Chinese Medicine and acupuncture: Can it help skin conditions like eczema, psoriasis & acne?
Many people will phone asking if acupuncture & Chinese Medicine can be used to help skin conditions like eczema, psoriasis and acne. In order to satisfy advertising guidelines from our governing body, AHPRA, we are always looking to the latest research for some scientific confirmation that acupuncture and Chinese herbs can help, regardless of whether we have a long tradition of working with these conditions.
Firstly, lets have a look at how we work.
Regardless of whether or not there has been published scientific trials surrounding an illness, as TCM practitioners we will always be more interested in the set of signs and symptoms that our patients bring to us. For example, symptoms like oily skin, feelings of stress, facial or skin redness etc.
What we are doing by acknowledging, and adding, theses signs and symptoms to our own diagnostic methods, is coming to an understating in TCM (Traditional Chinese Medicine) language, as to how those symptoms have appeared. “Ah, so that’s why those symptoms are there!” We will then use acupuncture and Chinese Medicine to help ease those symptoms based on our own understating of how they appeared in the first place. TCM appreciates that things like stress, weather, diet and emotions can all affect how we look and feel. Of course, we take these things into account when making a diagnosis based on TCM.
Through questioning, inspection and palpation, Doctors of Chinese Medicine in ancient, and modern China, diagnosed according to the principles of TCM. As Chinese Medicine developed over its 3-4000 year history, various areas evolved liked gynaecology and dermatology.
If you would like to talk further about whether TCM may be able to help your current set of symptoms, please call us at the clinic – 3357 3205.
A note on the Research:
So, to talk about the research first, there was a Systematic Review in 2009 (1) which suggested that acupuncture was an effective treatment for acne, but limitations in the review were seen because of the quality of some of the trials reviewed. Since then, our own Acupuncture Evidence Project (2) has not found enough recent top-quality research surrounding acne ( and skin conditions in general ), for us to be able to state that acupuncture can help treat them. Our registration and governing body AHRA , requires more recent Systematic reviews and good quality randomised controlled trials for us to be able to say unequivocally that we can treat them, so we are eagerly awaiting more research to be published so that we can analyse the results!
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 (2)! 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.
So, 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 (3). 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 (4,5).
The following is not to be considered medical advice in any way. Readers should always seek medical advice for persisting medical issues and or symptoms.
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 (4,5).
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 (4,5). – 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 has some interesting information on their website http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/stress.html (6).
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 (7,8,9 ).
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 (,8,97). 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 :
– Trauma, such as scratches or scrapes, sunburns
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 (8,10,11). 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 (12). Fortunately, acne in pregnancy is often short lived and leaves just as quickly as it arrived as the pregnancy develops through the trimesters(8,10,11). 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 (8,10,11).
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'(8,10,11).
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.
- 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.
- Li et al 2009 Systematic evaluation of the therapeutic effect and safety for clinic randomised and controlled trials of treatment of acne with acupuncture and moxibustion 2009 Mar;29(3):247-51.
- McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised Edition). Brisbane: Australian Acupuncture and Chinese Medicine
3 C. Lucida Eczema Genetics, the Filaggrin gene, and Environmental Influences 2010 https://www.dermaharmony.com/eczema/eczemageneticsfilaggrin.aspx (accessed 20 November 2016)
4 Australasian Society of Clinical Immunology and Allergy Eczema ( Atopic Dermatitis ) 2015 http://www.allergy.org.au/patients/skin-allergy/eczema (accessed 20 November 2016)
5 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)
6 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)
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 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 201
9 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.
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 Lyttleton J The Treatment of Infertility with Chinese Medicine Elsevier China 2013 pp 173-229