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Twak Vikar or disorder are considered under kushta Roga in Ayurveda classics. Kushta are further divided into two groups: mahakushta and khudrakushta. In the Charaksamhita, the causative factors of kushta are “Vipran Gurandhasyata papkarma cha kurvtam”. in Brihattriyi papakarma is considered as one of the etiological factor for kushtaroga .All these are the psychic factor which disturb the satvaguna and helps in the manifestation of skin disorder. There is always a mental factor associated with physical disease and vice versa. kushta is consider as disease which despises the skin .skin or twaka is one of the five gyanendriya which communicate with external environment. Acharyacharak stated that twaka is “chetnasamvayi” which show the relationship between the mana (psyche) and skin.”Papakarma” included all the sinful activity, anti-social activities, chinta (worry), shoka (sorrow) and bhaya (fear) which give negative impact on mana (psyche).this impact on mana leads to stress which directly or indirectly aggravate and help in the manifestation of skin disorders. Therefore, there is a direct impact of stress on skin. Twakvikar gave patients physical, mental and socioeconomic inferiority which leads to mental stress which aggravate the disease. Psychological factor and stress are the main etiological factor in the manifestation of skin disorder which are always doesn’t get as much importance .several studies shows that most of the skin disorder are chronic ,inflammatory and psychosomatic in nature .the unique approach of ayurveda to consider the whole body ,mind and spirit as one entity and goes through the holistic approach to treat the disease which is lack in modern science .So in case of twakvikar, psycho dermatological approach of ayurveda taken into consideration which include pharmacological approach and non-pharmacological approach ,the non-pharmacological approach are sattava jayachikitsa and devv yaprashya chikitsa which  increase the sattva guna and helpful in decreasing the native impact and stress .