External Application of Varuna (Crataeva nurvala Buch-ham) Patra Kalka with Ghrita after the Gomaya Gharshana versus Varuna Patra Siddha Ghrita versus Manjistha Ghrita in the Management of Striae Gravidarum: A Research Protocol for a Three Arm Study

Introduction: Ayurveda emphasises both preventive and curative aspects of disease, with an extensive repertoire of treatments, including those with cosmetic applications. Striae gravidarum, a prevalent dermatological condition, affects 75- 90% of pregnant women globally. In Ayurveda, striae gravidarum is referred to as “Kikkisa,” and is attributed to the stretching and tearing of the skin during pregnancy. Need of the study: Many cosmetic products and procedures claim to improve the appearance of striae; however, most merely alter superficial appearance rather than addressing the underlying physical characteristics of the condition. In some cases, they may even lead to undesirable side effects. Therefore, there is a pressing need to explore safe and reliable treatments grounded in Ayurveda. The external application of Varuna (Crataeva nurvala Buch-Ham) patra kalka with ghrita, following gomaya gharshana, holds significant potential and is supported by classical textual references for use in the management of striae gravidarum (Kikkisa). Despite this, the formulation has not yet been thoroughly evaluated. Hence, the present study aims to document and establish the specific therapeutic effects of this Ayurvedic remedy in the management of striae gravidarum, emphasising both safety and Ayurvedic principles. Aim: The aim of the present comparative study is to evaluate the efficacy of external application of Varuna (Crataeva nurvala Buch-Ham) leaf paste with ghee after cow dung rubbing; Varuna leaf medicated ghee; and Manjistha medicated ghee in the management of striae gravidarum. Materials and Methods: The present interventional, openlabelled, randomised controlled trial will employ a three-arm study design from June 2025 to September 2026 at Mahatma Gandhi Ayurved College, Hospital and Research Centre, Salod (Hirapur), Wardha, Maharashtra, India. Sixty female participants aged 25-45 years with a history of striae gravidarum will be randomly assigned to one of three treatment groups. Group A: Varuna patra kalka with ghrita after gomaya gharshana; Group B: Varuna patra siddha ghrita, and Group C: Manjistha ghrita. Treatments will be administered over 8 weeks, with biweekly assessments. Parameters will include subjective evaluations {such as kandu (itching), vidaha (burning sensation), twak bheda (skin tearing), rekha swaroopa / twak sankocha (linear stretch marks), and vaivarnya (discolouration)}, and objective assessments {such as photographic documentation, lesion count, lesion dimensions, and the Patient Scar Assessment Scale (PSAS)}.