Chinese Herbs for Mouth and Lip Sores – Cankers, Cold Sores and moreAdina Stanescu, R.TCMP February 1, 2022
Sores and skin rashes of all types cause us considerable discomfort, but none as much as those that affect the mouth and lips. These sores impact our intimacy, our ability to enjoy food, and our self esteem, and are so uniquely and exasperatingly ‘in your face’!
The most common oral sores and rashes are cold sores, canker sores, oral lichen planus, perioral dermatitis, and cheilitis (the medical term for inflamed lips).
Traditional Chinese Medicine (TCM) offers excellent treatment for every one of these conditions through herbal and dietary therapy. In fact, dietary therapy plays an especially important role here, as the mouth and lips are the portal to the digestive system and are easily flared by certain foods and drinks.
For herbal treatment, each condition will be discussed in turn, but dietary therapy is the same for all, as they are all negatively affected by ‘Damp-Heat’. Lately I’ve taken to translating this TCM term as ‘Hot Mucus’, or ‘Toxic Mucus’, in order to make it more understandable.
When digestion is sluggish and weak or the diet is too rich in greasy and oily foods, mucus results. This substance is sticky and difficult to remove from the gastrointestinal tract, especially if the bowels are also sluggish, and soon this persistent sticky stagnation turns to heat, and in severe cases ‘Fire Toxin’. Heat and Fire naturally rise up from the stomach and intestines, and show themselves on the lips, mouth and face.
Sufferers must therefore avoid Heat- and Mucus-forming foods: hot spices, raw garlic, ginger, cinnamon and other “chai” spices, alcohol, yeasted breads, creamy sauces, fried fatty meats, nuts and avocados, shellfish and fatty fish like farmed salmon, as well as vinegar and kombucha. When open sores are present in the mouth, acidic fruit like tomatoes and citrus should also be avoided.
Cold sores are caused by the herpes virus and are very common. Interestingly, most people who are infected – i.e. 80% of the population – do not ever develop the blisters; only 20% do. This shows that it is perfectly possible for this virus to be kept in check, and herbal therapy can accomplish this. The fluid-filled, yellow-crusted blisters of herpes are a perfect example of Damp Heat and extreme Fire Toxin. However, herbal prescriptions for cold sores will also include herbs which have shown anti-viral activity, such as Isatis root and leaf or Indigo powder.
Other standard additions are cold and cool herbs that clear heat from the stomach, intestines and liver, such as Gentiana root, Coptis root, Mulberry leaf and Crysanthemum flower. The last two herbs are light and ascending, in order to lift the effect of the formula to the face, like a feather borne on a light breeze. This is the utter magic of TCM prescriptions!
Also known as aphthous ulcers, canker sores are very common, affecting 25% of the general public. For most sufferers, they are a minor and transient bother, but occasionally they recur too often and in multiples, making eating extremely painful. They can effect the tongue or any of the mucous membranes inside the mouth. Treatment depends on how they present themselves. If the cankers are big and there is a thick yellow tongue coat, the cause is, once again, ‘Damp Heat’ in the stomach and intestines. Strong yellow bitters such as Coptis root, Scutellaria root and Phellodendron root are very useful.
But canker sores can also occur as part of an interesting pattern that includes mental/emotional agitation, insomnia, and scanty dark urine or urinary tract infections. This is called ‘Heart Fire’ in TCM. I once had a young male patient who fit this bill to a T. He had multiple large cankers that recurred on his tongue, he could not sleep more than three hours a night, he talked very fast, and his already poor sleep was disturbed by the need to urinate very small amounts up to 10 times a night. The well known formula Dao Chi San, which guides our ‘Heart Fire’, had a miraculous effect in just one week. He was a different person at our first follow up – well rested and calm, and his urination was normal.
Oral Lichen Planus
Lichen planus is an inflammatory skin disease of unknown cause, though occasionally it is triggered by pharmaceutical drugs, or associated with hepatitis C infection. Still, most sufferers do not have either in their history. Usually lesions affect the body primarily, but when they affect the mouth greyish white net-like strands form in the mouth, accompanied in the worst cases by ulceration, pain, and itching. Once again, TCM treats this with a very customized approach, adding the herbal combination Xie Huang San, which drains hidden fire from the stomach and spleen. It’s interesting to note that the herbs used to treat body lesions of lichen planus would not be enough to address the mouth presentation. It is this rather nit-picky attention to detail that makes TCM herbs work so very well.
Nowadays this is also called periorificial dermatitis in order to indicate that this dermatitis not only flares around the mouth, but can also appear around the nose and eyes – i.e. near all of the orifices of the face.
When it is confined to the mouth, we have our first clue that the digestive system is most likely involved, whereas the nose implicates the lungs, the eyes, and the liver. The symptoms include: red bumps, pimples, patchy redness, scaling, and mild itching, and they can range from mild to very severe, and can oscillate between the two from one day to the next. Often, there are accompanying digestive symptoms such as a thick tongue coating, constipation or diarrhea, bad breath, gas, bloating, etc. Bitter herbs are once again the mainstay of treatment. If there is a hormonal component, and it flares with the menstrual cycle, liver-regulating herbs like Dang gui root andBupleurum are added.
It is also essential to stop using any creams, lotions, and cleansers on the face whatsoever, even “all natural” ones. Perioral dermatitis is very reactive to just about everything.
Cheilitis is from the classical Greek word for lip – cheilo. Cheilitis is lip inflammation, often caused by fungal and bacterial infection. The lips are red, cracked, sometimes swollen and dry, but they can also weep and ooze. Fungal and bacterial cheilitis tends to occur in the mouth corners, when it is also called angular cheilitis.
Once again, TCM has an established protocol, in this case substituting aromatic digestives instead of the yellow bitters mentioned above. This is because aromatics have volatile oils which are strongly anti-fungal, and these are particularly effective in this situation where the Hot Mucus is mixed with fungus and yeast. Appropriate aromatics include Agastache (patchouli), Atractylodis and Eupatorium. Not only do these resolve the lip inflammation but also any accompanying digestive issues and the commonly seen symptom of a sweet and sickly taste in the mouth.
Adina Stanescu, R.TCMP is director of The TCM Skin and Internal Clinic in Toronto. She has 25 years experience treating inflammatory skin disease, allergic and autoimmune conditions, and gastrointestinal disorders with Traditional Chinese Medicine. She is the TCM Dermatology professor at Humber College. For appointments email firstname.lastname@example.org or visit www.thetcmclinic.com