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Chronic dermatological disorders such as acne vulgaris, psoriasis, eczema (atopic dermatitis), and chronic urticaria are multifactorial conditions driven by inflammation, immune dysregulation, oxidative stress, microbial dysbiosis, and environmental triggers. Conventional treatments, including topical corticosteroids, systemic retinoids, biologics, and antibiotics, often provide symptomatic relief but are limited by adverse effects (e.g., skin atrophy, antibiotic resistance, and metabolic disturbances), high recurrence rates, and poor long-term tolerability. Herbal medicines, particularly polyherbal formulations from Ayurveda, are increasingly investigated as adjunctive or alternative options due to their multi-target mechanisms and favorable safety profiles. Vishaghna Mahakashaya, a classical group of ten medicinal plants described in Charaka Samhita (Sutrasthana 4.16), is traditionally indicated for antitoxic effect (vishaghna), anti-inflammatory, and skin-purifying actions. This review critically evaluates the available clinical evidence (2010–2025) and pharmacological mechanisms of Vishaghna Mahakashaya and its constituent herbs in chronic dermatological conditions. Databases searched included PubMed, Scopus, Google Scholar, and AYUSH Research Portal. Included were human clinical or observational studies and pharmacological evaluations relevant to skin disorders. Evidence, though predominantly preclinical and preliminary clinical, demonstrates reductions in inflammatory lesions, pruritus, erythema, and oxidative stress markers. Constituent herbs exhibit cytokine inhibition (TNF-α, IL-6), NF-κB suppression, mast-cell stabilization, antioxidant activity, and antimicrobial effects against skin pathogens. Synergistic polyherbal action aligns with the pathophysiology of chronic skin diseases. High- quality randomized controlled trials (RCTs) with standardized formulations are still required to establish efficacy, optimal dosing, and safety in integrative dermatology. Vishaghna Mahakashaya offers a rational, evidence-supported herbal strategy for managing these prevalent conditions.

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