Traditional Chinese Medicine for Skin ConditionsAdina Stanescu, R.TCMP April 1, 2016
Editor’s note: According to the Acne and Rosacea Society of Canada, two million Canadians are affected by, so April 2016 has been declared Rosacea Awareness Month. To offer an alternative to medication, we have pulled two relevant features from Vitality’s archives, and updated them for re-release in this issue. Here they are.
Herbs for Rosacea
The primary feature of rosacea, as the name suggests, is flushing. This inflammatory condition is transient at first, triggered occasionally by alcohol, spicy food or the “heat” of emotional stress. Over time, if untreated, it can become permanent, without any ebb and flow.
Rosacea may also feature red, acne-like bumps, or occasionally pus-filled pustules. Inflammation of the eyelids and swelling of the face may be present in severe cases. People of Celtic origin are disproportionately affected.
Conventional medicine has no effective treatment for this condition. If pustules are present, they can indeed be helped by antibiotic treatment, but this would be lengthy and incur the risks and side effects generally associated with antibiotics. Furthermore, over time the pustules return. Topical steroids (cortisone cream) are sometimes mistakenly used to treat rosacea, and unfortunately they may make it much worse, or trigger a similar condition called perioral dermatitis. Retinoid compounds such as the infamous Accutane are also prescribed by conventional physicians, despite the risk of liver damage. Unfortunately, none of these methods lead to lasting, appreciable improvement.
TCM for Rosacea
Traditional Chinese Medicine treats this problem very successfully by tailoring the treatment to the phase and particularities of each case, as follows:
- EARLY ROSACEA – As mentioned, the early phase is characterized by transient flushing and blushing. There may also be some digestive complaints such as acid reflux, excessive appetite, bad breath, and constipation. TCM considers this stage a manifestation of ‘stomach heat’, as the stomach meridian vertically traverses the cheeks. At this point, the rosacea can be treated fairly quickly, often within about eight weeks.
- PERSISTENT ROSACEA – At this stage the redness is permanent and unchanging, and is often accompanied by red bumps and possibly coarse skin. Congested capillaries may be visible at the surface. Occasionally sufferers skip directly to this stage of the condition, sometimes without any preceding history of flushing, and for no apparent reason. However, my experience with patients at the TCM Skin Clinic suggests a strong emotional connection to this type of sudden flare, especially pent-up anger and resentment over a long time.
As such, from the point of view of TCM, the persistent phase of rosacea is much more a problem of stagnation of blood flow in the channels of the face – a problem of poor circulation. We commonly tend to think of poor circulation as being a cold condition, intuitively. However, this stage of rosacea is a very good illustration of heat causing congestion of the blood vessels and “thickening” of blood, so that it can no longer flow properly. In fact, it is interesting that women with this condition tend to also have gynecological symptoms of blood stagnation such as clotted blood and painful periods. These often clear up as the rosacea treatment is administered.
Prescriptions consist of blood-quickening herbs, as well as herbs for any accompanying features such as eye involvement or facial swelling. Persistent rosacea will necessarily take longer to treat completely, up to 18 weeks. No matter what the case, treatment is almost entirely internal, as all skin disease can only be successfully treated from the inside. Occasionally a herbal cream may be prescribed. Once cured, the treatment can be discontinued and the condition will not relapse.
(Editor’s note: An overly rich diet and inadequate exercise also contribute to the build-up of toxic heat.)
Foods that Heal Skin Disease
“What should I eat?” That is the question I am asked most often by patients who come for skin treatment at my Traditional Chinese Medicine practice. They ask it in a tone of despair and frustration, because they have already been avoiding various foods on the advice of health writers, bloggers, nutritionists and naturopaths, and yet their skin condition persists. So lets try to shed some light on this confusing question, and lay to rest some of the undue expectations that surround it.
The most common misconception is that dietary changes alone can cure inflammatory skin diseases like eczema, psoriasis, acne, and rosacea. After treating a great many skin disease sufferers and hearing their stories, I have come to understand that this is very much the exception, not the rule. Thus, the great effort these patients make to modify their diet can sometimes lead to disappointment if they put all their eggs in that one basket.
There is no doubt that abstaining from inflammatory food and drink can improve a skin condition to some degree. In combination with a targeted therapeutic treatment – the best of which is herbal medicine – dietary changes can ultimately lead to a cure. It is also true that during herbal treatment for the most aggressive and stubborn of these illnesses, a change in diet may be just the thing that tips the balance from failure to success. Let’s look at some common dietary advice given to patients who come to a Chinese Medicine clinic looking for relief. It may be quite different from what is recommended elsewhere, but I believe it to be intuitively reasonable.
Dietary Advice for Rosacea
Avoid ‘Heating’ Types of Food and Drink – This is by far the most important and useful dietary modification that you can make if you suffer from any skin disease that is red, hot, burning and itching. Why add fuel to the fire? According to TCM theory, ‘heating’ foods are those which cause the body temperature to rise, the capillaries to dilate, and generally cause an increase to the warming, yang functions of the body. (Ed. note: ‘Heating’ foods include lamb, red meat, processed meat, hot sauce, ginger, eggs, and anything deep fried.)
Alcohol – We can plainly feel how a glass of red wine warms us up on a cold day, but this effect can be harmful to a person with skin inflammation. Once this is pointed out, people become instantly aware of the connection between alcohol and increased itching. Red wine and hard liquor is the worst culprit, while beer and white wine may be better tolerated. Avoiding alcohol is especially recommended when the skin disease is on the face or head, where heat will naturally rise more rapidly and affect one’s appearance. Rosacea, acne, seborrheic or atopic dermatitis, and psoriasis are the most likely to affect the face.
Spices – Hot pepper, black pepper, ginger, and garlic are also contraindicated, as are all the “gingerbread house” spices: cinnamon, nutmeg, clove. This means avoiding chai teas, ginger teas, hummus, Thai food, and the like. Of all of these, garlic seems to trigger the worst flare-ups of redness, burning, and itch. On the other hand, fresh green herbs, cumin, coriander, and anything without a pungent, spicy bite are OK.
Smoking – Cigarette smoking is strongly associated with psoriasis, especially pustular psoriasis of the palms and soles. Quitting will often improve the condition. Teenage acne, as well, is adversely affected by smoking. Teens already have a great deal of naturally occurring ‘heat’ in their lungs and stomach, as evidenced by their loud voices and voracious appetites – this is a sign of health and vitality during a time of great growth. However, smoking and drinking will push this lung and stomach heat over the upper limit of ‘normal’ and turn it into the red fire of acne. The fat-, sugar-, and calorie-dense diets that teens have in the West also fuel this fire. It may be that the calories that have made kids increasingly tall and strong have also given them acne at rates unseen in more traditional societies.
Avoid Oil, Shellfish, Tropical Fruit – The most controversial recommendation that I make concerns oil supplements. I ask that anyone with weepy skin disease, most often eczema, reduce consumption of these or avoid them entirely. Patients are often taking fish oil supplements precisely because they believe them to be anti-inflammatory. This may be true, but all oils are rich, damp, and hard to digest. When the skin is oozing and weeping sticky fluids or pus, the last thing needed is a sticky, rich supplement like oil, especially in a high dose. Flax is generally better than fish oil in this regard (if the person is not willing to give up oil altogether).
Greasy fried foods and bad oils are even worse, and should be avoided. Shellfish and fatty fish like salmon should be avoided for the same reason as oils, not only by weepy skin sufferers, but by anyone whose skin is red or itchy at all.
Tropical fruit may also irritate inflamed skin. Mango, papaya, pineapple are the worst, while banana seems to be OK. It is probably the high sugar content and acidity of these that are responsible. Apples and berries are quite good to eat, since they are cooling and hydrating.
What About Gluten, Sugar, and Dairy? This is where I part ways with standard naturopathic opinion. I believe that gluten, sugar, and dairy are only a problem for a small proportion of people with skin disease, and that they do not need to be avoided by the majority of sufferers. It may be that avoiding these foods will improve digestion, but rarely will this translate into an improvement of the skin disease. And yet, these are the most common ingredients removed from the diet, often at great cost of effort and planning. My rule of thumb on these items is a digestive check: If a person suffers from chronic bloating, diarrhea, constipation, gas or heartburn, then it may be worthwhile to remove them. If not, I believe they pose no problem, but would recommend staying away from fatty, aged, or sharp cheeses.
(Editor’s note: Since gluten, sugar, and dairy rank among the top 10 most common food allergens, and contain GMOs, heavy metals, and drug residues respectively, Vitality encourages readers to make every effort to find suitable substitutes, readily available in health food stores.)
Good Foods for Healthy Skin
During the active phase of skin inflammation, when the itch is still strong, the skin still very red, and the lesions spreading, the best foods will be cooling, venting and draining. Green tea, mint tea, salad, fruit, and clean, light meals, freshly prepared, are best. White pearled barley and beans are excellent at draining away excess mucus and dampness if the skin is oozy. Mung beans and aduki beans are wonderful at this, and all three of these substances double as “herbs” which are found in many skin prescriptions. When the eyes and face are red and itchy, jasmine, chamomile, mint and crysanthemum teas are very soothing.
During the chronic and follow-up phases when redness has subsided but the skin is dry and flaky, flax seeds, sesame seeds, almonds, pears, lean red meat and pork bone soup are all good blood builders to nourish, hydrate and repair the skin. White pearl barley, or its herbal cousin, Job’s Tears, can continue to be used at every stage.
Changing one’s diet is not easy, and changing it forever is harder still. For some, a dietary change may bring new problems: tension, stress, guilt, binge eating, excessive self-control, and of course, hunger! These may have a more detrimental impact on our health than the eliminated foods. Listening to your own body is essential. For skin disease sufferers, adjusting the diet a little to avoid ‘toxic heat’ is a good idea. In combination with a cooling herbal treatment, a change of diet might be just the thing to cure a persistent skin disease.
Adina Stanescu, R.TCMP
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