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Dawson
Posted on Tuesday, January 27, 2004 - 04:49:   

Dear Dr. Halevi,

I have been having acne problem for several years and visited many doctors without improvement. Just recently I was introduced to acupuncture and the chinese doctor explained that my acne comes is in form of phlegm. She said I have many toxic (phlegm) in my internal system and this is due to the weak condition of my digestion system. Can you explain more what she means by phlegm can cause acne? This is very strange to me. In the past I have consumed too many antibiotic for the acne, could this be a problem to my internal system?

Thanks,

DA
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Shmuel Halevi
Posted on Tuesday, January 27, 2004 - 14:43:   

Hi Dawson and welcome to the forum. I wonder why your Chinese doctor does not explain this to you, they usually do.. after all they get paid for this too.
You are right with the assumption that antibiotics may aggravate or even initiate acne conditions. Anti-biotics, according to Ch.Med., attack and weaken the spleen Qi, which is the energy of the digestive system. This may produce excess dampness in the body, dampness that may manifest also as acne. In order for the dampness to appear as the comedons of acne, it must penetrate the "hormonal" meridians of the Chong Mai and Ren Mai. These meridians embark their routes from the uterus area and travel upward to the face and the chest. This is why acne is so much associated with puberty and hormonal imbalance. If you wish to understand more about the etiology and treatment of acne, here is a link to an article which I wrote on the subject http://acumedico.com/acne.htm.
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Dawson
Posted on Wednesday, January 28, 2004 - 03:31:   

Thanks Dr. Halevi, my chinese doctor speaks only little English

Referring to the case history for Ms. E in your excellent article, did her condition get worsen before getting better? After consuming the chinese medicines, my conditions seems getting worst (cold, ache, acne breakout, lot lots of phlegm discharge, tired and so on) for several days and than I felt good. Strangely the whole scenario repated again and again, but each time it finish I felt better a lot. This has been like this until today (it is my 4 weeks under treatment for both acupuncture and CM). Till today, I am still discharging lots of phlegm. Is this ok or not? cause I am really worried about this phlegm. And also, it seems that my acne is really really bad now. Those big red acne start popping on my face, but my health is generally picking up. Do you know what is happening to me?
Can I put some BP on my acne just to reduce its size?

Cheers,

DA
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Shmuel Halevi
Posted on Wednesday, January 28, 2004 - 11:29:   

It is really difficult to assess your condition without checking you physically, i.e., pulse, tongue, etc. Usually, there needn't be such worsening of the symptoms, rather a gradual improvement. You should be able to communicate these reservations with your therapist. In any event, local application of ointments on the comedons should not be a problem. I can also recommend such an ointment for you, it is made of Ch.herbs and its name is: 101e acne lotion, this may be ordered by Email from: orders@shizhen.co.uk
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Dawson
Posted on Tuesday, February 03, 2004 - 10:38:   

Hi Dr. Halevi, Sorry for the slow reply. Thanks for your advice. I am gonna give that 101e lotion a try. BTW, I am thinking of learning qigong exercise and I have come across this exercise offer by Falun Gong. Can you give me some opinion about their qigong style? Thanks a million...

DA
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Shmuel Halevi
Posted on Tuesday, February 03, 2004 - 17:49:   

Qigong is very good as a start, and it is very beneficial for your general health. There are even specific Qigong massage techniques that may help you with your acne problem. For these, consult with your Qigong instructor. As for Falun Gong, you'd better consult about this with our Almost Anonymous (who is gradually becoming less and less anonymous...) on the Tai Chi category (see the topic list).
Just post a query for him there.
All the best
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Pavel Pavlov
Posted on Saturday, February 14, 2004 - 00:42:   

Hello, Dr. Halevi

I have too greasy (especially on the face) skin and hair, withwot another skin diseases (erruptions, boils etc.). Can you explane me what is TCM`s opinion about this problem - what are possible causes and how to differentiate them?
I have heard that disfunction of liver or lungs results in greasy skin and hair. Is it true and what is the explanation of this?
Please excuse any eventual mistakes in my English.
Thanks a lot.
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Shmuel Halevi
Posted on Saturday, February 14, 2004 - 11:04:   

Hi Pavel. A greasy skin and hair condition is usually attributed to excessive dampness condition. Excessive dampness is a phenomenon mostly related to the spleen energetic system. When the spleen Qi (or Yang) is deficient, the digestive system accumulates dampness as a result of improper digestion. Now, the spleen is closely related to the lung system - they form together the Tai Yin system. This is why excessive internal dampness (of the spleen) may manifest in the respiratory system as asthma of the excessive sputum type, etc. The lung system governs also the skin, because the skin belongs to the respiratory system as well. Sometimes, excessive dampness will travel outward (especially if there is an internal Yang Qi activity that pushes away from the Yin) and appear on the skin. This may cause oily skin, seborrhea and greasy hair. In many instances (although not always), a greasy skin condition of the face and hair is prevalent in people suffering from respiratory problems as well.
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Pavel Pavlov
Posted on Friday, February 20, 2004 - 00:57:   

Hallo, Dr Halevi,
Thank you very mach for the professional answer. Can you tell me what is the role of liver in this process? Some authors say that people with liver disorders often have greasy skin and hair. May be the cause is liver fire, that lead to form of phlegm?
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Shmuel Halevi
Posted on Friday, February 20, 2004 - 11:36:   

The role of the liver, only in some of the cases Pavel, is to lead the dampness patogen upward to the face region. Sometimes, when liver Yang is excessive and when there is a dampness pathogen in the middle burner, the liver Yang carries the dampness on its route to the face and head. When this happens, the face skin will not only be damp but also red. still, in most of the cases, the mechanism involved in this syndrome belongs to the stomach/spleen/lung systems rather than the liver's. When also the liver is involved, there are unique symptoms and signs that show this pattern. These may be wiry and/or rapid pulse, red face and eyes, headache, red and coated tongue, tension and/or irritability and more.
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Pavel Pavlov
Posted on Friday, February 20, 2004 - 23:18:   

Hallo, Dr Halevi,

Sorry if I bore you, but this problem is very interesting and complicated to understanding in principle. The dampness is heavy and it tends to move downwards. When dampness and heat combine, dampness is pushed outward toward the surface. Does that mean that 'greasy skin and hair' is always yang symptom (because of internal heat)?
Can it be yin symptom sometimes (accumulation of cold and dampness or only dampness) and in this case what is the force, that moves the dampness upward and outward?
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Shmuel Halevi
Posted on Saturday, February 21, 2004 - 10:09:   

These are really good questions and you needn't be soory for asking - this is what the forum is for, after all
It is true that dampness is heavy and it has several characteristics. When dampness gets accumulated and excessive, it takes the shape of fluid or phlegm and it appears as edema or leukorrhea, etc. It also gets stuck in cavities and depressions such as the sinuses or articulations. Yet, dampness has various degrees of density and at the initial stage it may be in the form of energy (called in Chinese "evil" or aggressive Qi). When this is the case, dampness penetrates the meridians and interferes with the free flow of Qi. People may experience superficial pain at the muscle layer, rheumatism, general heaviness and tiredness and other symptoms. Also internally, dampness may be in the form of energy before it condenses to material fluid. The origin of such a phenomenon is mostly from the digestive system, i.e., the spleen. The spleen has a function of sending its Yang Qi to assist in the digestive process in the stomach and a further distilled Yang Qi to the brain and the sensory organs of the head. When the spleen is deficient in Yang Qi and is too damp, some of this damp energy is carried along to the head. In the head it may appear as moist skin, oily hair, wet or thickly coated tongue, watery eyes, etc. This phenomenon usually can not be seen in other parts of the body but the head region. In order to further clarify this phenomenon, just remember the basic functioning of Yun-Hua (transformation-transportation) of the spleen. The transformation of food energy is not complete thus creating internal dampness. The transportation is not complete, thus dampness travels upward (along with spleen Yang) instead of downward to the bladder.
Now, in Yin-Yang differentiation of syndromes, this dampness is a Shi pattern of Yin nature. The spleen is deficient in Qi, but accumulates dampness which is Yin. In order to resolve such conditions, you definitely need to reinforce and circulate Yang Qi so as to disperse the dampness and absorb it.
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Pavel Pavlov
Posted on Monday, February 23, 2004 - 14:42:   

Hallo, Dr. Halevi,

I'm very grateful to you for this so interesting and comprehensive answer. I have never supposed the existence of such relationships. I really thought that TCM may haven't satisfactory explanation of this syndrome...
You said also, that in some cases this condition appears when respiratory problems there are. I know that some disorders of lungs (like lung yin insufficiency) may cause dry skin and hair. Then may be congestion of dampness in lungs leads to obviously oily hair and face. Is it true or the causes are different? And whether this condition is due to stagnation of lung qi or due to lung qi deficiency (or both of them)?
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Shmuel Halevi
Posted on Monday, February 23, 2004 - 20:44:   

Pavel, lung and spleen pathologies often correlate due to the inter-relation between these two systems. As said above, lung and spleen form the Tai Yin system, a system responsible for the post-natal Qi absorption and assimilation. Excessive dampness in the spleen system may thus easily penetrate the respiratory system and cause asthma, sinusitis or other damp/phlegm related disorders. On the other hand, exogenous pathogens of dampness may penetrate through the lung system and interfere with the spleen physiological activities. Thus, patterns of damp skin and hair may be attributed to either internal or external causes, or both. If the liver interferes then there will be signs of heat involved, such as redness and irritation as usually seen in seborrhea. Yet, symptoms of heat may exist even without the liver joining in the party. Sometimes, long term dampness on the face may stagnate and cause local heat. This is due to lack of proper circulation and pressure. In any event, if such condition exist, it is necessary to treat both the lung and spleen mechanisms together, if only because of the close relation of the lung organ with the skin.
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Anonymous
Posted on Monday, April 05, 2004 - 22:45:   

Dear Dr. Halevi

I had really bad acne four years ago; the episode lasted a year, and was completely cured with accutane. However last year my bowel movement was practically non-existent, and around this time I developed my acne again! I went to see my GP, and he prescribed antibiotics for the acne, which I took for 6mths, during this time my bowel movement restored to normality and the acne cleared! However for the past 2mths my acne has reappeared again, once again I am having trouble with my digestive system. As a last rsort I am trying Chinese herbs and acupuncture, I had my second session of acupuncture today and have been on the herbs for a week now, how long before I see results, and before I see results will my condition get worse?
Thanks
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Shmuel Halevi
Posted on Tuesday, April 06, 2004 - 07:17:   

Well, anonymous, this depends on many factors. First, if the treatment you are receiving is really good, second, how deep inside is your acne i.e., which inner systems are involved in the pathogenesis of your acne, third, how fast your energetical system reacts to acupuncture... and more. It seems to me that your digestive system is involved in the formation and appearance of your acne. Thus, assuming that the treatment you are receiving is appropriate and effective, you'll need to be keeping to a strict diet so that your acne will not reappear as before. Your Ch. Dr. will probably speak to you about this issue in detail. Have a glance at my article on the subject on my home-page to get an idea about the involvement of diet with this disorder.

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