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Eczema & TCM

Tired of having itchy skin? Had enough of this annoying skin condition that never goes away? Read on to find out more about eczema and how to deal with it the TCM way!  

Eczema, also known as atopic dermatitis, is a chronic disorder of the skin that results in an itchy rash. It is the most common skin condition in Singapore, and the occurrence of eczema in Singapore is one of the highest in the world.

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What causes eczema?

Modern medicine shows that there are several factors behind the formation of eczema.  Genes play an important role as eczema often runs in families, but there are other conditions such as skin barrier defects, immune dysfunction and environmental factors.

In addition, an impaired skin barrier increases transepidermal water loss, causing dry skin and making it more prone to the penetration of allergens and bacterial/viral infections. All of these contribute to an overactive inflammatory response at the skin and cause itchy rashes.

On the other hand, TCM believes that eczema is mainly caused by Wind-Dampness-Heat. People with irritable body constitution that have poor eating habits, especially over-consuming spicy, pungent, oily foods, are more likely to weaken their Spleen and Stomach. 

The Spleen and Stomach governs the digestive system and the conversion of food and drinks into the essence that nourishes our body. When a malfunctioning Spleen and Stomach fails to convert all the food and drinks into essence, Dampness-Heat will arise. With Wind invading from the outside, and Dampness-Heat accumulating beneath the skin, the two forces will combine and result as an itchy rash.

Characteristics and symptoms

There are some distinct characteristics for a typical eczema:

  1. The skin lesions are located symmetrically on the body
  2. Different types of skin lesions: macule (discoloration, usually redness), papule (elevated solid lesion), vesicle (blister), pustule (blister filled with pus), erosion, and crust
  3. Intensely itchy
  4. Leaking wounds
  5. Recurrent symptoms
  6. Often develops into a chronic condition

Eczema can be differentiated into three stages: acute stage, subacute stage, and chronic stage.

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The stages are meant to describe the severity of the skin lesions rather than progression, as eczema’s progression through the stages isn’t always linear. For instance, it may start at the subacute stage and move to the acute stage. The same rash may cycle through the stages many times. A rash may also start and stop at nearly any stage.

How does TCM help?

The main principle behind the treatments for eczema is to clear heat, eliminate dampness, and relieve the itch. There are a few approaches:

Herbal prescription

Depending on which TCM syndrome the skin lesions belong to, different medications will be prescribed.

Acute stage eczema is equivalent to the dampness heat syndrome in TCM, hence herbs that can clear heat, eliminate dampness, and relieve itch are often used.

When the eczema reaches subacute stage, it typically represents spleen deficiency cum dampness syndrome, hence herbs are used to tonify spleen, eliminate dampness, and relieve itch.

For chronic stage eczema, more blood-tonifying and wind-dispelling herbs are used as it is usually symptomatic of blood deficiency cum wind syndrome.

Topical medication

Concoctions, ointments, or lotions can be applied on the skin lesion depending on which stage it is.

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At later stage when the wound leakage decreases, apply ointment that contain anti-inflammatory substances, such as 黄连膏 (Huang Lian Cream) 、紫云膏 (Zi Yun Cream).

Subacute stage eczema: 紫云膏 (Zi Yun Cream) can be used to apply on the skin lesions.

Chronic stage eczema: Various types of ointments or lotions can be used. Some contain anti-itchy substances.

Acupuncture

Inserting hair-thin needles at acupoints and around the skin lesions can help to improve qi and blood circulation, so as to achieve heat removal, eliminate dampness, and relieve itching. Plum-blossom needles relieve itch effectively and are often used at the skin lesions to release a small amount of blood.  

Skin Care Tips for Eczema

The following are the important skin care tips for people with eczema:

  1. Avoid scratching, rubbing and picking the skin. This aggravates the eczema and may also lead to unsightly pigmentation, open wounds, infections and scars.
  2. Avoid irritants like soaps and detergents. Use gentle soaps or soap substitutes instead.
  3. Do not wash the skin using hot water (>40°C), this will cause the water on the skin to evaporate faster after the shower and cause transepidermal water loss.
  4. Moisturise the skin frequently. Normal moisturisers (non-steroids) do not cause thinning of the skin and should be applied liberally and frequently throughout the day. Remember to apply moisturisers after swimming.
  5. When in a dry and cold environment, it is important to keep the skin well moisturised to prevent flare-upsof the eczema.
  6. Certain clothing materials such as wool and linen tend to irritate the skin while materials like cotton are more comfortable for sensitive skin.
  7. Avoid consuming some foods that might worsen the skin condition. For example: spicy food, seafood, beef, mutton, and spices, such as coriander, chives, celery, ginger, onion, garlic, etc.

Topical steroids can be effective upon eczema flare-ups. However, topical steroids should not be used without supervision. Do consult doctors for guidance before using them. Ask for medical advice if you are planning on stopping the usage of topical steroids anddo not stop the treatment suddenly.

Eczema: a marathon

Having eczema may be tiring, and managing this skin condition may require a lot of time and effort to see results. However,with an appropriate therapeutic approach combined with good lifestyle habits, it is definitely possible to manage this skin condition effectively for a better quality of life.

Note: Information provided is not a substitute for a physician or any form of medical care. Individual symptoms differ due to different body constitutions and diagnosis. One should consult a licensed TCM practitioner for accurate diagnosis and treatment.




ABOUT THE AUTHOR

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Physician Hao Li

Management Trainee

Double Degree (Honours With Highest Distinction): Bachelor Of Science In Biomedical Sciences & Bachelor Of Medicine (Chinese Medicine), Nanyang Technological University And Beijing University Of Chinese Medicine

Hao Li graduated with double degrees in Biomedical Science and Traditional Chinese Medicine from Nanyang Technological University and Beijing University of Chinese Medicine respectively.

He was a first-prize scholarship recipient of the Beijing Government Foreign Student Scholarship. He also received two gold medal awards for his outstanding performance in studies when he graduated from NTU: The Lee Kuan Yew Gold Medal Award and the Mdm Chow Kwai Wah and Mr Law Ka Yin Gold Medal Award.

As a beneficiary of TCM himself, Physician Leong can relate to his patients well. He is keen on applying and sharing his knowledge in TCM in order to assist his patients in achieving optimal health. He values the importance of communication with his patients as he firmly believes it is essential for the formulation of a customised and holistic treatment.

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