Abstract

A COMPREHENSIVE REVIEW OF TWAKARSH (SKIN OUTGROWTH) WITH SPECIAL REFERENCE TO PAPILLOMA: HOLISTIC MANAGEMENT IN AYURVEDA

Dr. Sampurna Nand Prajapati*, Dr. Kapil, Dr. Tejaswini Jagannath Haryan

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Abstract

Cutaneous outgrowths, clinically manifesting as warts or papillomas, are a common dermatological concern caused by the Human Papillomavirus (HPV). In Ayurveda, such conditions are primarily classified under the broad term Twakarsha which literally translates to "roughness or outgrowth of the skin." Despite their often-benign nature, their persistent, recurrent, and sometimes cosmetically distressing presentation necessitates effective management. Objective - This review aims to systematically correlate the Ayurvedic concept of Twakarsha with modern dermatological understanding of papilloma, analyze its etiopathogenesis (Nidana, Doshic Dushti, Samprapti), and critically evaluate the holistic treatment modalities described in classical texts including Shodhana (bio-purification), Shamana (palliative care), and topical interventions. Methods - A meticulous search of classical Ayurvedic texts including Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya and their principal commentaries was conducted to compile data on Twakarsha. Contemporary medical literature from databases like PubMed, Google Scholar, and DHARA was also reviewed to establish a clinicopathological correlation. Results - Twakarsha is primarily a disorder of Tridosha with a strong predominance of Kapha and Vata Dosha, vitiating the Twaka (skin), Mamsa (muscle tissue) and Rakta (blood) Dhatus. Its Samprapti (pathogenesis) involves the formation of Granthi (cystic swellings) or Arbuda (neoplasms). Ayurvedic management is multifaceted. Shodhana therapies, especially Virechana (therapeutic purgation) and Raktamokshana (bloodletting) are indicated for deep-rooted purification. Conclusion - Ayurveda offers a robust, holistic paradigm for managing Twakarsha/papilloma by addressing the root cause (Moola Chikitsa) through Doshic balance and Dhatu purification, rather than mere local destruction.

Keywords: Twakarsha, Papilloma, Charmakeela, Raktamokshana, Shodhana, Shamana.