Rosacea According to Chinese Medicine

The 3 main TCM (Traditional Chinese Medicine) patterns seen in rosacea are Accumulation of Heat in the Lungs and Stomach, Heat in the Blood, and Blood Stasis.  Let’s examine each one individually.

Mild Rosacea (I'm not wearing any makeup here)

In the earlier stages of rosacea, the most common TCM pattern is simply Accumulation of Heat in the Lungs and Stomach.  Heat begins accumulating in the Stomach often due to overindulgence of spicy foods, alcohol or strong tea (this isn’t always the case, though).  The Heat in the Stomach can go directly to the cheeks via the Stomach Channel and/or it “steams” to the Lungs where it eventually rises to the face via the nose.   At first, when the Heat is just beginning to accumulate, the face flushes easily but it is only temporary.  This redness blanches upon pressure (i.e. it becomes white when you press on it).  Eventually the redness becomes persistent erythema that never goes away entirely and gets worse upon exposure to heat (hot water, hot air, rise in body temperature due to exertion or fever).  Patients often report that their face flushes almost immediately after drinking alcohol or eating spicy foods.   Other accompanying symptoms may include dry mouth and nose, thirst, and constipation.  The tongue will likely be red with a thin yellow coat and the pulse will be rapid.  If tiny papules or pustules form (usually on the cheeks or nose) this often indicates Heat Toxins are also present.

Increased redness, more papules, and dilated capillaries

As the condition progresses, the erythema (redness) becomes darker and capillaries become dilated (called telangiectasia).  This is the development of Heat in the Blood.  Pinpoint papules or larger pustules form more fequently (sometimes rosacea and acne are difficult to differentiate, but acne will not have the diffuse erythema or the telangiectasia).   In addition to the redness in the cheeks (and possibly forehead), the bulb of the nose may become red.  In rosacea, this Heat in the Blood is often secondary to Disharmony of the Ren & Chong Vessels.  [According to Traditional Chinese Medicine (TCM) the energy (Qi) in the body circulates through a network of vessels (also called “channels” or “meridians”).  The Chong and Ren vessels are particularly important in woman’s health because fertility and the menstrual cycle depend on the flow of Qi and Blood through these channels.]  When the Chong & Ren Vessels are involved, women will often experience worsening of symptoms or have sensitive facial skin right before or during their periods.  Accompanying symptoms can include drier stools, yellow urine, and irregular menses in women.  The tongue most likely will be the same as in Heat in the Lung and Stomach (red with a thin yellow coating).  The pulse will be rapid and possibly even slippery.

Rhinophyma, a.k.a "W.C. Fields nose"

When the bulb of the nose becomes chronically inflamed and darker red, Blood Stasis has become the predominant pattern.  The skin on the nose may become thicker with more dilated blood vessels, enlarged pores and oily skin.  Rhinophyma might eventually develop (this is irreversible hypertrophy of the nose); this can be very disfiguring and cosmetic surgery is often the only treatment.   There will likely be more papules and pustules on the nose and cheeks and forehead with generally more oily skin.  From the TCM perspective, this Blood Stasis develops from pre-existing Accumulated Heat in the Lungs and Stomach or the Disharmony of the Chong & Ren Vessels.  If Cold or Wind-Cold invades the face (from exposure to cold air or cold water), the skin’s exterior defenses become blocked and the Cold settles in the skin preventing the ventilation of accumulated Heat in the face.  This combo causes local Stasis of the Blood (and Qi).  The patient’s tongue will be dull red or purple and may even have ecchymosis (dark purple spots) with a sticky yellow coating.  The pulse will likely be choppy or wiry.

So how do we treat rosacea with Chinese Medicine?  And what can YOU do to improve your rosacea?  You will have to wait for the next posts to find out!

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