Alteration in Asbāb-e-Sitta Ḍarūriyya (Six Essential Factors) for the Prevention of Buthūr Labaniyya (Acne Vulgaris): A Narrative Review of Unani and Contemporary Perspectives

Acne vulgaris (Buthūr Labaniyya) is a prevalent chronic inflammatory disorder of the pilosebaceous unit, commonly affecting adolescents and young adults. The condition often leads to significant psychosocial distress and impaired quality of life. In the Unani system of medicine, Buthūr Labaniyya is attributed to humoral imbalance and disturbances in Asbāb-e-Sitta Ḍarūriyya, the six essential prerequisites for maintaining health. Classical Unani scholars emphasize disease prevention through regulation and moderation of these factors before initiating pharmacological treatment, aiming to restore systemic balance and limit drug dependency. This narrative review examines the role of alterations in Asbāb-e-Sitta Ḍarūriyya in the prevention and management of acne vulgaris by integrating evidence from classical Unani texts with contemporary understanding of acne pathophysiology. The review highlights lifestyle and dietary modifications as supportive, non-pharmacological strategies that may complement conventional acne management and contribute to a holistic therapeutic approach. Keywords: Acne vulgaris; Buthūr Labaniyya; Unani medicine; Asbāb-e-Sitta Ḍarūriyya; Lifestyle modification