Curing Eczema of the Hands with Chinese HerbsAdina Stanescu, R.TCMP December 1, 2007
Eczema of the hands is a very interesting skin condition, although this quality may well be lost on sufferers whose lives are undeniably impaired by it. It is indeed very difficult to attend to daily tasks while the hands are covered in blisters, open wounds or deep fissures.
However, hand eczema is a very satisfying condition to treat, as it generally responds exceptionally well to Traditional Chinese Medicine (TCM), and the expectation is that virtually every case can be cured.
It is also known as pompholyx or dishydrotic eczema, from the Greek meaning “bad” or abnormal sweat, and this gives us a clue as to the causes or co-factors responsible. For many people, the onset is preceded by a period of high stress, anxiety or tension which produces chronically sweaty palms. Eventually, small fluid-filled blisters begin to appear under the skin, usually on the palms and sides of the fingers. These are often extremely itchy, and may either retreat without discharging, or rupture, weep and crust.
Either way, this very wet phase is then followed by its opposite – extreme dryness to the point of cracks and fissures so deep that, in severe cases, one has the impression of being able to see inside the flesh.
Bending the fingers, washing, and general use of the hands is extremely painful. After some time, the cracks heal mysteriously, only to be followed once more by wet, weepy blisters. This dynamic cycle can recur for months or years, with varying degrees of severity. Eventually the condition may settle into the dry, cracked manifestation only.
Some cases will even show a seemingly paradoxical co-existence of blisters and fissures simultaneously.
THE WESTERN MEDICINE APPROACH
Conventional dermatology treats hand eczema very poorly. Steroid creams are the usual prescription, but their skin thinning effect is particularly harmful on the hands, predisposing it to further injury in the long term. And after a relatively short time steroids lose effectiveness.
The newer generation of eczema creams, known by their trade names Protopic or Elidel, contain an immune suppressive drug called tacrolimus. Used internally, it prevents organ transplant rejection by suppressing the immune system. However, it seems that even the small doses used externally for conditions such as eczema and vitiligo have enough of a systemic effect to increase the risk of skin or lymphatic cancer. Faced with such prospects, many patients seek alternative routes.
TRADITIONAL CHINESE MEDICINE APPROACH
TCM treats hand eczema in one of three ways: by detoxifying the Liver, cleansing digestion, or cooling Blood.
LIVER DETOX – This type of eczema will most often show the stress connection described above, with patients describing a traumatic event preceding the onset of the condition. In TCM, it is well recognized that emotions can cause as much toxicity to the liver as pollutants and chemicals. Such stress will make the Liver energy seize up, impairing its cleansing function.
Toxins and Damp Heat will rise to the skin, causing excessive sweating and inflammation. However, it is important to note that sweating is not present in every case.
With or without it, the presence of fluid-filled blisters is enough to indicate that there are Damp-Hot toxins which need to be expelled with the use of very bitter Liver cleansers such as Gentian root and Scutellaria.
Diuretics like Poria mushroom help to excrete the excess moisture through the urine.
At the same time, the hands are soaked in a tea of herbs and minerals. This provides instant relief and begins to close the open wounds and prevent infection.
DIGESTION – Sometimes, it is a malfunctioning digestive system which is the root of the problem. Instead of a stressful event, the patient reports chronic symptoms such as bloating, foul diarrhea, gas, heartburn or nausea.
Their tongue coating may be quite thick, either white or yellow, reflecting the accumulation of mucus and damp in their gastrointestinal tract. Eventually this damp becomes so excessive that it overflows to the skin. Interestingly, this type may also show the same eczema presentation on the feet, which is fairly rare. The involvement of the feet should always alert the practitioner to a possible digestive connection.
In any event, the treatment here focuses on herbs such as Coptis root and Atractylodis rhizome, both of which are potent digestive system cleansers. Aromatics such as cardamom or patchouli may also be included to “revive” the stomach and intestines.
BLOOD COOLING – When the blisters have been replaced by dryness, cracks and fissures, treatment changes to cooling and moistening. Herbs such as Rhemannia root and Red Peony root are primary. It is very important at this stage to avoid excessive hand washing and contact with irritating substances such as shampoos, soaps and detergents. Even peeling fruit and vegetables may expose the skin to irritating acids, and cotton gloves are indispensable. In fact, hand eczema used to be known colloquially as “housewife’s dermatitis,” and the herbalist may well write the patient a note excusing them temporarily from any and all house work!
At this stage, alongside the internal treatment, a honey and mixed herb cream works miraculously to close the fissures and cracks.
As mentioned, the vast majority of cases can expect to be cured. Results will be slowest – up to 6 months of treatment – in those cases where blisters and cracks occur simultaneously.