External Application of Lodhra (Symplocos Racemosa) Paste with Mahamanjishthadi Ghana Vati in Mukhadushika (Acne Vulgaris): A Randomised Controlled Clinical Trial

Introduction: Acne vulgaris, a common skin disease affecting younger adults, is generally managed by antibiotics, antiseborrheic agents, hormonal therapy, and topical applications. In ayurveda, this disease is described as Mukhadushika, characterised by minute thorn-like eruptions. Its treatment includes both internal administration and external application of blood-purifying drugs. Aim: To evaluate the effect of external application of Lodhra (Symplocos Racemosa) paste adjuvant to Mahamanjishthadi Ghana Vati (MGV) herbal tablet internally in acne vulgaris. Materials and Methods: An open-label, randomised controlled clinical trial was conducted between March 2023 to June 2024, at Karnataka Lingayat Education (KLE), Ayurveda Hospital, Belagavi, Karnataka, India. A total of 50 patients of either sex, aged between 16-40 years, were assessed using the Mukhadushika Roopa (symptom) assessment score and Global Acne Grading Scale (GAGS), and were randomised into two groups. Both group A (control, n=25) and group B (intervention, n=25) were administered MGV herbal tablet (500 mg) orally, twice daily, for 30 days. Patients in group B were additionally treated with the external application of Symplocos Racemosa paste. The Dermatology Life Quality Index (DLQI) of the participants was also assessed. Study outcomes were assessed using Mukhadushika Roopa (symptoms) and GAGS on baseline, on 15th and 30th day, whereas DLQI was assessed at baseline and 30th day. Statistical results were evaluated through the MannWhitney U test and the Wilcoxon signed-rank test. A p-value of <0.05 was considered statistically significant. Results: Both groups showed significant improvement in all three parameters after 30 days of intervention (p-value <0.001). On intergroup comparison, Symplocos Racemosa paste showed better improvement in symptoms of acne vulgaris (p-value <0.001). Conclusion: External application of Lodhra (Symplocos Racemosa) paste, as an adjuvant to MGV herbal tablets, appears more beneficial than internal administration of MGV herbal tablets alone in acne vulgaris.