Lepankarma is application of medicated paste on skin. Classical texts describe the utility of Lepa in treatment of Vatrakta. Sushruta has mentioned Lepankarma in Twakgat vata (vitiated Vata in skin) as reference cited in Vranshoth chikitsa (inflammatory condition), Mansagata Vata (vitiated Vata in muscles) and Snayuroga (Diseases related ligaments).25,26 Mode of action of lepankarma can be explained with the help of Transdermal absorption of drugs. Epidermis behaves as a lipid barrier whereas; Dermis is freely permeable to solutes. Inflammation increases cutaneous blood flow and also enhances absorption. Moreover, thermoreceptors in the skin have cold receptors (thin myelinated Aδ fibres) and warm receptors (unmyelinated C fibres) which help in understanding the regulation of Pralepa and Pradeha respectively. Probable role of Pralepa can be explained with the mechanism of transduction of cold thermoreceptors as for example Menthol sensation is perceived via TRPM8 channel;m whereas role of Pradeha can be explained with TRPV1 channels and furthermore certain Warm receptors also being sensitive to painful stimuli function as nociceptors and thus, mediate action of herbs with hot consistency.

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