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Acne

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Acne - Above: Dec 2016

Acne - Above: April 2017


Dec 2016                                                                                   Apr 2017


Dec 2016                                                                             Apr 2017

Our article from the September 2014 issue of Essential Living Maine Magazine:

Got Acne?  Chinese Medicine May be the Answer

In our last article we talked about the 6 steps to healthier skin through Chinese medicine.  If you missed it, check out the online issue from August to get a basic understanding of why you might consider Chinese medicine for your skin disease.  Today we’re going to get more specific and talk about what Chinese medicine can do for you and your acne.

According to the American Academy of Dermatology, acne is the most common skin disorder in the United States.  It affects nearly 85% of people at some point in their life, and nearly 40% of adolescents have acne or acne scarring by their mid teens.  Those are big numbers—even bigger when you consider that $2.2 billion annually is spent on Western medical treatments.

We all know acne when we see it, but what is it, exactly?  Acne starts when oil and dead skin cells clog up your pores.  Pores are home to your hair follicles, so, excepting the palms of your hands, soles of your feet, and a few other small areas, your body is covered in pores.  Pores are also the opening where your body’s natural oil is released to the surface of the skin (this oil is called sebum and is produced in the sebaceous glands).  This is a useful system and keeps your skin nicely moisturized—as long as it’s functioning properly.  Problems arise when stress, medications, or hormonal imbalances prompt the sebaceous glands to overproduce sebum.  Excess oil mixes with dead skin cells and clogs up the works, bacteria enter the picture, and there we have the telltale whiteheads, blackheads, and cysts we all recognize as acne.

From the perspective of Chinese medicine, there are additional factors that contribute to the development of acne. Chinese medicine has recognized and treated acne for centuries, with traditional names including “pink/white thorns” (fen ci), “lung wind thorns” (fei feng fen ci), and “wine thorns” (jiu ci).  In treating acne, the modern practitioner of Chinese medicine understands that the pores are clogged.  We understand that bacteria are often involved.  We understand that stress and hormones likely play a role, and we understand the importance of keeping the area clean.  However we also have the benefit of an altogether different approach to human physiology that allows us to look at acne from a perspective unavailable to a Western doctor, dermatologist, or aesthetician.  And the benefit of that different perspective is that it gives us different treatment options—options that may finally get to the root of your acne, once and for all.

You might hear us talk about things like Lung heat, Yang Ming heat, Ren and Chong vessels not being regulated, fire toxin, phlegm heat, and blood stasis.  These terms might sound cuckoo to you, or profoundly “unscientific.”  I get it, I really do.  But these “cuckoo” terms are part of a large, complex, time-tested, extraordinarily elegant system of understanding and explaining the inner-workings of the human body.  Not one that’s less scientific than the Western understanding, just one that’s different.  The usefulness in these terms—and they are so useful!—lies in the way they match up with a treatment plan in the hands of a skilled practitioner.  Certain symptoms in a patient might indicate what we call “blood heat,” others a “heat in the Lung” (capitalized purposefully as the Lung in Chinese medicine represents more than the lung as an organ—but that’s a topic for another article).  Practitioners will match these patterns with a treatment plan to clear blood and Lung heat.  When the treatment matches the pattern, symptoms improve.  Yay! 

Your lesions tell us a lot.  Where are they located?  Just on your face or also on your chest, shoulders, and back?  What color are they?  How frequently do new breakouts occur and how quickly do they resolve?  How greasy does your skin feel?  Does it itch?  Are the lesions tiny and right on the surface or are they big, deep, and cystic?  Are they painful?  We also want to know the details of your sleep, your digestion, your mood, your temperature, your bowel habits, and your menstrual cycle.  We are not treating skin, we are treating a person who has skin.  All of you matters.

Let’s run through a couple of examples.  We have a patient, female, age 22.  She’s had acne since the age of 16—not severe, but persistent with background erythema (redness) and pustules and papules (whiteheads and pimples) mostly on her cheeks.  Her general health is good aside from frequent acid reflux after big meals.  Bowels are normal.  Her skin worsens premenstrually.  Her tongue is slightly redder than normal.  (If you’ve been to an acupuncturist or Chinese herbalist you know how much we like to look at your tongue.  Believe it or not, it’s another window into what’s going on inside your body and it gives us important information.) 

So what to do?  We know we’ll be clearing heat as acne is inherently inflammatory—this is true for many common skin diseases.  The relatively mild presentation and accumulation of lesions mostly on her cheeks leads us toward a pattern of Lung heat.  The acid regurgitation indicates Stomach heat.  Acne in general tends to benefit from toxic heat clearing medicines (medicines which, not surprisingly to Chinese herbalists, modern research has shown to have anti-bacterial properties) so we know those will be included in the formula, and the level of background erythema indicates qi (pronounced “chee”) level heat.  From there, we put together an individualized formula containing 10-15 herbs to address the pattern(s) we see. 

Let’s take another example of a 17-year-old male.  He’s suffered with acne since the age of 13.  Four months of treatment with oxytetracycline (an antibiotic often prescribed to treat the bacterial aspect of acne) has shown very little benefit.  His skin is prone to feeling greasy at the end of the day, and his face is often itchy.  He frequently feels hot, his mouth and lips are dry, he’s thirsty, and he has bad breath.  His bowels are sluggish and dry, opening only every other day.  His appetite is large, with a strong desire for sweet foods.  He has difficulty falling asleep.  His tongue is red with a greasy white coating, and his pulse is slippery. (Yes, we take your pulse in all kinds of “cuckoo” ways, too.  Yes, it’s extraordinarily helpful!)

We can see immediately that this case is appreciably different from the first.  The greasiness and itchiness of his face reveals that there is more dampness in his system than we saw in the first case.  There are also more symptoms of heat, as seen in his tongue, his restless sleep, his slow bowels, his bad breath, his thirst, and his large appetite.  A photo would reveal that this patient’s acne looks more “severe” than the first.  While her lesions sat upon the surface of the skin, his are more entrenched, with more redness, more swelling, more pustules, more cysts.  As such, our treatment approach will be different.  We’ll have stronger and more toxic heat clearing medicinals in this formulation.  We’ll address the symptoms of damp heat with herbs that drain damp heat from the skin.  We’ll be sure to include herbs to open his bowel—it’s of the utmost importance that the bowels move at least once daily to empty the body of its accumulated waste products.  A backed up bowel is likely contributing to the accumulation of damp and heat in his system that’s being expressed through his skin.

So, can you start to see how this “cuckoo” language actually serves a very useful purpose?  Not only are practitioners of Chinese medicine able to access a unique physiological understanding of the human body, we’re also able to obtain results that last.  Chinese medicine is much less interested in treating symptoms than it is in addressing the root cause of those symptoms.  The herbal formulations prescribed in the cases above are not masking the acne or suppressing it.  On the contrary, they’re addressing the fundamental imbalances in the body that are generating the acne in the first place.  This means the whole body benefits from the treatment of the skin.  It’s a win-win!

Skin disease is notoriously difficult to treat—this is true in Western as well as Chinese medicine, and acne is no exception.  We don’t often see changes overnight—treatment of chronic skin disease can take anywhere from 3-8 months, and sometimes longer.  That said, most patients do see improvement, often very significant improvement or complete resolution.  For those of you suffering from disfiguring lesions on the most public part of your body—your beautiful face—consider Chinese medicine.  It may offer you some hope where other methods have failed.

Alexa Gilmore
LAc, MAcOM, LMT

Phone (207) 756-4301

Fax (866) 566-0298

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