Baraṣ (Vitiligo) in Historical and Unani Literature: A Comprehensive Review

Baraṣ (Vitiligo) is a chronic depigmentary disorder marked by well-demarcated glossy white macules due to selective loss or dysfunction of melanocytes, causing significant psychosocial morbidity despite being nonfatal. The review traces historical descriptions of Baraṣ across Unani, Ayurvedic, GrecoRoman and other classical texts, and synthesizes classical Unani concepts including Fasād al-Dam, Balghami Ghalīẓ, weakness of Quwwat-i Mughayyira/Mushabbiha/Dāfi‘a, and prognostic signs such as bleeding on pricking with contemporary pathophysiological models (autoimmune, neural, oxidative stress, genetic susceptibility and convergence theory). Clinical classification parallels modern nosology (nonsegmental, segmental, mixed), while Unani subtypes (Baraṣ-i Uẓmā, Baraṣ-i Muntashir) emphasize depth and chronicity of humoural involvement. Diagnosis relies on clinical examination complemented by Wood’s lamp, targeted laboratory screening for associated autoimmune disorders (notably thyroid disease), and, when indicated, biopsy. Therapeutic strategies integrate Unani principles Tanqiya-i Badan, Ta’dili Mizāj, Islāhi Haḍm, topical Jālī/Muḥammir/Musakhkhin agents, and regimental therapies with evidencebased modern treatments such as topical corticosteroids, calcineurin inhibitors, NBUVB phototherapy, and surgical grafting for stable lesions. The review highlights areas of concordance (sun exposure/psoralen use historically and in PUVA), identifies limitations in prognostication, and advocates for rigorous clinical trials to evaluate Unani single and compound formulations alongside conventional modalities. Integration of traditional Unani approaches with modern dermatological care may offer a holistic, patientcentred pathway for managing Baraṣ, but requires standardized protocols and safetyefficacy data. Keywords: Vitiligo, Baraṣ, Unani Medicine, PUVA