The Argument for combining Ayurveda, Personalized Medicine, and Dermatology
Ayurveda, Personalized Medicine, and Dermatology
As a NYC Dermatologist I see a diverse population of patients with whom I apply the Ayurvedic principles to address their skin conditions. What does this mean? I look at their skin condition as an imbalance in their overall health, and treat that imbalance with relevant dermatology prescription medications and procedures, and discuss lifestyle shifts in diet, fitness, over the counter topicals and supplements to compliment these medications. For example, if someone presents with rosacea, that imbalance is an increase in inflammation and heat in their body, I can treat this with a prescribed topical cream, a red-reducing cosmetic laser, and then I talk about eating less rosacea trigger foods such as hot drinks, spicy food, or alcohol. I recommend supplements and meditation to deal with stress that could be worsening the rosacea, advise what types of physical activity to avoid like hot yoga, and what over the counter face serums or cream ingredients would help like niacinamide or green tea extract, and suggest taking Zinc which helps with the inflammation. Read on for a deeper dive into what Ayurveda is, the emerging scientific evidence behind it, and how I apply it to my patients.
Introduction
Ayurveda is an ancient form of medicine that has been used for thousands of years in India. It is unique in that it uses a whole-body approach, and sees parallels between disease, body type, personality, diet, fitness and reaction to stress. It puts emphasis on gut health and digestion. Western medicine is catching up to, and proving Ayurvedic principles. We are learning via evidence based medicine that what we put into our bodies plays a large role in our health and genetic expression, and that there are indeed three subtypes of people, which in Ayurveda are characterized as “Doshas,” that have been identified in genetic studies under three genetic patterns, and in the fitness world as the three body types: ectomorph, mesomorph, and endomorph correlating with Vata, Pitta, and Kapha.
What is Ayurveda
Here is an oversimplified summary of Ayurveda: Every person is at their baseline some balance of the three doshas. These are Vata (air, space), Pitta (fire, earth), and Kapha (earth, ether). When one of these goes out of balance, say too much Pitta from increased heat (could be from a hot summer day, spicy food, pent up anger), disease happens. In the case of too much Pitta, that could be heat stroke, GERD, and/or a red and inflamed face.
Evidence Based Medicine
A genome wide SNP (single nucleotide polymorphism) analysis looked at people across all ethnicities and saw people clustered into 3 groups according to their genetic makeup, there were 52 SNPs that were significantly different between each of the 3 subtypes(1). For example, one group expressed the “PGM1” gene, which is involved in digestion and energy metabolism. In Ayurveda, that group correlates with those with a “Pitta” constitution, where they have strong digestion, high energy, and are more prone to skin conditions with a lot of inflammation like rosacea and that red, angry acne, and they are more likely to get GERD/ heart burn. Another study (2) looked at whole genome expression and what biochemical (bloodwork) correlated, this also found that the population could be grouped into three categories. Those with genetics patterns that fit the “Kapha” traits have higher cholesterol, “Pitta” traits have higher blood levels, and “Vata” traits are the least likely to have high cholesterol or be at risk for heart disease. A third study (3) looked at physical characteristics between the population if they were split into three genetic groupings and found those with Kapha traits tend to have a BMI over 25 (overweight), and those with Vata traits tend to have a BMI less than 20 (underweight).
Ayurveda and Skin
Let’s apply Ayurveda to skin. Knowing what your type is helps predict what type of skin issues you will have, genetically, and you can tailor your skin care routine, diet, physical activity, and emotions in such a way to prevent or treat those skin conditions. For the Kapha types, this means you have strong, thick, oily skin, and if your Kapha is out of balance, are more likely to swelling, cystic acne or blackheads, keloids, hidradenitis suppurativa, and skin infections. You are the caring, supportive friend who is a social butterfly. You can be stubborn, and when faced with stress can binge eat, retreat or lose motivation. Lifting weights bulks you up but HIIT and cardio slim you down. You need thinner creams, a toner, astringent serums, strong exfoliators. For the Pitta type, you have sensitive, somewhat oily skin, and when your Pitta is out of balance you get gray hairs, reactive skin, red acne, or rosacea. You are ambitious and hardworking, when faced with stress you may get angry, or act without thinking, You are naturally athletic. You need calming, cooling skin care products that will help chill your skin out, like a good mask, creams, a light exfoliator. If you are Vata, you have thin, dry skin. You are creative, a dreamer, and love multi-tasking. You are more likely to have eczema, hair loss, brittle nails, and are more susceptible to wrinkles and signs of aging. Stress can lead to anxiety and worry. You need a thick moisturizer, hydrating serums, need to exfoliate less often than the rest or find one that is more gentle, and sunscreen needs to be your best friend. You stay thin and have a small frame but it can be difficult for you to pack on muscle.
Diet and Lifestyle
These examples are three extremes where a person is all kapha, all pitta, or all vata but in reality we all have a little of each, and any one of these can become out of balance. The beauty in Ayurveda is there is a whole systems approach to bring you back into balance, one that involves prescriptions and OTC supplements and topicals, but also diet. Kaphas need more astringent, bitter, salty, or sour tastes to get back into balance, Pitta needs more cooling, sweet, astringent, bitter tastes to get back into balance, and Vata needs more warm, sweet, salty, or sour foods to get back into balance. Spices that are added to flavor foods fall into these “Taste” categories and can tailor a meal according to what is out of balance. Lastly the same principles help everyone keep their balance in the face of stress, or in the Ayurvedic texts, have strong “Ojas”- that is sleep, nutritious diet, stress management, and sense of community.
Sources
1 Govindaraj P, Nizamuddin S, Sharath A, Jyothi V, Rotti H, Raval R, Nayak J, Bhat BK, Prasanna BV, Shintre P, Sule M, Joshi KS, Dedge AP, Bharadwaj R, Gangadharan GG, Nair S, Gopinath PM, Patwardhan B, Kondaiah P, Satyamoorthy K, Valiathan MV, Thangaraj K. Genome-wide analysis correlates Ayurveda Prakriti. Sci Rep. 2015 Oct 29;5:15786. doi: 10.1038/srep15786. PMID: 26511157; PMCID: PMC4625161.
2 Prasher B, Negi S, Aggarwal S, Mandal AK, Sethi TP, Deshmukh SR, Purohit SG, Sengupta S, Khanna S, Mohammad F, Garg G, Brahmachari SK; Indian Genome Variation Consortium, Mukerji M. Whole genome expression and biochemical correlates of extreme constitutional types defined in Ayurveda. J Transl Med. 2008 Sep 9;6:48. doi: 10.1186/1479-5876-6-48. PMID: 18782426; PMCID: PMC2562368.
3 Rotti H, Raval R, Anchan S, Bellampalli R, Bhale S, Bharadwaj R, Bhat BK, Dedge AP, Dhumal VR, Gangadharan GG, Girijakumari TK, Gopinath PM, Govindaraj P, Halder S, Joshi KS, Kabekkodu SP, Kamath A, Kondaiah P, Kukreja H, Kumar KL, Nair S, Nair SN, Nayak J, Prasanna BV, Rashmishree M, Sharanprasad K, Thangaraj K, Patwardhan B, Satyamoorthy K, Valiathan MV. Determinants of prakriti, the human constitution types of Indian traditional medicine and its correlation with contemporary science. J Ayurveda Integr Med. 2014 Jul;5(3):167-75. doi: 10.4103/0975-9476.140478. PMID: 25336848; PMCID: PMC4204287.
