Comparative efficacy of ayurveda interventions Shwitrahara Lepa and Avalgujabeejadi Lepa in the Management of Shwitra (Vitiligo): An open-labeled, parallel-group, randomized, controlled clinical study

INTRODUCTION: Vitiligo is one of the major skin diseases affecting the normal pigmentation of the skin. It is an auto-immune disorder resulting in skin hypopigmentation due to reduced melanin production. In Ayurveda classical texts, the external application of Shwitrahara Lepa (SHL) and Avalgujabeejadi Lepa (AGL) is indicated for managing vitiligo. Hence, given literary indication, the present study was undertaken to evaluate the efficacy of SHL and AGL in managing vitiligo. MATERIALS AND METHODS: An open-label, parallel-group, randomized, controlled clinical study was conducted among 40 participants aged between 21 and 60 diagnosed with vitiligo. The participants were randomly assigned into two equal groups. Group A was treated by using an external application of SHL with water. Group B received AGL external application with cow urine. The external application of the interventions was done over the lesion once a day following early morning (7:00 a.m.) sunlight exposure for 15 min daily for 45 days. The effect of therapy was assessed through clinical parameters such as Vitiligo Area Scoring Index (VASI), pigmentation, margin, and the number of lesions along with classical symptoms of vitiligo, such as discoloration of the skin, reddish or coppery discoloration, skin dryness, burning sensation, itching, and thickening of the skin. RESULTS: The results of the study indicate that both SHL and AGL are significant in improving the score of VASI (P < 0.001) and pigmentation and reducing the margin of the lesions compared to baseline. Significant reduction in skin dryness and itching was noted in both SHL (P = 0.004, P = 0.023) and AGL (P = 0.034, P = 0.009) groups. SHL also significantly reduced whitish skin discoloration and burning sensation (P < 0.05). On comparing the effect of SHL and AGL, statistically nonsignificant results (P > 0.05) were obtained for all the assessment parameters, indicating that both interventions are equally effective. No adverse drug reactions were noted. CONCLUSION: Both the formulations are equally effective.