Early Integrative Management of Visarpa (Herpes Zoster) with Jalaukavacharana (Leech Therapy): A Case Report
DOI:
https://doi.org/10.70066/jahm.v14i3.2627Keywords:
Case Report, Herpes zoster, Integrative Management, Jalaukavacharana, Leech therapy, Post-herpetic Neuralgia, VisarpaAbstract
Background: Herpes zoster is a viral infection characterized by painful vesicular eruptions unilaterally with a propensity for post-herpetic neuralgia despite standard antiviral therapy. It resembles the features of Visarpa in Ayurveda, and Raktamokshana is indicated as a line of treatment. This is a peculiar case of early leech therapy as an adjunct to conventional treatment in herpes zoster for its neural complications as well as pain relief. Clinical Findings: A 25-year-old female had an episode of severe burning pain associated with erythema and grouped vesicular eruptions over the left side of the neck as well as the upper chest for 2 days. Pain was severe (7 on Visual Analog Scale-VAS). Eruptions were limited to left C3, C4 dermatomes with no secondary infection. Intervention: Patient was treated with 3 sittings of Jalaukavacharana along with Kaishora Guggulu, Mahamanjishthadi Kashaya, and Avipattikar Churna. Shatadhauta Ghrita was applied locally from the 7th day. Antiviral therapy (acyclovir for 5 days) was given concomitantly for supportive purposes. Outcome: There is a considerable reduction in burning pain and erythema following initiation of integrative treatment, including Jalaukavacharana, internal Ayurvedic medications, and antiviral therapy. Vesicular lesions healed in due course. Lesions disappeared by 30 days. Overall, the VAS score was reduced to 0 by the 15th day. There were no episodes of post-herpetic neuralgia during the 6-month follow-up period. No adverse effects were noted. Conclusion: Early application of leech therapy sittings at alternate intervals along with internal ayurvedic medicines for 1 month and supportive antiviral therapy had rapid pain relief, increased healing, and prevented post-herpetic neuralgia without any adverse events. This highlights the role of integrative management and Jalaukavacharana as early intervention in herpes zoster in order to accelerate the healing process and avoid complications, including PHN. Further large-scale clinical trials are needed to validate these findings.
References
Nair P, Patel BC. Herpes Zoster. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan [cited 2026 Mar 1]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441824/
Patki A, Vora A, Parikh R, Kolhapure S, Agrawal A, Dash R. Herpes zoster in outpatient departments of healthcare centers in India: a review of literature. Human Vaccines & Immunotherapeutics. 2021 Nov 2;17(11):4155–4162. Available from: https://doi.org/10.1080/21645515.2021.1968737
Feller L, Jadwat Y, Bouckaert M. Herpes zoster post-herpetic neuralgia. South African Dental Journal. 2005 Nov;60(10):432, 436–437. Available from: https://pubmed.ncbi.nlm.nih.gov/16438359/
Opstelten W, Eekhof J, Neven AK, Verheij T. Treatment of herpes zoster. Canadian Family Physician. 2008 Mar;54(3):373–377. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2278354/
Yadavaji Trikamaji (editor). Charaka Samhita of Charaka, Chikitsasthana, chapter 21, verse no.11, 35-36 Fifth edition, Varanasi; Chaukhambha Sanskrita Sansthana; 2001; 559-561.
Singh SK, Rajoria K. Medical leech therapy in Ayurveda and biomedicine – A review. Journal of Ayurveda and Integrative Medicine. 2020 Oct–Dec;11(4):554–564. Available from: https://doi.org/10.1016/j.jaim.2018.09.003
Yadavaji Trikamaji (editor). Charaka Samhita of Charaka, Chikitsasthana, chapter 21, verse no.69, Fifth edition, Varanasi; Chaukhambha Sanskrita Sansthana; 2001; 563.
Sriram S Savrikar (editor). Sarngadhara Samhita of Sri Sarngadhara, Madhyama Khanda, chapter 07, verse no. 70-75 First edition, Varanasi; Chaukhambha Sanskrita Pratishthana; 2020; 272.
Sriram S Savrikar (editor). Sarngadhara Samhita of Sri Sarngadhara, Madhyama Khanda, chapter 02, verse no. 137-142 First edition, Varanasi; Chaukhambha Sanskrita Pratishthana; 2020; 91.
Gyawali S, Khan GM, Lamichane S, Gautam J, Ghimire S, Adhikari R, Lamsal R. Evaluation of anti-secretory and anti-ulcerogenic activities of Avipattikar Churna on the peptic ulcers in experimental rats. Journal of Clinical and Diagnostic Research. 2013 Jun;7(6):1135–1139. Available from: https://doi.org/10.7860/JCDR/2013/5309.3058
S S, Hiremath BB, Kumar D, Pujari S, M RV. Tradition and technology with special respect to Dhouta Samskara of Shatadhouta Ghrita. International Journal of Ayurvedic Medicine. 2015;6(2). Available from: https://doi.org/10.47552/ijam.v6i2.520
Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. Journal of the American Academy of Orthopaedic Surgeons Global Research & Reviews. 2018 Mar 23;2(3):e088. Available from: https://doi.org/10.5435/JAAOSGlobal-D-17-00088
Subimol PR, Warma SP, Kumar M, Shivani A. Management of Visarpa (herpes zoster) with Nimba Tila Kalka Lepa: A case report. J Ayurveda Holist Med. 2023;11(6). Available from: https://doi.org/10.70066/jahm.v11i6.854
Masal A, Shinde A. Management of herpes zoster solely employing Ayurveda: A case report. Int J Ayurvedic Med.2024;14(4):1127–1132. Available from: https://doi.org/10.47552/ijam.v14i4.3909
Nakanekar A, Khobarkar P, Dhotkar S. Management of herpes zoster in Ayurveda through medicinal leeches and other composite Ayurveda treatment. Journal of Ayurveda and Integrative Medicine. 2020 Jul–Sep;11(3):352–356. Available from: https://doi.org/10.1016/j.jaim.2020.05.008
Hosseini M, Jadidi A, Derakhshan Barjoei MM, Salehi M. Applications of leech therapy in medicine: a systematic review. Frontiers in Medicine. 2024 Sep 16;11:1417041. Available from: https://doi.org/10.3389/fmed.2024.1417041
Sig AK, Guney M, Uskudar Guclu A, Ozmen E. Medicinal leech therapy – an overall perspective. Integrative Medicine Research. 2017 Dec;6(4):337–343. Available from: https://doi.org/10.1016/j.imr.2017.08.001
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Sawarkar Nirmala Prashant , Pakade Sushama, Bawadkar Prasad, Shukla Ashutosh
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain the copyright of their work and grant the Journal of Ayurveda and Holistic Medicine (JAHM) the right of first publication. All published articles are licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) license, which permits non-commercial sharing, use, distribution, and adaptation with proper attribution and the same license terms.
JAHM ensures free, irrevocable, worldwide access to its content. Users may copy, distribute, display, and share published works for non-commercial purposes with appropriate credit to the author(s) and the journal. Limited printed copies for personal, non-commercial use are allowed under the same license.
If a submission is not accepted for publication, the author(s) will be notified.
By submitting, authors confirm that the work is original, that all listed authors have contributed and approved it, and that it does not infringe any third-party rights or duplicate work submitted elsewhere.
