ANCIENT CONCEPT IN THE MANAGEMENT OF HYPERTROPHIC SCAR AND KELOID

Dr. Suman Yadav* and Dr. Sudeep Tiwari

ABSTRACT

The Keloid and Hypertrophic scar are wound healing disorders. These disorders occur during phase of proliferation and remodelling in wound healing. In Hypertrophic scar, there is excess scar but it will not extend beyond the margins of the scar of original wound where as in Keloid persistent excessive growth of scar beyond its margins into the adjacent skin. Although various attempts has been made to understand the exact patho –physiology, molecular abnormalities and treatment of Hypertrophic scar and Keloid but it is yet to be determined clearly. So, it is high time for us to explore and validate the ancient concept of the texts. Even though there are many treatment modalities for Hypertrophic scar and Keloid but the recurrence rate is very high despite of the present ways of treatment. In Ayurvedic text, Acharya Sushruta mentioned many procedures for the treatment of Vrana vastu (can be correlated to Hypertrophic scar and Keloid) which are known as Vaikratapaham/ warding off the abnormalities. Term „Vaikratapaham’ is formed by two words „Vikrati’ and „Apaham’ means to remove the deformity formed after wound healing.At present we believe that the following combination of therapeutic procedures in a definite sequence will most reliably achieve a complete cure i.e. prophylactic as well as curative treatment for Hypertrophic scar and Keloid. These therapeutic procedures are Snehana/oleation, Swedana/fomentation, Vranabasti/oil pooling on scar, Pratisarana/ rubbing, Patradan/covering with leaf, Avasadana/ removal of granulation tissues, Kshar karma/ caustic application and Pandu karma/ bring to normal skin colour etc. The prophylactic treatment includes Shamana therapy while in curative treatment we can choose Shodhana therapy as well as Shamana therapy.

Keywords: Keloid, Hypertrophic scar, Vrana vastu, Shamana, Shodhana, Dosha.