Petechial haemorrhage- Ayurvedic management and home remedies

Article by Prof. MS Krishnamurthy MD(Ayu), PhD.
Petechial hemorrhage is common in old age, during pregnancy, in puerperal period, post operative period, tractioned or compressed areas etc. In few of the States of India people consider petechial hemorrhage as the ‘scar/markings of ghost’ also !

Petechial heamorrhage

What is petechial hemorrhage?
Petechia, (plural petechiae) is a small red or purple spot found on the skin due to minor bleeding from the broken capillary blood vessels. Petechiae are by definition less than 3 mm in general.

Petechia refers to one of the three descriptive types of bleeding occurring in the skin; it is differentiated by size, the other two being purpura and ecchymosis. This may be found in any part of the skin surface preferably in the lesions where maximum capillary flow is found.

Causes

Why it occurs?
Physical trauma such as chronic cough, holding breath/asthama, vomiting or crying, may result in facial petechiae, especially around the eyes. Strong hit/ pressure, small blunt injury, long time unusual pressure  etc may result in petechial haemorrhage in other parts like thigh, foreleg, chest, flanks, breast etc.

What are the most common conditions for Petechial haemorrhage?
Infections-
Chikungunya
Cerebral malaria
Dengue fever
Ebola
Influenza A virus subtype H1N1
Bolivian hemorrhagic fever
Congenital syphilis
Rocky Mountain spotted fever
Sepsis
Scarlet fever
Typhoid etc

Non-infectious conditions-
Hypocalcemia
Idiopathic thrombocytopenic purpura
Leukemia
Childhood protein-energy malnutrition such as Kwashiorkor or Marasmus
Aplastic anaemia
Scurvy
Lupus vulgaris
Erythroblastosis fetalis
Thrombocytopenia (low platelet count)
Vitamin K deficiency etc

Ayurvedic explanation

How it is discussed in age old Ayurveda?
Ayurveda refers this condition as Sirashrita pitta or Pittashrita sira.It means that the condition is caused due to the vitiation of Sira(veins) especially due to the Pitta dosha.

Bhrajaka pitta situated beneath the skin is badly affected by the Ushna(warmth)-Teekshna (penetrative nature)-Laghu(lightness)-Drava(liquidity) and Sara (motileness) quality of pitta.

Due this the proper flow of the blood is disturbed and hence obstruction is caused to the minor pathways of the blood and hence petechial haemorrhage is caused in the affected lesions,especially in pressure points.

Line of treatment

Line of treatment of hemorrhage as per Ayurveda:
The line of treatment of Vatarakta (gouty arthritis) or Raktapitta (bleeding disorders) is recommended in this condition.

Alternatively cold and hot medication is recommended as a factor of principle of practice. Raktaprasadana (blood sootheners) and Pittahara (coolant) medicaments stand as the ultimate choices in this condition.

Ayurvedic therapies, formulations

Therapies beneficial in petechial hemorrhage:
Utsadana (gentle massage) and abhyanga (oil massage) are found to be utmost use in this respect. Alepa (thin anoint) of medicaments/fresh wet paste) is also useful in few of the cases.

Formulations of choice in Petechial hemorrhage:
Kamadugha with mouktika
Laghusootashekhara rasa
Sootashekhara rasa
Chandanasava
Sarivadyasava
Mahamanjishthadi kashaya
Kaishora guggulu
Triphala guggulu
Guduchyadi kashaya
Parpataka kashaya
Parpatakadyarishtha
Laghupanchamoola ksheerapaka etc

Ayurvedic home remedies

Home remedies for Petechial hemorrhage:
Turmeric powder and leaf juice of pepper is mixed together and applied to the lesions repeatedly 3-4 times a day.
Betel leaf, ginger leaf and tender leaves of Pome granate are made into fine paste and applied over the lesions  twice or thrice a day.

2-3 days medication of above home remedies gives significant benefits.

Do’s and dont’s

Do’s and Don’ts in Petechial hemorrhage:
Rest, soothing massage, easily digestible food, light food, juicy substances like ash gourd-cucumber-musk melon etc have good effect over this condition.
Pressure application, bandaging, thick wrapping, tourniquets will worsen the condition.

The medicines like Anticoagulants (warfarin, heparin)-  Atropine (Atropen)-   Carbamazepine (Carbatrol, Epitol, Tegretol etc)-  Nitrofurantoin (Furadantin, Macrobid, Macrodantin etc)-  Penicillin derivatives-  Quinine (Qualaquin)- Chloral hydrate (Somnote)-  Desipramine (Norpramin)-  Indomethacin (Indocin)-  Naproxen (Aleve, Anaprox, Naprosyn)  etc are to be taken with utmost caution.

Bruises and Doshas

When a person bruises very easily, is it due to Pitta aggravating factors only? 
Dr JV Hebbar: 
शोणितक्षये त्वक्पारुष्यमम्लशीतप्रार्थना सिराशैथिल्यं च
śoṇitakṣaye tvakpāruṣyamamlaśītaprārthanā sirāśaithilyaṃ Sushruta Samhita, Sutrasthana 15th chapter
Easy bruising implies weak and brittle blood vessels, veins. This indicates depleted quality of blood tissue and also of blood channels (Rakta kshaya). Brittleness and weakness is also a sign of Vata dosha increase. 

Injury to the blood vessels = Brittle Sira, Dhamani – Vata Dosha affecting Rakta. 
Treatment and remedies: 
Virechana, Ghrita, Stambhana medicines – Triphala – Amla, Haritaki, Vibhitaki, 
Manjishta – Rubia cordifolia 
Tikta Ghrita 
Patola katurohinyadi kashayam 
Abhyanga with eladi taila, ksheerabala taila, Bala aswagandhadi taila are also useful to strengthen muscles, veins, arteries and skin.