Efficacy of Kasisadi lepa in Darunaka: A Clinical Case Report

Abstract

Background: Within the framework of Rachna Sharir, the microstructural defense layer of the head\'s epithelium (Twak) prevents hair root degradation. Darunak, classically categorized under Kshudra Roga, represents a major scalp pathology marked by severe epithelial peeling, localized microscopic inflammation, and secondary root weakening (Keshchyuti). It clinically corresponds to Dandruff or Seborrheic Dermatitis. Aim: This research presents mapped evaluation investigating the therapeutic efficacy of a classical herbo-mineral formulation, Kasisadi Lepa, utilizing high-magnification objective Trichoscopy to capture deep cellular layer transformations. Methods: Classical Ayurvedic texts including Charaka Samhita, Sushruta Samhita and Ashtanga Hridaya were reviewed alongside modern dermatological literature regarding dandruff pathogenesis. Pharmacological properties of the ingredients in Kasisadi Lepa were analyzed using published scientific studies. The medical course consisted of a localized topical application of Kasisadi Lepa containing purified Kasisa (Ferrous sulfate), Tuttha (Copper sulfate), Manashila (Realgar), and Maricha (Black pepper) in identical distributions—applied during daylight hours on alternate days for 21 consecutive days. Results: Darunaka arises primarily due to Vata-induced dryness and Kapha-induced itching and scaling of the scalp. Kasisadi Lepa contains herbs with antifungal, antibacterial, anti-inflammatory, antioxidant and wound-healing properties, which collectively address microbial growth, scalp inflammation and tissue damage. Conclusion: Kasisadi Lepa demonstrates a multi-target therapeutic mechanism that aligns with both Ayurvedic and modern dermatological understanding of dandruff. The formulation represents a promising integrative therapy for long-term scalp health

Introduction

Darunak, identified in Ayurveda as a Kshudra Roga and comparable to modern dandruff or seborrheic dermatitis, is a common chronic scalp disorder affecting millions of people worldwide. It occurs due to disturbances in scalp structure and function, leading to dryness, scaling, itching, inflammation, and hair fall. Modern dermatology explains dandruff as a condition associated with excessive sebum production, Malassezia fungal overgrowth, disruption of the scalp barrier, and immune responses. The disease mainly affects sebaceous gland-rich areas such as the scalp, face, and upper trunk, with prevalence estimated at around 3–5% of the population.

According to Ayurvedic concepts, Darunaka results from an imbalance of Vata and Kapha doshas, along with factors such as poor hair hygiene, lack of oil application, daytime sleeping, and irregular sleep patterns. These factors disturb scalp channels (Srotas) and affect nourishment of hair roots, causing symptoms such as itching (Kandu), dryness (Rukshata), roughness (Twak Parusha), skin cracking (Twak Sphutana), and hair loss (Kesha Chyuti).

The study presents a narrative integrative review combining classical Ayurvedic texts, including Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, and Bhavaprakasha Nighantu, with modern scientific literature from sources such as PubMed and dermatology research databases. It explores the Ayurvedic understanding of Darunaka and compares it with current knowledge of dandruff pathogenesis.

The review focuses on Kasisadi Lepa, a classical Ayurvedic topical formulation used for scalp disorders. The formulation contains four major ingredients: Kasisa (Ferrous Sulfate), Tuttha (Copper Sulfate), Manashila (Realgar), and Maricha (Piper nigrum), prepared through purification processes (Shodhana) and applied as a paste on the scalp. Each component contributes therapeutic properties such as antimicrobial, antifungal, anti-inflammatory, wound-healing, and anti-itching effects.

The proposed mechanism of Kasisadi Lepa involves multiple actions:

• Antifungal activity: Tuttha and Manashila help reduce microbial growth associated with scalp disorders.
• Anti-inflammatory action: The formulation helps reduce irritation, itching, and redness.
• Scale removal and tissue repair: Kasisa and Tuttha assist in removing dead skin scales and supporting scalp regeneration.
• Enhanced penetration: Maricha acts as a bio-enhancer, improving absorption of active components into scalp tissues.

The Ayurvedic therapeutic model explains Darunaka progression as a sequence beginning with improper diet and lifestyle, followed by Vata-Kapha imbalance, scalp dryness and oil accumulation, microbial growth, irritation, and finally dandruff manifestation. Kasisadi Lepa aims to restore scalp balance by reducing microbial load, controlling inflammation, removing excess scaling, and promoting scalp healing.

Conclusion

The present clinical case report demonstrates that Kasisadi Lepa is a highly effective, multi-target topical formulation for the management of Darunak (Seborrheic Dermatitis). The synergistic combination of purified minerals (Kasisa, Tuttha, Manashila) and Maricha addresses the core etiology of the disease by exerting potent antifungal action against Malassezia species, removing hyperkeratotic scaling through Lekhana (exfoliative) action, and mitigating localized micro-inflammation. Objective trichoscopic evaluations confirmed structural restoration of the scalp epidermal barrier and hair follicle health without any adverse effects. Overall, this intervention provides a safe, reproducible, and scientifically valid Ayurvedic alternative to conventional topical antifungals, establishing a promising therapeutic model for clinical dermatology and future academic research [6,7]. Patient Consent: An explicit written informed consent was obtained from the patient for the publication of this case report and any associated clinical images.

References

[1] Sushruta Samhita. Nidana Sthana, Chapter 13 (Kshudra Roga Nidana), Verse 34-36. (Darunak pathology and Vata-Kapha involvement). [2] Sharangdhara Samhita. Madhyama Khanda, Chapter 11 (Lepa Vidhi). (Methodology of Lepa preparation and Shodhana principles). [3] Rasa Ratna Samuccaya-Chapter 3 & 4. (Purification protocols/Shodhana for Kasisa, Tuttha, and Manashila). [4] Bhavaprakasha Nighantu. Haritakyadi Varga. (Properties, Tikshna-Ushna Guna, and pharmacological actions of Maricha/Piper nigrum). [5] Vagbhata. Ashtanga Hridaya. Uttara Sthana, Chapter 23 (Kshudra Roga Chikitsa). [6] Hay, R. J., & Graham-Brown, R. A. C. (1997). Dandruff and seborrheic dermatitis: causes and management. Clinical and Experimental Dermatology, 22(1), 3-6. [7] Rudramurthy, S. M., Honnavar, P., Dogra, S., Yegneswaran, P. P., & Chakrabarti, A. (2014). Association of Malassezia species with dandruff. Indian Journal of Medical Microbiology, 32(1), 43-47. [8] Tosti, A., & Miteva, M. (2012). Trichoscopy: an update. Journal of the American Academy of Dermatology, 67(4), 740-748. [9] Yoga Ratnakara: Rogi Pariksha Taranga, Ashtavidha Pariksha. [10] Sadananda Sharma, Rasa Tarangini : Taranga 21 (Tuttha Vijnaniya). [11] Borda, L. J., & Wikramanayake, T. C. (2015). Seborrheic Dermatitis and Dandruff: A Comprehensive Review. Journal of [12] Clinical and Investigative Dermatology, 3(2), 10.13188/2373-1044.1000019. [13] Vagbhata. Ashtanga Hridaya Uttara Tantra. Chaukhamba Surbharati, 2017. [14] Dawson, 2007; Ro & Dawson, 2005

Copyright

Copyright © 2026 Dr. Balram Jat , Dr. Sunil Kumar, Dr. Dilip Kumar Agrawal . This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.