Alteration in Asbāb-e-Sitta Ḍarūriyya (Six Essential Factors) for the Prevention of Buthūr Labaniyya (Acne Vulgaris): A Narrative Review of Unani and Contemporary Perspectives
Abstract
Acne vulgaris (Buthūr Labaniyya) is a prevalent chronic inflammatory disorder of the pilosebaceous unit, commonly affecting adolescents and young adults. The condition often leads to significant psychosocial distress and impaired quality of life. In the Unani system of medicine, Buthūr Labaniyya is attributed to humoral imbalance and disturbances in Asbāb-e-Sitta Ḍarūriyya, the six essential prerequisites for maintaining health. Classical Unani scholars emphasize disease prevention through regulation and moderation of these factors before initiating pharmacological treatment, aiming to restore systemic balance and limit drug dependency. This narrative review examines the role of alterations in Asbāb-e-Sitta Ḍarūriyya in the prevention and management of acne vulgaris by integrating evidence from classical Unani texts with contemporary understanding of acne pathophysiology. The review highlights lifestyle and dietary modifications as supportive, non-pharmacological strategies that may complement conventional acne management and contribute to a holistic therapeutic approach.
Keywords: Acne vulgaris; Buthūr Labaniyya; Unani medicine; Asbāb-e-Sitta Ḍarūriyya; Lifestyle modification
Keywords:
Acne vulgaris, Buthūr Labaniyya, Unani medicine, Asbāb-e-Sitta Ḍarūriyya, Lifestyle modificationDOI
https://doi.org/10.22270/jddt.v16i2.7578References
1. Griffiths CEM, Barker J, Bleiker T, Chalmers R, Creamer D, editors. Rook's textbook of dermatology. 9th ed. Oxford: Wiley-Blackwell; 2016. https://doi.org/10.1002/9781118441213
2. Khanna N. Illustrated synopsis of dermatology and sexually transmitted diseases. 5th ed. New Delhi: RELX India Pvt Ltd; 2017. p. 305-309.
3. Raza K, Talwar V, Setia A, Katare OP. Acne: An understanding of the disease and its impact on life. International Journal of Drug Development and Research. 2012 Apr;4(2):14-20.4.
4. Eichenfield DZ, Sprague J, Eichenfield LF. Management of Acne Vulgaris: A Review. JAMA. 2021 Nov 23;326(20):2055. https://doi.org/10.1001/jama.2021.17633 PMid:34812859
5. Dhoot D, Budamakuntla L, Parasramani S, Deshmukh G, Barkate H. Acne in Indian population: An epidemiological study evaluating multiple factors. IP Indian J Clin Exp Dermatol. 2020 Oct 28;6(3):237-42. https://doi.org/10.18231/j.ijced.2020.048
6. Arzānī MA. Mīzān al-Ṭib. Kabiruddin T, editor. New Delhi: Idārā Kitāb al-Shifā; c2001. p. 24.
7. Baghdadi I. Kitab al-Mukhtarat fi'l Tibb. Vol IV. New Delhi: CCRUM, Department of AYUSH; 2007. p. 188.
8. Ansari S. History of acne vulgaris and topical drugs in Unani medicine. Arch Med Health Sci. 2019;7(2):293. https://doi.org/10.4103/amhs.amhs_128_19
9. Anjum S, Tabasum A, Manzoor F, Faisal MU. Concept of Busoore Labaniya (Acne Vulgaris) and its Management In Light of Unani System of Medicine. J Drug Deliv Ther. 2021 Oct 15;11(5-S):159-63. https://doi.org/10.22270/jddt.v11i5-S.5081
10. Antaki D. Tadhkira Ul al-Albāb. 1st ed. New Delhi: CCRUM, Ministry of Health and Family Welfare; 2010. p. 87.
11. Zakariyya AR. Al-Hawi fi'l Tibb. Vol 23. Aligarh: Saba Publishers; 1994. p. 36-37.
12. Sina I. Al-Qanun fi'l Tibb. New Delhi: Idara Kitab al-Shifa; 2010. p. 1420-1432.
13. Shabiya Sultana, Shahnawaz, Abdul Haseeb Ansari et al. Buthūr-i-labaniyya (Acne vulgaris) With Special Reference to Unani Medicine: Review. Journal of AYUSH: Ayurveda, Yoga, Unani, Siddha and Homeopathy. 2015; 4(3):
14. Ibn Sīnā. Al-Qānūn fī al-Ṭibb. Vol II. New Delhi: Idara Kitab-us-Shifa; 2007. p. 186-190.
15. Rāzī Z. Kitab-ul-Mansoori. New Delhi: Central Council for Research in Unani Medicine, Ministry of Health & Family Welfare, Govt. of India; 2012.
16. Kabiruddin M. Sharh-e-Asbab (Tarjama Kabir). Ejaz Publishing House, New Delhi; 2007.
17. Tarique M, Naaz N, Habeeb K, Afzal SMA, Ahmad I. Unani understanding of Buthūr labaniyya (Acne Vulgaris): A holistic and evidence-oriented comprehensive review. Int J Unani Integr Med. 2025 Sep 1;9(3):321-34. https://doi.org/10.33545/2616454X.2025.v9.i3e.417
18. Ibn Sina, AAHIA. Al-Qanoon Fil Tibb. New Delhi : Aijaz, 2010. pp. 97-98.
19. Akhlaq S, Ara SA, Ahmad B, Fazil M, Akram U, Haque M, et al. Interventions of Unani medicine for maintenance of health with special reference to air quality: an evidence-based review. Rev Environ Health. 2023 Mar 28;38(1):85-96. https://doi.org/10.1515/reveh-2021-0116 PMid:34883008
20. Okeah IR, Afzal UM, Ali FR. Impact of environmental pollution on acne: a systematic review. Skin Health Dis. 2025 Dec 30;vzaf090.
21. Rāzī Z. Kitāb al-Manşüri (Urdu translation). New Delhi: Central council for Research in Unani Medicine; 1991:175-79.
22. Khan MA. Muhit-i-Azam (Urdu translation). Vol. 3 & 4 New Delhi: Central council for Research in Unani Medicine; 2013:27, 303, 463, 558, 621, 711, 820.
23. Ghani N. Khazain'al advia. New Delhi: Idara Kitab-us-Shifa: YNM: 932, 955, 981, 999, 1069,1229.
24. Rao KS, Babu GV, Ramnareddy YV. Acylated Flavone Glycosides from the Roots of Saussurea lappa and Their Antifungal Activity. Molecules. 2007 Mar 7;12(3):328-44. https://doi.org/10.3390/12030328 PMid:17851392 PMCid:PMC6149399
25. Raja AF, Ali F, Khan IA, Shawl AS, Arora DS, Shah BA, et al. Antistaphylococcal and biofilm inhibitory activities of acetyl-11-keto-β-boswellic acid from Boswellia serrata. BMC Microbiol. 2011 Dec;11(1):54. https://doi.org/10.1186/1471-2180-11-54 PMid:21406118 PMCid:PMC3066120
26. Wu K, Lin Y, Chai X, Duan X, Zhao X, Chun C. Mechanisms of vapor‐phase antibacterial action of essential oil from Cinnamomum camphora var. linaloofera Fujita against Escherichia coli. Food Sci Nutr. 2019 Aug;7(8):2546-55. https://doi.org/10.1002/fsn3.1104 PMid:31428342 PMCid:PMC6694428
27. Canli K, Yetgin A, Akata I, Altuner EM. IN VITRO ANTIMICROBIAL SCREENING OF AQUILARIA AGALLOCHA ROOTS. Afr J Tradit Complement Altern Med. 2016 Aug 12;13(5):178-81. https://doi.org/10.21010/ajtcam.v13i5.23 PMid:28487909 PMCid:PMC5416638
28. Okmen G, Turkcan O, Ceylan O, Gork G. The Antimicrobial Activity of Aliquidambar orientalis mill. Against Food Pathogens and Antioxidant Capacity of Leaf Extracts. Afr J Tradit Complement Altern Med. 2014 Oct 27;11(5):28. PMCid:PMC4202513 https://doi.org/10.4314/ajtcam.v11i5.4 PMid:25395700
29. Kumar MG, Jeyraaj IA, Jeyaraaj R, Loganathan P. Antimicrobial activity of aqueous extract of leaf and stem extract of Santalum album. Anc Sci Life. 2006 Jan;25(3-4):6-9.
30. Meixiong J, Ricco C, Vasavda C, Ho BK. Diet and acne: A systematic review. JAAD Int. 2022 Jun;7:95-112. PMid:35373155 PMCid:PMC8971946 https://doi.org/10.1016/j.jdin.2022.02.012
31. Sina. I. Al-Qanoon fi al-Tibb. Vols. 1-3. New Delhi: Idara Kitab-us-Shifa; 2007. 62, 87; Vol 2: 75 p.
32. Kabeeruddin H. Kulliyat Nafisi. Vol. 1. New Delhi: Idara Kitab-al-Shifa Koocha cheelan Darya Ganj; 1954. 382-383 p.
33. Razi Z. Kitab-ul-Mansoori (Urdu). New Delhi: Central Council for Research in Unani Medicine; 1991.89-96, 175-79 p.
34. Bin Zuhr A. Kitabul Aghziya. Central Council for Research in Unani Medicine;2009. 66 p.
35. Khatoon F, Azahar M, Jabeen A, Uddin Q, Khan S, Moin MS, Ahmad K, Zaki MK. A comprehensive Review on Buthūr Labaniyya (Acne vulgaris) with special references of Unani System of Medicine. seed. 2021;28:31. doi: 10.31254/phyto.2021.10607. https://doi.org/10.31254/phyto.2021.10607
36. Unani Diet Detox Guide 250707 194707 | PDF [Internet]. Scribd. [cited 2026 Jan 29]. Available from: https://www.scribd.com/document/887230149/Unani-Diet-Detox-Guide-250707-194707
37. Unani Insights on Acne Vulgaris Management | PDF [Internet]. Scribd. [cited 2026 Jan 29]. Available from: https://www.scribd.com/document/740594104/Acne-Vulguris-Busoor-e-Labaniya-With-References-to-Unani-Medicine-Review-April-2020-1587370171-8010043
38. The Acne Diet: What to Eat and What to Avoid for Flawless Skin [Internet]. NDTV Food. [cited 2026 Jan 29]. Available from: https://food.ndtv.com/food-drinks/the-acne-diet-what-to-eat-and-what-to-avoid-for-flawless-skin-1671383
39. Guyton AC, Hall JE. Textbook of Medical Physiology. 13th ed. Elsevier; 2016.
40. Bellew S, Thiboutot D, Del Rosso JQ. Pathogenesis of acne vulgaris: what's new, what's interesting and what may be clinically relevant. J Drugs Dermatol JDD. 2011 Jun;10(6):582-5.
41. Ibn Sīnā. Al-Qānūn fī al-Ṭibb. Vol. 1. New Delhi: Jamia Hamdard.
42. Rāzī ABMZ. Kitāb al-Ḥāwī fī al-Ṭibb. Hyderabad (India): Dairatul Maʿarif al-Osmania.
43. Majūsī. Kāmil al-Ṣinā'ah al-Ṭibbiyyah. New Delhi: CCRUM;2005.
44. Zouboulis CC. Acne and sebaceous gland function. Clin Dermatol. 2004 Sep;22(5):360-6. PMid:15556719 https://doi.org/10.1016/j.clindermatol.2004.03.004
45. Zouboulis CC, Böhm M. Neuroendocrine regulation of sebocytes - a pathogenetic link between stress and acne. Exp Dermatol. 2004 Dec;13(s4):31-5. https://doi.org/10.1111/j.1600-0625.2004.00254.x PMid:15507110
46. Arck PC, Slominski A, Theoharides TC, Peters EMJ, Paus R. Neuroimmunology of Stress: Skin Takes Center Stage. J Invest Dermatol. 2006 Aug;126(8):1697-704. https://doi.org/10.1038/sj.jid.5700104 PMid:16845409 PMCid:PMC2232898
47. Ibn Nafīs. Sharḥ Tashrīḥ al-Qānūn. Cairo: Al-Matbaʿah al-Amīriyyah.
48. Tabari R. Moalajat-e-Buqratiya. Central Council for Research in Unani Medicine, Ministry of Health and Family Welfare, New Delhi, Govt. of India; 1995.
49. Qarshi A. Afāda-e-Kabīr (Mujmal), Urdu translation by Hkm Kabiruddin. Idara Kitab-us-Shifa, New Delhi; 2010.
50. Ibn Sīnā. Al-Qānūn fī al-Ṭibb. Vol. III. New Delhi: Jamia Hamdard.
51. Ibn Sīnā. Al-Qānūn fī al-Ṭibb. Vol. II. New Delhi: Jamia Hamdard.
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Copyright (c) 2026 Shaikh Mohammad Aatif Afzal , Momin Arshad Manzoor Ahmed , Niyazi Abdullah Khizar , Mohd Tarique , Samira Khatoon Choudhary

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