Acne from a Western and TCM Point of View
If you are struggling for a solution to your acne, this may shed some light on what you're dealing with and possible solutions to treat it. I am writing this because an adult that I know has recently had an increased amount of acne show up on his face. He has been self conscious and frustrated that he has had to deal with acne again after withstanding a similar battle, in high school. He has searched the internet and found information that says he should drink coconut water, plenty of regular water, wash his face often, try eliminating stress in his life, and possibly see a dermotologist. He isn't too fond of the thought of seeing a doctor to resolve this issue, so that's out of the question, but he does want to try and resolve this issue on his own. As a witness to the aggravation that comes along with each bump that appears on his face I decided to do some research of my own. I hope and pray that he will be receptive to the information that I have found and that he may find a resolution to his issue.
In beginning my search, I first looked at his lifestyle; I know that he has handled what to most may seem like a stressful situation, fairly well, he eats fairly well but does tend to eat fried food a couple days a week, and he is a smoker. I figured that smoking is where the root of the problem lies, and that no matter what other preventitive measures were taken, if the smoking isn't eliminated the acne may be a continual problem, so I asked if he had thought of that and if anything he read mentioned discontinuing smoking to help with acne issues. Unfortunately, he had not seen anything on this subject. Disappointed in that answer my journey begins and some interesting information was found not directly connecting the smoke to the problem, as much as I had hoped, but interesting just the same....
First, we need to know what we're dealing with here, so I decided to look into things from a Western point of view. According to the Merck Manual Home Health Book acne is caused by an interaction between hormones, skin oils, and bacteria, which results in inflammation of hair follicles. Acne is characterized by pimples, cysts, and sometimes abscesses. Both cysts and abscesses are pus-filled pockets, but abscesses are somewhat larger and deeper.
Sebaceous glands, lie in the the middle layer of skin (dermis), and these glands are attached to the hair follicles. Sebum (oily substance that is secreted by the sebaceous glands), along with dead skin cells, passes up from the sebaceous gland and hair follicle and out to the surface of the skin through the pores.
Acne results when a collection of dried sebum, dead skin cells, and bacteria clogs the hair follicles, blocking the sebum from leaving through the pores. If the blockage is incomplete, a blackhead (open comedone) develops; if the blockage is complete, a whitehead (closed comedone) develops. The blocked sebum-filled hair follicle promotes overgrowth of the bacterium
Propionibacterium acnes, which is normally present in the hair follicle. This bacterium breaks down the sebum into substances that irritate the skin. The resulting inflammation produces the skin eruptions that are commonly known as acne pimples. Deeper inflammation produces cysts and sometimes an abscess.
General care of acne is very simple. Affected areas should be gently washed once or twice a day with a mild soap. Antibacterial or abrasive soaps, alcohol pads, and heavy frequent scrubbing provide no added benefit and may further irritate the skin. Cosmetics should be water-based; very greasy products can worsen acne. Although there are no restrictions on specific foods (for example, pizza or chocolate), a healthy, balanced diet should be followed.
Mild Acne: Drugs used to treat mild acne are applied to the skin (topical drugs). They work by either killing bacteria (antibacterials) or drying up or unclogging the pores. The two most commonly prescribed antibacterials are the antibiotics clindamycin and erythromycin. Benzoyl peroxide, another effective antibacterial, is available with or without a prescription. Older nonprescription creams that contain salicylic acid, resorcinol, or sulfur work by drying out the pimples and causing slight peeling. These drugs, however, are less effective than antibiotics or benzoyl peroxide. If topical antibacterials fail, doctors use other topical prescription drugs that help unclog the pores. The most common such drug is tretinoin. Tretinoin is very effective but is irritating to the skin and makes it more sensitive to sunlight. Doctors therefore use this drug cautiously, starting with low concentrations and infrequent applications, which can be gradually increased. Benzoyl peroxide inactivates tretinoin, so the two must not be applied together. Blackheads and whiteheads can be removed by a doctor. A large pimple may be opened with a sterile needle. Other instruments, such as a loop extractor, can also be used to drain plugged pores and pimples.
Moderate Acne: Moderate acne is usually treated with antibiotics given by mouth. Doctors often combine a topical treatment and an oral antibiotic. People may need to take antibiotics for weeks, months, or even years to prevent a recurrence. Women who take antibiotics for a long time sometimes develop vaginal yeast infections that may require treatment.
Severe Acne: For the most severe acne, when antibiotics do not work, oral isotretioin (also known as accutane) is the best treatment. Isotretionoin, which is related to the topical drug tretinoin, is the only drug that can potentially cure acne. However, isotretinoin can have very serious side effects. Isotretinoin can harm a developing fetus, and women taking it must use strict contraceptive measures so they do not become pregnant. Other, less serious side effects may occur as well.
Hmmmm, very interesting, yet some of these treatments seemed harsh, so the next step was to look into things from a Traditional Chinese Medicine point of view.
Traditional Chinese Medicine considers acne
as a skin condition that is mainly associated with the pathogenic effects of Heat on the Fundamental Substances, the meridians and the Zang Fu organs. Excessive heat may result from
improper diet,
stress,
fatigue,
genetic condition or a
natural increase of Yang energy that is typical in puberty.
Heat may have an effect on the Stomach or Lung Meridians and can travel to the facial skin and the skin of the chest where acne’s characteristic inflammation can occur. If the acne appears on the back, it means the Heat escaped from the Small Intestine and Bladder channel. In the Lung Meridian, the External Pathogen of the Wind aggravates Heat may also change into Toxic Heat or affect the Blood and cause lesions. Lastly, emotional wellbeing is also a factor in the formation of acne. Very intense emotions of stress, anxiety, sadness, or anger can disrupt the body’s harmony and lead to Qi stagnation, causing Heat to transmit to the surface of the skin and manifest as acne.
In Traditional Chinese Medicine theory, the Liver also has a close energy relationship with the Stomach—it "controls" the Stomach. This means that when Stomach energy or Qi is in a state of excess, the Liver's job is to bring it back into balance. A red nose is a clear signal that there is excess Stomach Qi and it has stagnated, in turn causing a lot of heat to build up. This heat is then reflected on the face and the nose in particular. People who suffer from this type of acne rosacea might first experience bad breath, heartburn and constipation. Women may experience a menstrual cycle disorder preceding the condition. These are all early warning signs of a Liver function disorder. Stress, anger, or some kind of emotional disorder has impacted the way the Liver works and now prevents Liver energy from flowing freely.
Chinese Medicine perceives that acne and rosacea may be caused by three groups of factors:
- Lung Heat
- the "heat" already residing in the lung that subsequently 'fire' toxin on the face.
Yang Ming- this includes accumulation of heat in the stomach and large intestine, or the excess of rich and fatty food leading subsequently to 'fire' toxin on the skin.
Ren and Chong Channels not regulated
- this occurs in post-adolescent female acne. Typically it involves a mixture of pre-disposition and emotional factors, as well as coming off the contraceptive pill after being on it for a few years.
The basic treatment principle for acne in TCM is to clear Heat from the appropriate meridian, Zang Fu Organ, or Fundamental Substance, thus removing the underlying energetic cause of the disease.One TCM method that can be used to relieve acne symptoms is acupuncture but the preferred modality to treat acne is Chinese herbal medication.
To use herbal medicine, a combination of herbs will be prescribed according to the diagnosed type of pathogenic Heat in the body. An individual can take in herbal formulations, which may come in liquid, tablet or powder form, and apply a topical solution to the affected area to reduce inflammation and prevent new acne formation. Herbal medicine also lessens internal dampness and enhances the function of the intestines to prevent toxic buildup that contributes to acne.
Since nutrition plays a significant role in Traditional Chinese Medicine, the TCM physician will also include dietary recommendations in the acne treatment regimen. A low-carbohydrate and high-protein diet is advised while fried and processed foods should be avoided. TCM also stresses lifestyle changes, resulting in not just acne treatment but the restoration of balance in the body.
According to TCM, smoking affects the functions of the heart, pericardium, lung, spleen and stomach, especially leading to disorder of pulmonary Qi. Therefore, it only made sense that although the smoking may not be the "cause" of acne, smoking would definitely aggravate an existing heat disharmony in the body. I also found that the primary areas of his acne fell right along both the stomach (ST-3) and large intestine (LI-19 and LI-20) meridians on his face. This I found interesting because these areas were listed under the Yang Ming factor of causes, which points to diet being a large influence on the recent outbreak, according to Tradional Chinese Medicine, where Western medicine says there are no restrictions on specific foods. This is because in the West it's viewed mainly as a skin problem to be treated symptomatically. From the TCM perspective, good results come from treating the root cause of this condition, and harmonizing these imbalances for true healing to occur.
Eventhough, acne can be stressful and aggravating there are options for treating it and it is worth looking into the best options that work for you. I hope that this information will help him and anyone else that may be experiencing the same issue, whether a Western or Traditional Chinese Medicine approach is taken.
TCM Resources:
TCM World foundation
Discovery TCM
Driftwood Acupuncture and Wellness blog
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