The frustration in your teen's voice as they lament about a recurrence of pimples initiates a flurry of thoughts in your own mind. You ask yourself: “what's started this latest round of teen torment...was it too much soda and chips over the weekend, the less-than-ideal sleeping habits, or is it just par for the course during adolescence?” More importantly, what can you do to help?
Traditional Chinese herbal medicine can provide significant benefit for both adults and adolescents to address breakouts. Certainly, taking preventative measures to reduce the causes are important, but restoring a clear complexion with herbal treatment strategies is paramount.
TCM Differential Diagnosis
There are several primary etiologies responsible for this condition, which is known in traditional Chinese medicine as “white thorn disease (feng ci 風刺<)”. Determining the specific internal imbalance yields the best results, and treatment usually involves treating both the interior causes and the surface manifestation of this complaint. Following are the four most common TCM syndromes.
A diet of rich, greasy, sweet, high fat fried, and spicy foods are the precipitating factors in this clinical picture. Heat accumulates in the stomach and intestines and rises, leading to pimples around the mouth, back and chest. The appearance of the skin is usually oily, and the patient may have additional heat signs such as strong appetite, bad breath, and a thirst for cold beverages.
This syndrome is the result of stagnation of the seven emotions leading to Blood Heat. This heat eventually stagnates in the skin leading to outbreaks around the nose, mouth, between the eyebrows, and forehead. As a result, the complexion may also appear slightly reddish due to capillary dilation. Female patients may also notice an increase in symptoms during week three of their monthly cycle. Additional heat signs such as constipation and dark urine may be present, and the tongue tip is often slightly redder than normal.
The etiology of this picture arises from Lung and/or Stomach Heat combining with toxic Heat in the upper body. The patient typically presents with comedones that are small inflamed pus-filled sores that are red around the base and are often tender or painful. Patients may tend to have other interior heat symptoms such as constipation and concentrated yellow urine.
Damp Heat with Blood Stasis
Pre-existing internal Dampness predisposes a patient to this syndrome. The resultant stagnation leads to Damp Heat which can cause Blood Stasis. The comedones are deep, nodular, inflamed and painful, and appear under the skin’s surface. Outbreaks appear on the face, chest and back, and due to the deeper location, scars often remain when the condition resolves.
Determining the specific clinical etiology for this condition is straightforward and is based on evaluating the characteristics of the skin blemishes, their locations, additional patient symptoms, and the tongue and pulse. There are also universal features to all the feng ci 風刺 etiologies, which include stagnation in the collaterals of the skin, nodule formation, toxic Heat on the surface, and Heat in the Blood.
Margarite Acne Pills
Margarite Acne Pills can address the symptoms common to all these etiologies and can be used alone or in combination with other formulas appropriate to the specific pattern presentation.
Formula Treatment Principles
- Cools the Liver and extinguishes Wind
- Cools the Blood
- Clears toxic Heat from the skin
- Resolves swellings and sores
- Dispels nodules and softens areas of hardness under the skin
- Promotes healing of the skin
- Enhances the complexion
Jin Yin Hua (Lonicera japonica flower) clears Heat and fire toxin from the skin, resolves sores and swellings, and clears wind Heat. Sheng Di Huang (Rehmannia glutinosa root-raw) clears heat, cools the blood, and nourishes the skin. Hai Dai, (Zostera marina herb), dispels phlegm nodules specifically in the head and neck, and resolves accumulations. Zhen zhu, (Cristeria plicata pearl, or the freshwater pearl), enhances the skin in healing, promotes the generation of new tissue, resolves toxic Heat, and enhances the complexion. Shui Niu jiao (Bubalus bubalis horn) powerfully cools blood and resolves fire toxins. Finally, synthesized Niu Huang (Bos taurus domesticus bezoar) strongly drains Liver heat and resolves toxic Heat from the skin.
Dosage: 6 pills twice daily. In severe cases or in the initial phase of treatment, dosage may be increased to 6-9 pills 3 times per day, then reduced to 6 pills twice daily as the treatment takes effect. Cautions and contraindications: Contraindicated during pregnancy. Use with caution during heavy menstrual bleeding. Use with caution in spleen deficient patients with loose stools, diarrhea, poor appetite, or chronic digestive weakness.
Assisting Formulas for Specific Etiologies
Margarite Acne Pills can be combined with other formulas to address the specific etiologies referenced at the beginning of this article. Treatment can be carried out utilizing formulas simultaneously or by treating the pimples first, with Margarite Acne Pills, and the underlying etiology can be addressed afterwards. Following are some suggested herbal recommendations for the etiologies listed above. Appropriate differential diagnosis and assessment of the clinical picture should be carried out before prescribing any of the following recommended formulas:
- Stomach Heat: Qing Wei San Wan
- Blood Heat: Jia Wei Xiao Yao Wan
- Damp Heat: Ban Xia Xie Xin San
- Blood Stasis: Tong Qiao Huo Xue Wan
The most successful treatments come from evaluating all factors influencing a clinical presentation. Read about one practitioner’s successful case study here. Daily lifestyle habits such as diet, sleep habits, emotional factors, facial cleansing hygiene, the reproductive cycle in females, water intake, and the amount of aerobic exercise are especially important in both treatment and prevention. For powerfully resolving stagnation in the channels and collaterals, dispelling accumulated toxic Heat on the surface, and clearing heat in the blood, we think you'll find Margarite Acne Pills second to none!
- Bensky, D. et al., Chinese Herbal Medicine Materia Medica, 3rd ed., Eastland Press: 2004.
- Chen, J. & Chen, T., Chinese Medical Herbology and Pharmacology, Art of Medicine Press: 2004.
- Maclean, Will, Clinical Manual of Chinese Herbal Patent Medicines, Pangolin Press: 2003
- Wrinkle, A. et al., A Practitioner’s Formula Guide, Elemental Essentials Press: 2008.
- Stropes, L., & Borges, J., https://www.mayway.com/articles/differential-diagnosis-of-acne-in-chinese-medicine
Mark W. Frost, MSTCM, L.Ac. is chair of the Herbal Medicine Department at the American College of Traditional Chinese Medicine in San Francisco, California. Professor Frost teaches in both the Masters and Doctoral Programs, serves as a clinical supervisor in colleges Community Clinic, and has had a private practice in San Francisco for over 30 years. He is the author of numerous articles on Chinese herbal medicine and has presented at several TCM conferences since 2014.