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Hemidesmus indicus (L.) R. Br. ex Schult. (Apocynaceae) is widely used in traditional medicine in the different parts of the Indian subcontinent due to the various biological activities attributed to its different parts, especially the roots. It has traditionally been used for treating snakebites, scorpion stings, diabetes, urinary diseases, dyspnea, menorrhagia, oligospermia, anorexia, fever, abdominal colic and pain, dysentery, diarrhea, cough, rheumatism, headache, inflammation, pyrosis, skin diseases, leprosy, sexually transmitted diseases and cancer. In Ayurveda, the plant is used in the treatment of bone-loss, low body weight, fever, stress, topical wound and psoriasis. Besides, Ayurvedic literature also depicts its use as anti-atherogenic, anti-spasmodic, memory enhancing, immunopotentiating and anti-inflammatory agents. In this review, we aim to present a comprehensive update on the ethnopharmacology, phytochemistry, specific pharmacology, and toxicology of H. indicus and its bioactive metabolites. Possible directions for future research are also outlined in brief. Popular and widely used international databases such as PubMed, Scopus, Science Direct, Google Scholar and JSTOR were searched and traditional literature were consulted using the various search strings to retrieve a number of citations related to the ethnopharmacology, biological activity, toxicology, quality control and phytochemistry of H. indicus. All studies on the ethnobotany, phtochemistry, pharmacology, and toxicology of the plant up to 2019 were included in this review. H. indicus has played an important role in traditional Indian medicine (including Ayurveda) and also in European medicine. The main pharmacological properties of H. indicus include hepatoprotective, anti-cancer, anti-diabetic, antioxidant, neuroprotective, anti-ophidian, cardioprotective, nephroprotective, anti-ulcerogenic, anti-inflammatory, and antimicrobial properties. Phytochemical evaluations of the root have revealed the presence of aromatic aldehydes and their derivatives, phenolics, triterpenoids and many other compounds, some of which were attributed to its bioactivity. This review also compiles a list of Ayurvedic formulations and commercial preparations where H. indicus has been used as an active ingredient. We have included the critical assessment of all the papers cited in this manuscript based on experimental observation and other important points which reflect the loop-holes of research strategy and ambiguity in the papers reviewed in this manuscript. The study presents an exhaustive and updated review on the traditional, pharmacological and phytochemical aspects of H. indicus with notes on its quality control and toxicological information. Although the crude extracts of H. indicus exhibit an array of pharmacological activities, it is high time to identify more active phyto-constituents by bioactivity-guided isolation besides elucidating their structure-activity relationship. More designed investigations are needed to comprehend the multi-target network pharmacology, to clarify the molecular mode of action and to ascertain the efficacious doses of H. indicus. Moreover, H. indicus is not fully assessed on the basis of its safety and efficacy on human. We hope this review will compile and improve the existing knowledge on the potential utilization of H. indicus in complementary and alternative medicine. Image 1 [ABSTRACT FROM AUTHOR]

Traditional knowledge is a particular form of practice or skill set that was developed in ancient times and was sustained through generations via the passing of knowledge, essentially confined within a specific tribe, local people, or family lineages. Ethnodermatological use of medicinal plants in India is still a subject to conduct more studies to see if there is chemical, microbiological, and/or clinical evidence, from a scientific perspective, of their effectiveness for those skin disorders. Thus, this review can be the basis for further studies and may provide targets for drug development. We compile and emphasize the most important part of ethnodermatology, namely, traditional knowledge of medicinal plants and their applications for several skin diseases in India. We also include a brief review and explanation on dermatology in Ayurvedic and Unani medicine. We review the pharmacological activity of extracts derived from some of the most cited plants against problem skin diseases as well. Different kinds of key phrases such as "Indian traditional ethnodermatology", "ethnodermatology", "ethnobotany", "skin diseases", "Ayurveda dermatology", "pharmacological activity" were searched in online search servers/databases such as Google Scholar (https://scholar.google.com/), ResearchGate (https://www.researchgate.net/), PubMed (https://pubmed.ncbi.nlm.nih.gov/), NISCAIR Online Periodicals Repository (NOPR) (http://nopr.niscair.res.in/). Based upon the analyses of data obtained from 178 articles, we formulated several important findings which are a summary shown in Tables. Tables. A total of 119 records of plants' uses have been found across India against 39 skin diseases. These are depicted with their localities of report, parts used, and preparation and administration methods against particular skin diseases. The knowledge and utilisation of herbal medicine in the Indian subcontinent has great potential to treat different kinds of human skin disorders. The administration of extracts from most of the plant species used is topical and few only are administrated orally. We also investigated the pharmacological activity of the extracts of the most cited plants against mice, bacterial and fungal pathogens, and human cells. Complementary therapy for dermatological problems and treatment remains the main option for millions of people in the Indian subcontinent. This review on the practices of ethnobotanical dermatology in India confirms the belief that their analysis will accelerate the discovery of new, effective therapeutic agents for skin diseases. However, more studies and clinical evidence are still required to determine if the identified species may contribute to skin condition treatment, particularly in atopic eczema. Today, ethnodermatology is a well-accepted international discipline and many new practices have been initiated in numerous countries. We hope this article will further accelerate the development of this area to identify a new generation of natural human skin treatments that will help meet the growing consumer demand for safe, sustainable, and natural treatments. In this context, research on plants utilised in ethnodermatology in India and elsewhere should be intensified. [Display omitted] • Skin diseases are a major public health concern worldwide. • The potential use of medicinal plants for the treatment of skin diseases and related problems in India were critically reviewed. • Ayurvedic formulations of medicinal plants for dermatology were evaluated. • Preclinical and clinical evidence, as well as cellular investigations, on the pharmacological activities of medicinal plants, were summarized. • Further research is needed to deeply understand the molecular mechanism of action of herbal compounds used in dermatology. [ABSTRACT FROM AUTHOR]