ABSTRACT:
Acne lesions develop from the sebaceous glands associated with hair follicles—on the face, external auditory meatus, back, chest, and ano-genital area. (Sebaceous glands are also found on the eyelids and mucosa, prepuce and cervix, where they are not associated with hair follicles.) The sebaceous gland contains holocrine cells that secrete triglycerides, fatty acids, wax esters, and sterols as “sebum”. A 19 year old male patient reported with complaints of acne on trunk area. A complete case history was taken, repertorization done & Sulphur as anti-miasmatic followed by Sepia as individualized medicine were given. This case shows the effect of homoeopathic treatment in a case of acne.
KEYWORDS: Homoeopathy, Acne, Sepia, Sulphur, Repertory.
INTRODUCTION:
Acne is a disorder of the pilosebaceous apparatus characterized by comedones, papules, pustules, cysts and scars[1]. Acne is a general term for eruptions of similar morphology produced by a variety of causes. Investigations are rarely required.[5]
PREVALENCE
Nearly all teenagers have some acne (acne vulgaris). It affects the sexes equally, starting usually between the ages of 12 and 14 years, tending to be earlier in females. The peak age for severity in females is 16–17 and in males 17–19 years. Variants of acne are much less common.
ACNE VARIANTS:[2]
This term incorporates special types of acneiform eruptions which need to be treated as separate entities.
Acneneonatorum:
This occurs in newborns, mostly males around 3 months, and may sometimes last up to 5 years of age. These lesions are often seen on the nose and adjacent portions of the cheeks.
Acne excoriee:
In young females, on rare occasions mild Acne is accompanied by extensive excoriations. These excoriations have an emotional basis. The lesions usually leave behind scarring.
Tropical Acne:
It is a severe variant of Acne vulgaris characterised clinically by the presence of large and painful cysts, nodules and pustules, which lead to frequent scarring and tend to localise on the back, nape of the neck, buttocks, thighs and upper arms rather than the face which frequently remains clear.
Drug Acne:
Many drugs have been sown to produce acneiform eruptions. Corticosteroids, both orally and topically may do so. Steroid Acne is usually more monomorphic. Androgens, gonadotrophins and ACTH given early in puberty may precipitate Acne. Anti-epileptic drugs, especially phenytoin, isoniazid, iodides and bromides have also been known to produce acneiform lesions.
Occupational Acne:
Many oils and tars produce acneiform eruptions at the site of contact with the skin. Acne at the wrong site and wrong age coupled with history of exposure to oils or tars suggest the diagnosis of occupational Acne. Contact with heavy oils, waxes, cutting oils and chlorinated hydrocarbons occurs universally among workers involved in the operation of machinery.
Acne conglobata:
It is almost always found in men during late puberty and continues into later life. It is characterised clinically by the presence of comedones, papules, pustules, nodules, cysts, sinuses and severe scarring on the chest, shoulders, back and posterior neck. The course of the disease is chronic and the prognosis is poor. Aggressive long-term antibiotic therapy supplemented with oral glucocorticosteroids might help in these patients.
ACNE TYPES:[3]
- Whiteheads: These remain under the skin and are small in shape.
- Blackheads: Clearly visible, they are black and appear on the surface of skin.
- Papules: Small, usually pink bumps, visible on the surface of skin.
- Pustules: Red, pus-filled pimples.
- Nodules: Large solid painful pimples that are embedded in the skin.
- Cyst: Painful, pus-filled pimples on the surface of skin.
CASE STUDY:
Mr. Xx, 19 years old married, Hindu male from middle socio-economic status reported at my clinic, a known case of acne with itching on trunk. Complaints had started gradually 2 years ago. He took allopathic medication orally and as external application applies many ointments.
Presenting complaint:
- Acne with itching on trunk.
- Severe itching which increases in daytime & during perspiration.
- Redness & dryness present.
Clinical Finding:
- Papule type of acne seen on trunk of body. It looks like red bumps on the skin.
Past History:
- Malaria (2 times) 10 years ago & 9 years ago.
- Constipation 7 years ago.
- Tinea corporis 4 years ago.
PHYSICAL GENERAL:
Averse to milk. Unrefreshing sleep. Thirsty. Thermal reaction of the patient: ambithermal.
MENTAL GENERAL:
Patient was timid and fearful. He is also angry in nature especially when he thinks about his past events. Dreams are specific: Falling from heights & amorous with pollution. Didn’t take interest in anything. Brooding nature.
ANALYSIS OF CASE
MENTAL GENERALS:
- Cowardice
- Anger on past event.
- Indifference
- Brooding
Dream:
- Falling from heights & amorous with pollution.
PHYSICAL GENERALS:
- Aversion milk.
- Unrefreshing sleep.
- Thirsty
- Ambithermal
PARTICULAR GENERAL:
- Acne on trunk area
- Acne: papule, redness, itching
Modalities:
- Aggravation: daytime & during perspiration.
Evaluation:
Cowardice
Anger on past events
Dream: Falling from heights & amorous with pollution.
Aversion – milk
Thirsty
Ambithermal
Acne papule, redness with itching on trunk area
Aggravation: daytime & during perspiration
RUBRIC:
| S. No. | CHAPTER | RUBRIC |
| 1. | MENTALS | ANGER, past events, about |
| 2. | MENTALS | COWARDICE |
| 3. | MENTALS | DREAMS falling high places, from |
| 4. | MENTALS | DREAMS amorous pollutions, with |
| 5. | SKIN | ERUPTIONS pimples itching |
| 6. | MOUTH | CLEAN, clear satiety |
| 7. | STOMACH | APPETITE easy satiety |
| 8. | PERSPIRATION | HEAD, general perspiration except the |
| 9. | GENERALS | FOOD and drinks milk aversion |
| 10. | GENERALS | Daytime agg. |
| 11. | GENERALS | PERSPIRATION agg. during |
REPERTORY SHEET:[4]
Figure 1 Showing repertorization of case from Complete Repertory using Cara Professional (Version 1.4)
ANALYSIS OF REPERTORIAL RESULT:
| S.No. | Medicine | Mark |
| 1. | SEPIA | 20/11 |
| 2. | SULPHUR | 19/11 |
| 3. | NUX VOMICA | 13/8 |
| 4. | CALCAREA CARBONICA | 9/7 |
Selection of Medicine:
It was astonishing to note that the two medicines, SULPHUR and SEPIA that emerged out after repertorization, covered almost similar marks 20/11 and 19/11 respectively. Both the medicines covered all the 11 rubrics. Both the medicines were considered important for curing the patient.
Symptoms like eruptions, itching and burning, redness and sweat aggravation are main characters of Sulphur, whereas, Sepia was also also considered important because Sepia covered very important mental symptoms of indifference and brooding nature. Keeping in view the nature and condition of the patient, the treatment was started by giving an anti-psoric[6] medicine Sulphur as the psora[6] miasm was prominen,t followed by Sepia.
PRESCRIPTION:
| Date | Symptoms | Prescription |
| 17/05/2017 | Acne n trunk area.
Redness & itching. Advice: – To apply coconut oil on eruptions – Maintain hygiene |
Sulph 200 1 Dose Stat.
Sepia 30 TDS 4 hourly *15 Days |
FOLLOW UP:
| Date | Symptoms | Prescription |
| 01/06/2017 | Status quo | Sepia 30 TDS 4 hourly * 15 Days |
| 14/06/2017 | New eruption not seen. | Sepia 30 TDS 4 hourly * 30 Days |
| 07/07/2017 | Eruption gradually decreasing
Redness reduced Itching persists |
Rubrum 30 TDS 4 hourly * 30 Days |
| 28/07/2017 | Eruption gradually decreasing
Itching slightly decreased |
Rubrum 30 TDS 4 hourly * 30 Days |
| 24/08/2017 | Improvement. | Rubrum 30 TDS 4 hourly *15 Days |
| 08/09/2017 | Improvement. | Rubrum 30 TDS 4 hourly * 15 Days |
| 21/09/2017 | Improvement. | Rubrum 30 TDS 4 hourly * 15 Days |
| 05/10/2017 | Improvement. | Rubrum 30 TDS 4 hourly * 30 Days |
Picture:
| BEFORE | AFTER | |
 |
 |
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CONCLUSION:
Homoeopathy always gives best results in skin diseases. This case shows the effective role of homoeopathy in the treatment of acne.
REFERENCE:
- Hunter j., Savin J., Dahl M., Clinical Dermatology, third edition, blackwell publishing, 2002.
- Sainani G.S., Abraham, Dastur F.D., Abraham P, Dastur FD, Joshi VR, et al. A.P.I. Text Book of Medicine. 6th Association of Physicians of India Mumbai, 1999.
- https://www.drbatras.com/different-types-of-acne-and-their-homeopathic-remedy
- Complete Repertory, Cara V1.4.
- Davidson’s, (2018). Principles and Practice of Medicine. (23rd): ELSEVIER Ltd.
- Hahnemann SCF, The Chronic Disease and their Peculiar Nature and their Homoeopathic Cure, B Jain Publisher (P) , New Delhi, 2002.
