Skin is a barrier protecting the underlying tissue from physical, chemical and biological toxic agents. Skin diseases are mainly affecting the external beauty of the patients that clogs the routine of ones life. Skin disorders constitute one of the largest groups of health problems in general clinical practice. Kushta is a broad term which covers almost all the skin disease in Ayurveda. In general, Tvak Vikaras are mainly affecting due to altered lifestyle, lack of physical exercise, poor hygiene, mental stress and improper food habits. Kushta is further divided into Maha Kushta and Kshudra Kushta. Kitibha Kushta is one of the Kshudra Kushta. Here Tridosha, Rasa, Rakta, Mamsa, Ambu (Sapta Dushya) are affected. Rasa and Rakta Dushti are the main causes of Tvak Vikaras for which Vamana and Virechana Karma are the Agrya Shodhanas respectively. After Shodhana, Shamana Chikitsa plays a major role in Alpadosha Nirharana. This case study highlights Kitibha Kushta as a Rasa-Raktavahasrotodusti Vikara which was intervened with a unique therapeutic modality Ubhayatahamarga Shodhana - a duo - directional cleansing.