Advanced TCM Techniques for Treating Dermatological Conditions

By: Alex Qiu

Advanced practitioners of Traditional Chinese Medicine (TCM) are well aware that treating dermatological conditions such as eczema, psoriasis, and acne requires a nuanced approach that integrates both herbal and acupuncture treatments. This discussion delves into sophisticated strategies for managing these skin disorders, supported by clinical research and case studies.

Eczema: Comprehensive TCM Approaches

Eczema, or atopic dermatitis, is characterized by chronic, inflammatory skin conditions. TCM approaches this condition through the differentiation of syndromes, primarily involving Wind, Dampness, and Heat.

Herbal Formulations:

1. Xiao Feng San (Eliminate Wind Powder):

• Ingredients: Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), Niu Bang Zi (Arctii Fructus), Chan Tui (Cicadae Periostracum), Cang Zhu (Atractylodis Rhizoma), Ku Shen (Sophorae Flavescentis Radix), Mu Tong (Akebiae Caulis), Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhenae Rhizoma), Sheng Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Hei Zhi Ma (Sesami Semen Nigrum), Gan Cao (Glycyrrhizae Radix).
• Mechanism: This formula dispels Wind, clears Heat, and eliminates Dampness, effectively reducing inflammation and itching.

Case Study: A randomized controlled trial by Xue et al. (2015) demonstrated that Xiao Feng San significantly reduced the severity of eczema in patients, with marked improvements in itchiness and skin lesions (Xue et al., 2015).

2. Long Dan Xie Gan Tang (Gentiana Longdancao Decoction to Drain the Liver):

• Ingredients: Long Dan Cao (Gentianae Radix), Huang Qin (Scutellariae Radix), Zhi Zi (Gardeniae Fructus), Mu Tong (Akebiae Caulis), Che Qian Zi (Plantaginis Semen), Ze Xie (Alismatis Rhizoma), Chai Hu (Bupleuri Radix), Sheng Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Gan Cao (Glycyrrhizae Radix).
• Mechanism: This formula clears Liver Fire and Damp-Heat, suitable for eczema with intense erythema, itching, and exudation.

Acupuncture Points:

1. LI11 (Quchi), SP10 (Xuehai), and BL40 (Weizhong):

• Mechanism: These points clear Heat, cool the Blood, and relieve itching.

2. ST36 (Zusanli) and SP6 (Sanyinjiao):

• Mechanism: These points strengthen the Spleen and resolve Dampness, addressing the root of chronic eczema.

Psoriasis: Targeted TCM Treatments

Psoriasis is an autoimmune condition characterized by rapid skin cell proliferation. TCM attributes its etiology to Blood Heat, Blood Stasis, and Dampness.

Herbal Formulations:

1. Si Wu Xiao Feng Yin (Four Substances Decoction to Eliminate Wind):

• Ingredients: Sheng Di Huang (Rehmanniae Radix), Shu Di Huang (Rehmanniae Radix Preparata), Bai Shao (Paeoniae Radix Alba), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), Chan Tui (Cicadae Periostracum), Ku Shen (Sophorae Flavescentis Radix), Gan Cao (Glycyrrhizae Radix).
• Mechanism: This formula nourishes and invigorates Blood, dispels Wind, and clears Heat.

Case Study: A clinical study by Zhang et al. (2017) reported that Si Wu Xiao Feng Yin significantly improved psoriasis symptoms, reducing the Psoriasis Area and Severity Index (PASI) scores (Zhang et al., 2017).

2. Yin Xie Pian (Psoriasis Tablet):

• Ingredients: Sheng Di Huang (Rehmanniae Radix), Mu Dan Pi (Moutan Cortex), Chi Shao (Paeoniae Radix Rubra), Xuan Shen (Scrophulariae Radix), Ku Shen (Sophorae Flavescentis Radix), Tu Fu Ling (Smilacis Glabrae Rhizoma).
• Mechanism: This formula clears Heat, cools the Blood, and resolves Toxicity, effective for chronic, stubborn plaques.

Acupuncture Points:

1. GV14 (Dazhui), LI11 (Quchi), and SP10 (Xuehai):

• Mechanism: These points clear Heat, cool the Blood, and expel Wind.

2. BL17 (Geshu) and SP6 (Sanyinjiao):

• Mechanism: These points invigorate Blood and resolve Stasis, addressing the chronicity of psoriasis.

Acne: Holistic TCM Approaches

Acne vulgaris is a common skin condition often linked to Heat and Dampness in the Lung and Stomach meridians.

Herbal Formulations:

1. Pi Pa Qing Fei Yin (Loquat Leaf Decoction to Clear the Lung):

• Ingredients: Pi Pa Ye (Eriobotryae Folium), Sang Bai Pi (Mori Cortex), Huang Qin (Scutellariae Radix), Zhi Zi (Gardeniae Fructus), Jie Geng (Platycodonis Radix), Lu Gen (Phragmitis Rhizoma), Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix).
• Mechanism: This formula clears Heat from the Lung and Stomach, detoxifies, and resolves Dampness.

Case Study: Research by Li et al. (2016) indicated that Pi Pa Qing Fei Yin was effective in reducing acne lesions, with significant improvements in inflammatory and non-inflammatory acne (Li et al., 2016).

2. Dan Zhi Xiao Yao San (Moutan and Gardenia Free and Easy Wanderer Powder):

• Ingredients: Chai Hu (Bupleuri Radix), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix), Mu Dan Pi (Moutan Cortex), Zhi Zi (Gardeniae Fructus).
• Mechanism: This formula clears Liver Heat, alleviates depression, and addresses hormonal acne.

Acupuncture Points:

1. LI4 (Hegu), ST44 (Neiting), and LI11 (Quchi):

• Mechanism: These points clear Heat and reduce inflammation.

2. CV12 (Zhongwan) and ST36 (Zusanli):

• Mechanism: These points harmonize the Stomach and resolve Dampness, addressing the root causes of acne.

Integrative Approaches and Case Studies

1. Eczema and Psoriasis Combination Therapy:

A combined approach using Xiao Feng San for acute flare-ups and Si Wu Xiao Feng Yin for chronic management was shown to provide significant symptom relief in patients with overlapping eczema and psoriasis (Chen et al., 2018).

2. Acne and Digestive Health:

Integrating Pi Pa Qing Fei Yin with acupuncture at ST36 and CV12 improved not only acne symptoms but also gastrointestinal health, highlighting the interconnectedness of organ systems in TCM (Wang et al., 2019).

Advanced TCM techniques for treating dermatological conditions such as eczema, psoriasis, and acne involve sophisticated herbal formulations and precise acupuncture protocols. By addressing the root causes and pathophysiology through an integrative approach, practitioners can achieve significant clinical outcomes. Embracing these advanced strategies, supported by scientific research and case studies, ensures that TCM continues to provide comprehensive and effective care for complex skin disorders.

References

• Xue, C. C., et al. (2015). Randomized controlled trial of Xiao Feng San for the treatment of eczema. Journal of Traditional Chinese Medicine, 35(4), 395-401.
• Zhang, Y., et al. (2017). Clinical efficacy of Si Wu Xiao Feng Yin in the treatment of psoriasis. Chinese Journal of Integrative Medicine, 23(10), 750-754.
• Li, J., et al. (2016). Effectiveness of Pi Pa Qing Fei Yin in treating acne vulgaris. Journal of Dermatological Treatment, 27(3), 235-240.
• Chen, J., et al. (2018). Combined TCM therapy for eczema and psoriasis: A clinical case series. Journal of Integrative Medicine, 16(5), 367-374.
• Wang, S., et al. (2019). Integrative treatment of acne with herbal medicine and acupuncture. Chinese Medicine, 14(1), 45-51.