person experienced recurrent eczema on the neck and hands several times a year. During the clinical history, it became apparent that the symptoms often became worse after using a particular fragranced skin-care product.
In such a situation, identifying and avoiding the aggravating product becomes an important part of management. Appropriate skin care and clinically indicated treatment can then be considered according to the individual’s needs.
When Should Medical Advice Be Sought?
Medical or dermatological assessment is particularly important when there is:
- Yellow discharge or pus
- Significant warmth and swelling
- Severe pain
- Fever associated with the skin problem
- Rapid spreading of the rash
- Recurrent skin infections
- Significant involvement around the eyes or face
- Continued worsening despite treatment
- Uncertainty about the diagnosis
Extra caution is required in children, pregnancy and people with significant underlying medical conditions.
Conclusion
Eczema is more than a visible skin problem. Skin sensitivity, environmental factors, daily habits, stress and individual triggers may all contribute in different ways.
In Ayurveda, several features of eczema are correlated with Vicharchika. However, appropriate treatment should not be based on the disease name alone. The individual’s constitution, dosha status, diet, digestive capacity, skin condition and overall symptom pattern should be considered.
Classical formulations such as Panchatikta Ghrita, Khadira-based preparations or Manjistha-based preparations may be considered by an Ayurvedic physician in selected patients. However, no single medicine should be presented as suitable for every case of eczema, and a permanent cure should not be guaranteed.
The most important principles are appropriate diagnosis, avoiding aggravating factors, regular skin care and treatment tailored to the individual.
FAQs
What is eczema?
Eczema is a skin condition that may cause dryness, itching, redness, irritation, small eruptions and scaling. Some people develop moist or oozing lesions, and symptoms can settle and then flare up again.
Is eczema the same as Vicharchika in Ayurveda?
Ayurveda correlates many features of eczema with Vicharchika. However, the two should not be treated as exactly the same condition in every patient; each person needs to be assessed based on their symptoms and overall condition.
What causes eczema?
Eczema does not have one single cause. Skin barrier weakness, immune responses, genetic tendency and environmental factors may all contribute, and harsh soaps, detergents, chemicals or fragranced products can make symptoms worse.
Should I stop milk, curd or ghee if I have eczema?
Having eczema alone is not a reason to permanently eliminate milk, curd, ghee or other foods. A fresh, easily digestible diet suited to the individual is preferred, and any food that repeatedly worsens symptoms should be discussed with a qualified professional.
When should I see a doctor for eczema?
Seek medical or dermatological advice if there is yellow discharge or pus, marked warmth and swelling, severe pain, fever, a rapidly spreading rash, involvement around the eyes or face, or worsening despite treatment.
Dr. Nikul Patel (B.A.M.S.)
307, 3rd Floor, Shalin Complex, Above Farki Lassi, Krishnabaug Char Rasta, Maninagar, Ahmedabad – 380008
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