Chinese Herbal Medicine for Eczema

Chinese herbal formulas for creating personalized eczema treatment

Copper mortar and pestle in front of wooden drawer shelves in background

Throughout Asia, Traditional East Asian herbal medicine is a very common therapy for eczema.[1] It is growing in popularity around the world as people look for natural therapies to treat this condition and reduce their dependence on steroids. A large study in Taiwan looking at children taking Chinese herbal medicine showed an overall reduction in the use of steroids.[2] 

Herbs are most often given in formulas that contain many herbs and each herb has a specific function to help in controlling the condition. Chinese medicine looks at the herbs in terms of their energetic function. Are the herbs hot or cold in nature? Do they get rid of dampness or moisten dryness?  Herbs can also work in the body to reduce inflammation,[3] combat the overgrowth of bacteria on the skin,[4] and improve allergic reactions.[5]

 

How Is an Herbal Formula Created and Modified?

In Chinese medicine, wind, dampness, and heat are all common factors in the development of eczema. TCM understands the health of the individual in relationship to the environment. It also uses the language of the natural world to describe the processes of disease in the body. For example, skin diseases caused by heat pathogens manifest as redness on the skin and are often involved in inflammatory diseases. Conditions with an excess of wind often produce strong itching and move quickly from one part of the body to the next, with flares coming and going regularly. Damp conditions may produce weeping or oozing sores.

If the eczema is predominantly heat, then herbs that reduce heat will be the focus of the formula. If the eczema is predominantly dampness, then herbs that drain and dry dampness will be the focus of the formula. Together, the herbs combine to address the symptoms as well as the underlying imbalance causing the eczema.

One commonly used formula that has been shown to be effective to treat eczema is xiao feng san (clear wind powder).[6,7]  This formula treats eczema caused by wind, dampness, and heat. Many of the herbs in the formula have shown anti-inflammatory and antibacterial effects.[1] For example, ku shen (sophora) is widely known for reducing inflammation, itch, and growth of Staphylococcus aureus, a bacterium involved in eczema flares. [8,9]

 

Combinations of Herbs

When specific combinations of herbs are used it can enhance the effect of the herbs. This is called dui yao, literally two herbs. In xiao feng san, we see many classic combinations. Jing jie and fang feng are a classic combination to reduce itching and dispel wind.[10] In addition, the above-mentioned ku shen is often combined with dang gui for treatment of eczema and acne. Laboratory studies have shown this combination is more powerful than either herb alone to reduce inflammation and bacteria.[11] 

If the eczema is more heat and heat toxicity predominant, then additional herbs to remove the heat may be added such as jin yin hua (honeysuckle). Honeysuckle has been shown to have anti-inflammatory and immunoregulatory properties.[3] It is often traditionally combined with lian qiao (forsythia fruit), which is known for anti-allergic and antibacterial properties.[12,13] 

If damp and damp heat is more predominant, herbs such as huang qin, huang lian, or huang bai may be added. These herbs are known as the three yellows for their color and are well known for their antibiotic and anti-inflammatory effects.[14]  When damp heat and toxicity is severe, they may be used as the formula huang lian jie du tang (copitis formula to reduce toxicity). This formula has shown anti-allergic and anti-inflammatory effects.[14,15] 

Chinese medicine looks for the underlying imbalance causing the eczema, which most often is a combination of heat, damp, and wind. Each formula will be tailored with herbs that address that particular type of eczema. We can see from the research that many of the herbs that treat heat and dampness have anti-inflammatory and antibiotic properties that may be the mechanism for their anti-eczema actions. 

 

Practical Tips

  1. If your patient is looking for an additional therapy to add to their eczema regimen, or if they are not responding well to therapy, consider a consult to a Chinese medical practitioner.

  2. Herbs, either oral or topical, may be prescribed to help reduce eczema flares.

  3. These herbs will likely be customized to the patient's particular signs and symptoms, including focusing on treating any underlying heat, wind, or dampness (inflammation, itching, or oozing sores), depending on which symptoms predominate.

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References

1.    Chen HY, Lin YH, Hu S, et al. Identifying chinese herbal medicine network for eczema: implications from a nationwide prescription database. Evid Based Complement Alternat Med.2015;2015:347164; PMID: 25685167.

2.    Chen HY, Lin YH, Wu JC, et al. Use of traditional Chinese medicine reduces exposure to corticosteroid among atopic dermatitis children: a 1-year follow-up cohort study. J Ethnopharmacol.2015;159:189-196; PMID: 25449448.

3.    Muluye RA, Bian Y, Alemu PN. Anti-inflammatory and Antimicrobial Effects of Heat-Clearing Chinese Herbs: A Current Review. J Tradit Complement Med.2014;4(2):93-98; PMID: 24860732.

4.    Sato Y, Suzaki S, Nishikawa T, et al. Phytochemical flavones isolated from Scutellaria barbata and antibacterial activity against methicillin-resistant Staphylococcus aureus. J Ethnopharmacol.2000;72(3):483-488; PMID: 10996290.

5.    Chan CK, Kuo ML, Shen JJ, et al. Ding Chuan Tang, a Chinese herb decoction, could improve airway hyper-responsiveness in stabilized asthmatic children: a randomized, double-blind clinical trial. Pediatr Allergy Immunol.2006;17(5):316-322; PMID: 16846448.

6.    Chen HY, Lin YH, Chen YC. Identifying Chinese herbal medicine network for treating acne: Implications from a nationwide database. J Ethnopharmacol.2016;179:1-8; PMID: 26721214.

7.    Cheng HM, Chiang LC, Jan YM, et al. The efficacy and safety of a Chinese herbal product (Xiao-Feng-San) for the treatment of refractory atopic dermatitis: a randomized, double-blind, placebo-controlled trial. Int Arch Allergy Immunol.2011;155(2):141-148; PMID: 21196758.

8.    He X, Fang J, Huang L, et al. Sophora flavescens Ait.: Traditional usage, phytochemistry and pharmacology of an important traditional Chinese medicine. J Ethnopharmacol.2015;172:10-29; PMID: 26087234.

9.    Kobayashi T, Glatz M, Horiuchi K, et al. Dysbiosis and Staphylococcus aureus Colonization Drives Inflammation in Atopic Dermatitis. Immunity.2015;42(4):756-766; PMID: 25902485.

10.    Bensky D, Clavey S, Stöger E. Chinese herbal medicine : materia medica. 3rd ed. Seattle, WA: Eastland Press; 2004.

11.    Han C, Guo J. Antibacterial and anti-inflammatory activity of traditional Chinese herb pairs, Angelica sinensis and Sophora flavescens. Inflammation.2012;35(3):913-919; PMID: 21976127.

12.    Sung YY, Lee AY, Kim HK. Forsythia suspensa fruit extracts and the constituent matairesinol confer anti-allergic effects in an allergic dermatitis mouse model. J Ethnopharmacol.2016;187:49-56; PMID: 27085937.

13.    Kuo PC, Chen GF, Yang ML, et al. Chemical constituents from the fruits of Forsythia suspensa and their antimicrobial activity. Biomed Res Int.2014;2014:304830; PMID: 24745011.

14.    Zeng H, Liu X, Dou S, et al. Huang-Lian-Jie-Du-Tang exerts anti-inflammatory effects in rats through inhibition of nitric oxide production and eicosanoid biosynthesis via the lipoxygenase pathway. J Pharm Pharmacol.2009;61(12):1699-1707; PMID: 19958594.

15.    Chen Y, Xian Y, Lai Z, et al. Anti-inflammatory and anti-allergic effects and underlying mechanisms of Huang-Lian-Jie-Du extract: Implication for atopic dermatitis treatment. J Ethnopharmacol.2016;185:41-52; PMID: 26976763.