1*PhD Scholar, Department of Basic Principles, Institute of Teaching and Research in Ayurveda (ITRA), Jamnagar, Gujarat, India- 361008. Email: dsrananavare333@gmail.com. Address for Correspondence: Department of Basic Principles, Third floor, Institute Building, Institute of Teaching and Research in Ayurveda (ITRA), Opposite City 'B' division Police Station, Opposite Reliance Smart, Gurudwara Road, Jamnagar, Gujarat, India- 361008. Mob- 9764271613.
2Professor, Department of Basic Principles, Institute of Teaching and Research in Ayurveda (ITRA), Jamnagar, Gujarat, India- 361008. Email: shubhangikamble@itra.edu.in
3Assistant Professor, Department of Dravyaguna, R. A. Podar Medical College (Ayu.), Worli, Mumbai, Maharashtra, India- 400018. Email: drsantosh231@gmail.com
Received: 12th Dec, 2025; Revised: 12th Feb 2026; Accepted: 13th Feb, 2026; Available Online: 10th March, 2026
Title: "Efficacy of Ayurvedic Interventions in the Management of Mukhadushika (Acne Vulgaris): A Systematic Review and Risk of Bias Assessment".
Background: Mukhadushika (Yuvanpidika), correlated with acne vulgaris, is a common dermatological condition, especially in adolescents and young adults. It not only affects physical appearance but also contributes to psychological distress. Ayurveda offers a multidimensional approach to treatment, including Shamana (oral medicines), Shodhana (Panchakarma), Jalaukavacharana (leech therapy), Nasya, and Lepa (external applications).
Objectives: The primary objective of this review is to critically evaluate the Ayurvedic interventions used in the management of Mukhadushika, with a focus on therapeutic trends, efficacy, and risk of bias.
Methods: Eligibility Criteria: Clinical trial evaluating Ayurvedic treatments for Mukhadushika were included. Studies that focused on Ayurvedic therapies like Shamana, Shodhana, Jalaukavacharana, Nasya, Lepa, or combined therapies were included. Studies without full text or those not related to Ayurveda were excluded. Information Sources: Studies were identified through databases including PubMed, Scopus, Web of science, Google scholar, AYUSH research portal, DHARA, J gate, ARD and UGC CARE, with the last search conducted on 08.10.2025. A total of 6,48,410 records were initially identified from database searches across Pubmed (3), Scopus (95,083), UGC care(69,423), Web of Science(87,644), google scholar (3,86,967), Ayush Research Portal(31), J Gate(9,259) After removing duplicates, 3,12,224 records remained for screening. Following title and abstract screening, 339 records were excluded. A total of 71 full-text articles were assessed for eligibility. Ultimately, 19 studies were included in the qualitative synthesis of this systematic review. Risk of Bias: Risk of bias was assessed on domains adapted from the Cochrane Risk of Bias tool and narrative appraisal suited to Ayurvedic clinical. Synthesis of Results: Descriptive analysis was conducted to present the frequency and proportions of various Ayurvedic interventions. Due to the diverse study designs, no meta-analysis was performed.
Results: A total of 19 studies were included, comprising 19 clinical trials. These studies investigated a variety of Ayurvedic interventions. Shamana interventions were the most common (57.8%), followed by Lepa (31.5%) and combined therapies (42.1%).
Synthesis of Results: The synthesis revealed that integrated therapies combining systemic and local treatments yielded the best results in treating Mukhadushika. The effectiveness of Shamana therapies, such as oral medications, and external treatments like Lepa, was consistently reported.
Discussion: The Ayurvedic management of Mukhadushika is multidimensional, involving both systemic (Shamana, Shodhana) and local (Lepa, Jalaukavacharana, Nasya) approaches. However, limitations include small sample sizes, inconsistent study designs, and variations in intervention protocols. These factors may introduce bias and affect generalizability.
Interpretation: Ayurvedic treatments for Mukhadushika, particularly integrated therapies targeting both systemic doshic imbalances and local manifestations, show promising results. However, larger-scale trials with standardized protocols are necessary to confirm findings and improve study quality.
Funding: Nil
Registration: This systematic review was registered with PROSPERO with the registration number: CRD420250465129.
Keywords: Acne vulgaris, Ayurvedic management, Mukhadushika, Herbal formulations, Risk of bias, Systematic review.
How to cite this article: Shivaji RD, Kamble S, Kadam S. Efficacy of Ayurvedic Interventions in the Management of Mukhadushika (Acne Vulgaris): A Systematic Review and Risk of Bias Assessment. Int J Drug Deliv Technol. 2026;16(3): 522-541. DOI: 10.25258/ijddt.16.3.60
Source of support: Nil.
Conflict of interest: None