Chinese Medicine and acupuncture for skin conditions like eczema, psoriasis & acne.

Whilst the doctors working in acupuncture clinics of ancient China may not have referred to themselves as dermatologists, they were diagnosing and treating skin diseases using acupuncture and Chinese herbs long before the invention of steroids or antibiotics. Through questioning, inspection and palpation, they diagnosed according to the guiding principles of Traditional Chinese Medicine. I’m very happy to play a part in continuing this tradition.

Chinese medicine has a very long tradition of working with skin conditions like eczema, psoriasis and acne (8).

So, first things first, what causes eczema, psoriasis and acne?

The exact causes of eczema are unknown, although recent discoveries surrounding a protective protein called Filiggrin may be involved (1). In fact, for each sufferer the cause often differs. For some it’s allergen based – meaning that the person’s body reacts to some allergen like pet dander, pollen or dust mites. For others it may be certain types of food such as eggs or dairy.  Some of the most common causes include –

– allergens eg pet dander – microbes – certain moulds – temperature – hot or cold weather – foods – such as eggs, nuts, dairy – stress & – hormones (1).

Avoid Hot Water – most patients will tell me that they avoid really hot showers. Warm showers and baths seem to work better. Adding a moisturising agent to your bath may also help prevent your skin barrier from drying out. Add moisture – keeping skin moisturised seems to help most eczema sufferers. Your skin is having trouble keeping moisture in, so it makes sense to moisturise. Find a good quality and chemical free moisturiser that works for you. Often simple is best, so Sorbolene with a Vitamin E component often works pretty well. Keeping it fragrance free is also a good  idea – the less irritants in your moisturiser the better off your skin will be. Think of it also as a barrier to stop skin from drying out. Applying your moisturiser during the day as well as immediately after your warm shower or bath may help (2,3).

Some other coping tips include: – avoiding big temperature changes i.e. try not to over heat or overcool your home using heaters and air conditioning.  Use extra layers and peel off the layers when the weather is cool or hot. Some heating and air con is ok of course, but moderation is the key. – avoid perfumed cosmetics and bath emollients, shampoos etc (2,3). – enjoy a healthy diet and get in some de-stressing type of exercise routine. We, as TCM practitioners, appreciate the role of stress in the role of eczema attacks;  we hear patients tell us that stress makes the condition worse.  Whilst we need more larger scale trials to understand the role that acupuncture may have in reducing stress, the British Acupuncture Council mentions some positive findings on their website http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/stress.html  (5).    

 

Psoriasis is seen as an chronic inflammatory disease and can present as one of five different ‘types’.  The type that we are all probably most familiar with is ‘Plaque Psoriasis’, which presents with raised pink patches which are covered in a silvery, scaly build up of dead skin cells. These patches are likely to appear anywhere on the body but are likely to appear on the outside of the knees, elbows, face, and lower back. The plaques found in psoriasis are seen as well defined and raised, versus what are often less well defined blemishes in eczema. Generally, there is a greater degree of inflammation in psoriasis than in eczema. Patients will describe various sensation relating to their Psoriasis – itching, burring, pricking and stinging. There are generally 5 types of Psoriasis :

Plaque Psoriasis ( Psoriasis vulgaris, ) Guttate Psoriasis,  Inverse Psoriasis,  Pustular Psoriasis Erythrodermic Psoriasis (6).

Western medicine believes there to be a genetic predisposition towards a person developing Psoriasis. They have identified a number of genes which they believe may be responsible for someone developing the plaque-looking skin lesions which typically represent Psoriasis.  Whilst there are five different types of Psoriasis , someone will typically present with just one of them at a time, though may go on to develop another kind when their existing type has gone (6). If you have an hereditary disposition towards developing Psoriasis, you will most likely have identified your trigger or triggers by now. Triggers will vary from person to person, but may include :

-Stress  –     Trauma, such as scratches or scrapes, sunburns     – Medications.

Patients may say that they can make a connection between weather changes, diet and the condition of their skin. This makes perfect sense to me as a TCM practitioner where the foods we eat play an important role in our skin health. So too does the environment, which in TCM terms, we are inseparable from. Ever had a friend who seems to be able to predict when there is a storm front coming judging by the ache in their ‘bung knee?’  Well a similar kind of thing can happen with people suffering from Psoriasis which is a ‘damp’ or ‘dry’ type of psoriasis (in TCM terms).  That is, when the weather is beginning to turn much more humid, damp-psoriasis sufferers will say that their skin is starting to play up – and the reverse for those suffering from ‘dry psoriasis’.

Acne, or Acne Vulgaris, is a common inflammatory skin condition where skin pores become blocked due to excessive amounts of sebum. This blockage is the result of a complex mechanism involving rising hormone levels, sebum and bacteria (6,10). Sebum levels rise largely in response to rising hormone levels – androgens ( male hormones produced by the adrenal glands in both men and women )  – which is why acne often appears around puberty as well as just prior to a women’s menses and/or leading up to menopause. Rising androgen levels is also the cause of problematic acne in Polycystic Ovarian Syndrome (PCOS) and pregnancy.  Fortunately, acne in pregnancy  is often short lived and leaves just as quickly as it arrived as the pregnancy develops through the trimesters(6,9,10). Acne is not necessarily dangerous, but excessive amounts of androgens can play havoc with a woman’s fertility. So, helping to clear the pimples may not only help your self esteem, but also help your overall hormone landscape and natural fertility (9).

How does a pimple occur? Each hair arises from a tube or follicle in the skin which has an opening at the skin’s surface ( pores ) and a ‘base’ under the skin called a gland . The gland produces sebum which helps collect and propel dead skin cells up through the follicle to the exterior where it can be exfoliated and washed away. Excessive sebum however, can cause this opening (pore) to become blocked at the surface, resulting in an excess of sebum or oil under the skins surface.

What types of Pimples are there?Blackheads – often referred to as open comedones – visible black spots on the surface of the skin made up of sebum, keratin and microorganisms – Whiteheads  – often referred to as closed comedones – small, visible, pus filled pimples on the surface of the skin – Deep Acne – refers to deep, inflamed nodules and pus-filled cysts which may rupture and go on to form abscesses. It is this deep type of acne which is more likely to leave scarring and is commonly referred to as ‘cystic acne'(6).

Treatment of Acne with Western Medicine: Your doctor here,  is obviously the expert, and the following is by no means intended as medical advice.

Superficial acne involving whiteheads and pustules will most likely involve topical creams, perhaps benzoyl peroxide, or various sulfur-resorciniol combinations. Deeper, cystic acne might be treated with high strength antibiotics (11).

When we use acupuncture and Chinese herbs, we aim to help someone into a better state of being, thereby  alleviating any annoying symptoms.

So, what are the benefits of using Chinese herbs and acupuncture for skin diseases?

1.  We aim to resolve the mechanism that is causing the symptom from a TCM perspective.  The appearance of psoriasis, acne or eczema is a clue to me that there is some internal imbalance within your body. Hormones, diet, age and lifestyle can all contribute to the appearance and persistence of the rash, blemish, spot or boil.  Often we will focus on the gut, given a large part of our natural immunity derives from the gut.

2. It’s doesn’t hurt! Many people say ‘I am scared of needles’.  Our needles are very fine, single use and disposable. There may some sensations ( tingling, warm, dull ..)  that come with certain points, but pain is something we really try to avoid!  3. As we have mentioned, when we use acupuncture and Chinese Medicine for skin issues, we are focused on the entire wellbeing of the person. Along the way, we will try to address any other health concerns that might be a part of your landscape.

Research Nerd?

We do like a bit of research too! There has been a long history of Chinese Medicine and acupuncture being used to treat acne, psoriasis, eczema, hives – even boils, non healing wounds, peri-anal abscesses and more. Our Eastern neighbours have used this medicine alongside allopathic medicine to improve the health of patients for decades. Along the way, there have been some excellent trials on how we can affect skin conditions – take a look at the link below from the British Acupuncture Council on some research on Acne and Eczema & Psoriasis:

Acne: Intro – https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/acne.html
Acne: Research Evidence – https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/acne.html
+
Eczema & Psoriasis: Intro – https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/eczema-and-psoriasis.html
Eczema & Psoriasis: Research Evidence – https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/eczema-and-psoriasis.html

Recent systematic reviews of evidence to date have concluded that the evidence to support acupuncture for these conditions is unclear or insufficient. We are aware of the huge issues with acupuncture research and how the true effect that acupuncture has on a condition is underrated – a real issue! (12). Our approach is always based on the long history of Chinese medicine, its unique approach to diagnosis and its ability to treat the individual no matter what the symptom.

 

 If you would like to talk about how acupuncture and Chinese medicine may help you towards wellness, then call me or contact me through the contact form on here.  

 You can reach me on 3357 3205.

 

Some useful tips for stubborn Skin Conditions from a TCM perspective:

  • Aloe Vera Gel for Acne: In TCM, Aloe Vera is named Lu Hui, and may be useful as a topical application in the treatment of acne. Each herb in Chinese Medicine has a thermal nature – Aloe Vera is thought to be cold in nature and so if very useful as an anti-inflammatory. It’s also useful as an antibacterial and bacteriostatic – so great if your acne is prone to developing pus filled pimples. Lu Hui also has the ability to penetrate deeply within the skin tissues, so is also beneficial for those suffering from deep, cystic lesions. Best thing? It’s plant based and safe to use!
  • Water: We need it, especially our skin. Adding water to our system is essentially like adding oil to an engine – it just runs better! If you can aim for 6 glasses a day, then you’re doing your skin and your overall health a big favour.
  • Vegetables: Acidity is a big problem for us in the modern Western world. We’re all prone to indulging in too many acid forming foods and not enough alkaline foods. Vegetables help to keep our blood alkaline – so eat them up! As many as you like. To make the most of the veges, lightly cook them in stir fries, steamers and slow cookers.
  • There is a big push or trend at the moment for ‘raw food’ and juicing diets. Whilst it’s true that juicing and eating raw foods does help maintain the vitamin and mineral content of the veges, raw foods ( including juices ) are seen as ‘cold’ natured foods in Chinese Medicine and help to extinguish the furnace which helps make our energy. Not so good. So whilst you might get a bit of a ‘buzz’ from the immediate hit of nutrients from a juice, long term, the cold nature of juices and raw food diets make your digestive system work way harder than what it needs to. The end result often leaves a kind of sediment hanging around in the body which we refer to as ‘damp’. This ‘damp’  within the digestive system,  if left untreated, tends to slowly leach out into the tissues and skin over time. This can result in all manner of skin conditions including eczema, psoriasis, acne, boils etc. Damp in the body also leads to general lethargy and sluggishness – especially when the weather conditions are humid. Do you know of people who can tell you when there is a shift in the weather i.e. when there is rain coming? Yep, these people have some significant damp within their body, often associated with sore joints.
  • So, enjoy your veges, but cook them lightly and help your body detoxify and alkalise. A good vegetable soup taken once a week is an excellent start. If you manage to add some Pearl Barley to the soup, even better. Pearl barley is used in Traditional Chinese Medicine to help drain dampness from the body – so it’s great as a general tonic to keep help skin healthy and free from puffiness. It’s also great as a general diuretic to help keep weight under control.
  • Exercise: Stress relieving exercise such as swimming, tai chi, yoga, boxing ( most exercise really ) , helps to vent pent up Liver energy and therefore vents excess heat from  the body ( which in TCM terms can be interpreted as inflammation ). So if you’re experiencing hot and painful inflammatory skin rashes, then exercise might just help.

 

References

1     C. Lucida  Eczema Genetics, the Filaggrin gene, and Environmental Influences  2010 https://www.dermaharmony.com/eczema/eczemageneticsfilaggrin.aspx  (accessed 20 November 2016) 2    Australasian Society of Clinical Immunology and Allergy   Eczema ( Atopic Dermatitis ) 2015 http://www.allergy.org.au/patients/skin-allergy/eczema (accessed 20 November 2016)
3     Primary Care dermatology Society & British Association of Dermatologists  Guidelines on the management of atopic eczema  2005  http://www.pcds.org.uk/images/stories/pcdsbad-eczema.pdf   (viewed 20 November 2016)
4    Pfab F et al. Influence of acupuncture on type i hypersensitivity itch and the wheal and flare response in adults with atopic  eczema – A blinded, randomized, placebo-controlled, crossover trial Allergy: European Journal of Allergy and Clinical Immunology 2010; 65: 903-10.
5    British Acupuncture Council    Stress  2015  http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of- conditions/stress.html  (accessed  November 2016)
6   Flaws B, Siounneau P    The Treatment of Modern Western Medical Diseases with Chinese Medicine – a Textbook and  Clinical Manual  Blue Poppy Press Boulder, Colorado USA  2015
7   British Acupuncture Council    Eczema and Psoriasis http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to z-of-conditions/eczema-and-psoriasis.html ( accessed 20 November 2016 )
8    Pacific College of Oriental Medicine 2016 Acupuncture for Eczema and Skin Disorders        http://www.pacificcollege.edu/news/blog/2015/01/16/acupuncture-eczema-skin-disorders ( accessed 20 November 2016 )
9     Lyttleton J   The Treatment of Infertility with Chinese Medicine Elsevier China  2013 pp 173-229
10   British Acupuncture Council   Feb 2015   Acne    http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of conditions/acne.html (accessed Feb 20 2016)
11    McKoy, K (MD)   March 2015   Acne http://www.msdmanuals.com/en-au/professional/dermatologic disorders/acne-and-related-disorders/acne-vulgaris#v960051(accessed 21 Novemebr 2016)
12   McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised Edition). Brisbane: Australian Acupuncture and Chinese Medicine