Lepa Chikitsa in Ayurveda: A Critical Appraisal of Classical Concepts and Contemporary Therapeutic Relevance

Ayurveda, the traditional system of medicine of India, emphasizes a holistic approach to disease management through internal and external therapeutic modalities. Among the external therapies (Bahya Karma), Lepa Chikitsa-the topical application of medicated herbal pastes-holds a significant place in the management of various inflammatory, painful, and dermatological conditions. Classical Ayurvedic texts, particularly Sushruta Samhita, describe Lepa as Adhya Upakrama and Pradhanatama Upakrama for the treatment of Sarva Shopha (all types of inflammation), highlighting its therapeutic importance. Objective: To critically appraise the classical concepts, principles, indications, methods of application, and contemporary therapeutic relevance of Lepa Chikitsa in Ayurvedic practice. Methods: “This review was conducted using classical Ayurvedic texts including Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, and Sharangadhara Samhita. Relevant references on Lepa formulations were compiled and analyzed. Secondary data from modern databases (PubMed, Scopus) were also reviewed to understand transdermal drug delivery correlations”. Key Findings: Classical literature describes different types of Lepa based on their therapeutic indications, ingredients, and methods of preparation. Lepa acts by alleviating vitiated Doshas, reducing inflammation, pain, swelling, and stiffness, while promoting tissue healing. Contemporary studies suggest that transdermal absorption of phytoconstituents, local anti-inflammatory effects, improved microcirculation, and analgesic properties may contribute to its clinical efficacy. Lepa has demonstrated promising utility in musculoskeletal disorders, inflammatory conditions, skin diseases, traumatic injuries, and other localized pathologies. However, robust clinical evidence and standardized treatment protocols remain limited. Conclusion: Lepa Chikitsa is a valuable external therapeutic modality in Ayurveda with a strong classical foundation and promising contemporary relevance. Integrating traditional knowledge with scientific validation through well-designed clinical studies may further establish its role as an effective, safe, and evidence-based treatment approach in integrative healthcare.