Acne

In Traditional Chinese Medicine (TCM), acne is seen as a condition which is related to the build up of Heat and Dampness in the body.

Symptoms of acne appear on the skin, normally on the face neck and back as inflamed areas, pimples, rashes or infections.

Heat
Excess heat can come from a range of sources, most often irritating chemicals, foreign organisms and factors leading to excess qi (energy).

Since heat is the by-product of our metabolism and diet, TCM practitioners believe that acne and similar skin problems can be caused as a result of an over-stimulating diet, in particular greasy and spicy foods.

Another cause of heat is the constrain of qi. This can come from a busy lifestyle or a hyperactive mind, where the sufferer is likely to have no or little means of releasing their excess qi, or from the emotional constraint of qi caused by frustration, anxiety, anger or emotional friction due to a variety of reasons. Some of the causes of excess qi include:

·    Stress (e.g. from exams and relationships)
·    Overworking
·    Poor diet
·    Pregnancy
·    The start of a period
·    Certain cosmetics and medicines

Adolescents and teenagers, due to an increased level of hormonal activity have a higher amount of heat than adults, and thus are more likely to suffer from the effects of acne. However, adults can still suffer from acne.

A build-up of heat in a patient is often shown through the skin as redness, rashes, pimples, infections or other inflammations. Toxic heat can also occur, where there is insufficient blood to dilute out the body’s normal toxins which are transported in the blood, leading to the symptoms of acne.

Dampness
Dampness is often caused by imperfect digestion (spleen deficiency), which leads to an accumulation of water or a lack of body heat (spleen yang deficiency) which fails to ‘boil’ off the water in the body. This can result if perspiration, urination or breathing is insufficient in clearing water from the body.

Pathogens and micro-organisms such as bacteria, fungus and viruses thrive in conditions with excess damp. Dampness is reflected in the skin as swellings, cysts, pimples, pus and fluid discharges.

The major signs and symptoms of the common Heat Patterns of Disharmony are as follows:

·    Lung Heat: Symptoms include acne with a predominance of lesions on the forehead and near the nose. There may be slight itching as well. In cases with a rapid onset of new lesions, the patient may complain of chills or sensitivity to Wind. The patient may have an aversion to heat and feel thirsty. The tongue is generally red with a thin yellow coat, and the pulse may be rapid and floating.

·    Stomach Heat: Symptoms include acne with a predominance of lesions around the mouth and on the chest, shoulders, and back. The patient may have an aversion to heat; have a large appetite and thirst; and prefer greasy, spicy foods. There may be a tendency to pass dry stools as well. The tongue is usually red with a thick yellow coating, and the pulse is rapid and forceful.

·    Toxic Heat: Symptoms include severe acne, strongly inflamed with pus-filled nodules and much reddening of the skin around the lesions. The patient may have an aversion to heat as well and may complain of malaise. The tongue is generally red with a dry yellow coating, and the pulse is rapid.

·    Damp Heat: Symptoms include acne composed of deep, pus-filled, inflamed nodules. The skin usually is oily, and the patient may have an aversion to heat. He or she may be thirsty but have no desire to take fluids. The tongue generally is red or crimson, with a greasy or sticky coating. The pulse is rapid and may have slippery or wiry qualities as well.

·    Blood Heat: Symptoms include acne that is accompanied by a flushed face and strong aversion to heat. The patient may complain of thirst, dark urine, and dry stools. The tongue usually is red (with a redder tip) and has a yellow coating, or may be crimson in color. The pulse usually is rapid and thin.

Herbal medicine treatments
Herbal medicine focuses on Heat according to the differential diagnosis, while reducing the inflammation and attempting to prevent the formation of new lesions. A combination of herbal medicines taken internally and an externally applied solution is preferable.

·    Lung Heat may be treated with formulas of herbs such as Pi Pa Ye (Folium Eriobotryae Japonicae) and Sang Bai Pi (Cortex Mori Albae Radicis).

·    Stomach Heat may be treated with proper supervision using combinations of purgative herbs, such as Da Huang (Radix et Rhizoma Rhei) and Mang Xiao (Mirabilitum).
·    Toxic Heat may be treated with combinations such as Jin Yin Hua (Flos Lonicerae Japonicae) and Lian Qiao (Fructus Forsythia Suspensae).

·    Blood Heat may be treated by using herbs such as Sheng Di Huang (Radix Rehmanniae) and Mu Dan Pi (Cortex Moutan Radicis).

·    Damp Heat may be treated with combinations of the herbs used to treat Toxic Heat, along with other herbs, such as Yi Yi Ren (Semen Coicis) and Tu Fu Ling (Rhizoma Smilacis Glabrae), to drain Dampness. The herbal decoction may also be applied to the skin twice a day as a soak to the affected areas, if recommended by a practitioner.