Clinical Cases

A Case of Acne Vulgaris

Written by Pravin Pente

Dr. Pravin Pente presents a case of acne vulgaris and depression.

Name: N. D. I.

Date: 18/12/2008

Female – Age 24



Acne Vulgaris Since 4 Yrs. – Severe and disfiguring

Presenting Complaint:

As she entered my cabin she said that this is the last acne (Homeopathy for Acne) treatment for her. If it will not help, then she will commit suicide.  She had the problem of acne on her face for 4 years.  She feels pain, burning sensation and throbbing pain in acne. There is pus formation in the acne, so she breaks the lesions herself and they are bleeding.  The acne is more on the right side of her face. She could not move her neck on the left side because of the pain in the acne.

She starts weeping while narrating symptoms. She said she has the capacity to bear any kind of pain. ( Main bahot dukh sahan kar sati hoon -I can tolerate all kinds of sorrow). She said: because of her problem she doesn’t like to go outside and avoids meeting anyone and even talking with her friends.  She has no interest in anything. If she went out of her home then everyone would ask about her illness.

“I also start hate myself.  I can’t see my face in the mirror and used to weep all the time.”  For the last month she didn’t see her face in a mirror. She tried all kinds of treatment but to no avail.

Weeping during narrating symptoms then within a second she started laughing and said, “Why is this thing happening to me only? Why did God give me this type of life?”

Just after her birth, her parents stopped communicating with each other.

Main hi ku badnasib hoon Dr. sahab



She is a very happy girl.

She likes to laugh all the time,

Even during narrating the symptoms she can’t control her laughing and because of her laughing, her brother scolds her all the time and then she starts weeping.

Said that she is very sensitive in nature; she can’t see the pain of others especially of animals feel like weeping,

If someone is not listening to her she gets angry. Usually she gets irritable if anything goes against her and then she becomes abrupt.  In anger she throw things.

“I have many friends but my best friend is very close to me. I share all the things with her- without her I am nothing because I ask her all the time what should I do or not; means right or wrong things.”

When people teases her about her looks and say she will not get a boy for marriage, she gets angry.  She feels she is is the only unfortunate person in her family.

All her problems started after her birth because her parents wanted a son. After her birth there was a big quarrel between her parents and since that her father is not communicating with her, So she thinks that she is the responsible for all. Reproaches herself.  She thinks she is bad luck for everyone.

Headache since 8 yrs

Headache in vertex region.

Throbbing and pulsating type of headache.

Headache followed by vomiting every time and after she felt better.

Aggravation: noise, light, talking,

Amelioration: sleep, dark place.

Menstrual history:

L.M.P. 14/11/08


Flow is blackish profuse and having offensive smell to it.

As the flow increase all pain and complaint decreases.

Pain in abdomen. Lower backache++


Appetite: –  reduced      

Desire: –      cold things+++, sweet+++      

Aversion: – chanadal, sour acid things.                        

Thirst:         thirsty+++

Tongue:      white coated

Urine:         nad

Stool:          constipated

Sleep:          sound..  Laughing During Sleep.

Dreams:      snakes, god

Sweat:         profuse

Thermals: –          hot+

Fear of: –    .snakes

Loves for dogs. If anyone beat dogs or animals then she felt bad and that hurts her.


1)  The main issue in the case is her feelings; in all areas of her life she feels that she is the only unfortunate girl, so she reproaches herself for everything      (her appearance, pain, relation with parents, not getting a boy for marriage, etc.) So UNFORTUNATE FEELING RUNS ALL OVER the case and that’s our genius of the case.

As per sensation method her miasm is Malarial.

2)   She is more concerned about her appearance, beauty. In beauty she is not good enough – also if you see the case properly, she is lacking in many areas of her life – lacking in relation with her parents , lacking in appearance, lacking to be good enough in her own identity, lacking her own choices, dependence on her friend.

So here we can understand that she belongs to a Mineral kingdom,

As there are no qualities of ANIMAL OR PLANT kingdom,

3)  She is ugly looking so she AVOIDs meeting others.  Indifference

For that she reproaches herself.  Anger outbursts on herself so she tries to injured herself by breaking her acne.  Blame herself in every situation.

Suicidal thoughts.

4) The most important point in the caseà

She thinks that she is ugly looking, so she avoids seeing her face in a mirror.

Now just think, is it possible that any woman can keep herself away from the mirror? I think not. So I tried to find a rubric for that.

In Kent’s repertory –

Mind; DELUSIONS, imaginations; wretched, she looks, when looking in a mirror (1)

In Mac repertory

Mind; DELUSIONS, imaginations; wretched, she looks, when looking in a mirror (8)

The whole story moves around the unfortunate feeling





-injured herself

-suicidal tendency

– brooding on thoughts

– reproaches herself

June 2016 Pravin Pente1


mind; WEEPING, tearful mood; alternating with; laughing (59)

mind; SUICIDAL disposition (202)

mind; LOATHING; life, of (101)

mind; INDIFFERENCE, apathy (551)

mind; REPROACHES; oneself (92)

mind; UNFORTUNATE, feels (33)

mind; MUTILATE his body, tendency to (41)

mind; DELUSIONS, imaginations; wretched, she looks, when looking in a mirror (8)

mind; HELPLESSNESS (121)

mind; COMPANY; aversion to (376)

mind; HOPEFULNESS (63)

mind; DREAMS; snakes (87)

mind; SENSITIVE, oversensitive (626)

generalities; FOOD  drinks; sweets; desires (249)

generalities; FOOD  drinks; cold; drinks, water; desires (285)

generalities; PAIN; pulsating, throbbing (539)

head; PAIN, headache; sleep; amel. (91)

head; PAIN, headache; noise agg. (158)

In the rubrics above you see Sepia and Natrum muriaticum Nat mur being from the mineral kingdom is our remedy.

Rx:  Nat mur 200, single dose

Note: Before coming to Nat Mur I was giving SEPIA according to the repertory chart but she was not better. To understand Sepia and Nat mur I started reading both the remedies from different books. Then I found the exact matching of the patient and remedy in Soul Of Remedies (Sankara) and I found the  rubric-

mind; DELUSIONS, imaginations; wretched, she looks, when looking in a mirror. Then I started reading more of Sankaran and got a better undertanding of the sensation method.

Dr. Sankaran mentioned in his book Soul of Remedy that in Nat Mur when she looks in the mirror she sees her face as wretched. This is an exact match of patient to the remedy. Kent’s MM also has that.

               SYNERGY METHOD



              June 2016 Pravin Pente2

   SYMPTOMS                                    SYSTEM

-Acne on face                                                          -suicidal tendency

-right> left                                                               -angry on herself

-Pain throbbing                                                      -injured her self

-Pain burning                                                         -unfortunate feeling

-Headache-pulsating                                              -loathing of life

-amelioration by sleep, vomiting                          -identity           

-Aggravation by noise                                            -appearance 

– Weeping alternating with laughing                    -reproaches herself

-desire sweet                                                                                                   

-laughing sleep during                             



Follow up chart

18/12/08 Nat Mur 200+1drx
20/12/08 Acne contains the pus, throbbing pain in that. Suicidal tendency the whole day.

She weeps and wonders why is she is in this world.


She is thinking about suicide.

Irritability increased.

21/12/08 Acne become dry>>, pain reduced, Sl
23/12/08 Acne becomes dry. She visited skin specialist at Amravati adv. antibiotics.

Menses 13/12/08 there was 4 days profuse clotted bleeding blackish in color.

Flow as more as compare to previous,

Offensive smell is less, pain in the back is reduced.

Acne becomes drier than before and it automatically gets removed itself.

She is feeling fresh and better.

27/12/08 Sleep sound, no suicidal thoughts,

Feeling fresh. No pain, right side of face is clear.

1/01/09 She is happy today, almost all acne on face is cured but still mild pain and black spots are there. She started meeting her friends, SL+1drx
7/01/09 Looking good, feeling fresh. Sl+1drx
09/01/09 Toady her face is looking clean only small marks of acne on face but no new acne.

good sleep-

Now there is hope to get married because she said that now “I am looking better than before.” Doing all her daily work, no suicidal thoughts.

21/01/09 There is mild pain in calf muscles-everyone asks me about my health then I feel good.



About the author

Pravin Pente

Dr. Pravin Pente B.H.M.S C.C.A.H. completed his B.H.M.S. from Panchasheel Hom. Medical College Khamgaon in 2006. He did C.C.A.H. from “the other song” International Academy of Advanced Homoeopathy, Mumbai in 2013. He subsequently studied with Dr. Narendra Mehta and Dr.Rajan Sankaran. He began clinical practice in 2008 at Karanja in Vidharbha Region, Maharashtra. Dr. Pente has taken seminars at Jabalpur, Bhopal, Indore through “the other song” and won the Best Case Presentation Award in 2013 and 14. His current focus is more on pathological cases and pediatric cases. He is presently doing an F.C.A.H. fellowship course at “the other song” Academy, Mumbai.

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