Chinese Medicine

Acne can be seen mostly on face, chest and back. Adult acne is very common, especially during adolescence. When I was still at school, I ever talked about acne treatment with my teachers. My teachers confessed to me that acne treatment was not so easy and it seemed a general malaise but it was a stubborn infection and a refractory case of acne. I still remember that at that time I refused to be convinced that acne could not be cured. I thought to myself, acne could not be cured just because the right solution for acne treatment was still not to be found.

But years later, clinically I come to know the fact that curing acne is not so as easy as I thought. Curing acne need not only medication, but also regulating diet, rest and mood etc.

Acne treatment and me

When I was in high school, one or two pieces of acne began to be found on my face. But acne still rose one after another even in my senior year in college. At fist I did not pay too much attention to it, but more and more acnes still upset me. Sometimes acne was large and it hurt when I washed my face and touched it. It was also disgusting that sometimes it ruptured with discharges of yellow and white. I had to turn to my clinic teacher for help. He saw my tongue coating, took my pulse, then picked up his pen and prescribed me the minus and plus formula of Pu Ji Xiao Du Yin. After 5 dosages, it seemed that this acne remedy works and the condition improved. There was no new acne any more and the old acne was getting dim and smaller.

Later I knew that the experience of using this formula for acne treatment was from my teacher’s teacher. The primary cause behind adult acne is accumulation of dampness and heat. The principle of Pu Ji Xiao Du Yin is to clear heat-toxicity and dispel latent heat. Usually my teacher likes to add Yi Yi Ren to promote diuresis, clear heat and expel pus. This acne treatment has a very good effect clinically. In Traditional Chinese Medicine (TCM), as treating other any conditions, acne treatment also need to be conducted based on syndrome differentiation. There are not only pungent and cool natured drugs such as Chai hu, Bo he, Niu bang zi and Lian qiao, but also bitter cold natured drugs like Huang qin, Huang lian and Ban lan gen etc. So this acne treatment works better on pattern of accumulation of heat-toxicity and dampness-heat stagnating in spleen and stomach. It is cautious not to use this acne treatment in the syndrome of deficient cold of spleen and stomach.

Patterns of acne treatment

According to textbook of Chinese medicine, currently there are several patterns of acne, like wind-heat invading lung channel, dampness-heat in intestine and phlegm-dampness obstruction. Acne treatment includes clearing heat in lung, purging dampness-heat, resolving phlegm and dispelling blood stasis. Of course these patterns work technically but it is more than that clinically.

There is also description in Nei Jing for this condition, so for acne treatment, dispelling pathogenic wind also is one of very important options. Wind medication not only dispels latent heat, but also opens striae and interstitial space and allows those pathogens knotted in skin vent out. Actually my teacher choosing Pu Ji Xiao Du Yin also implies this principle. Personally based on my clinical experience, Jing Jie and Bai zhi would be added for pattern of dampness-heat, latent heat and stagnation of blood and heat. Jing jie, warm but not dry natured, can dispel stagnated heat in Xuefen (blood realm). Bai zhi, pungent natured, can resolve carbuncle and expulse boil. Bai zhi can whiten complexion, according to Shennong’s Classic of Masteria media. And Bai zhi was used very often in external beauty medications in ancient royal court. Both are of warm nature, but it is viable to ignore their warm nature while preserving their use in the formula of overall cool nature. It can shorten the whole therapy time needed greatly by this way.

Personally I think applying assisting pungent medication in acne treatment inclined to pattern of excessive heat can function as follow:

1. Open striae and interstitial space to allow pathogens have vents to dispel;
2. Dispel latent heat and assist clearing heat;
3. Scurry and circulate, resolve carbuncle and expulse boil;
4. Assist to restrain over cold to prevent latent ice and protect the spring qi of spleen and stomach.

Other acne treatment patterns

Currently a lot of the young people don’t pay much attention to their life style. They often stay up all night, toil and work and worry their hair gray to get a living. Xiang huo (ministerial fire) is easy to be stirred in puberty, which results in deficient yin and excessive fire. So nourishing yin for lowering fire is one of the options for acne treatment. A poor-effected case by clearing fire, I ever heard from my teacher, was improved tremendously after by the minus and plus formula of Zhi bo di huang tang. But the patients using this acne treatment often reveals not only with excessive fire, but also with outstanding deficient yin. Most of them are with acne in the jaw, where belongs to Shen (kidney). If Shen water/essence is full, ministerial fire would swim beneath; if Shen water/essence is deficient, dragon fire would flare up. Else, dispersing stagnated spleen qi is also an important point for acne treatment.

In terms of western medicine, the main cause of acne is endocrine dyscrasia. Clinically acne sufferers for moodiness, stagnation of spleen and stagnated qi transforming fire can be seen very often too. This pattern can be seen mostly in female and over-scrupulous persons. Females of this pattern usually are with other symptoms of dysmenorrhea and irregular menses. Clinically attention should be paid to therapy of dispersing stagnated spleen and regulating menses, clearing latent heat, such as formulas of Dan zhi xiao yao san, Si ni san or Dang gui shao yao san ect.

Other factors for acne treatment

Besides of medication, bland diet, sleeping early and peaceful mood are as important too. If ignoring these factors, sometimes even perfect diagnosis could get nowhere at all.