Nineteen-year-old polytechnic student Megan Koh first developed acne five years ago. “It was itchy and painful at times,” she recalls. When antibiotics from her dermatologist failed to clear her skin, her sister encouraged her to try TCM.
When she first visited the TCM clinic, the acne on her cheeks and chin were red, swollen and pus-filled. The physician explained that she had developed them due to hormonal changes during puberty. He recommended acupuncture, which would strengthen her body, improve her energy and manage the issue from the inside out.
In addition to acupuncture treatments, he prescribed oral medication in the form of pills, powder and a liquid mixture for both day and night, as well as creams to apply on the affected areas two to three times a day. He also recommended that she avoided fried and spicy food, cold drinks and ice cream.
A month after beginning treatment, “my breakouts were not as frequent, the acne spots were smaller and some were not filled with pus,” she says.
Getting to the root causes
Acne affects up to 50 million Americans each year. Research shows that 85 per cent of those between the ages of 12 and 24 will experience some amount of acne during their teen years1.
Acne occurs when the skin over-produces sebum, causing pores to get clogged. The build-up also causes surrounding hair follicles to swell, allowing the bacteria that live on the skin surface to enter the pores and infect the sebum.
The condition appears in various forms, ranging from mild to severe. Whiteheads and blackheads appear as small blemishes on the skin. Papules are red and inflamed, while pustules are painful, pus-filled lesions. In severe cases, skin may develop large and inflamed nodules or cysts, which may leave permanent scarring2.
In Traditional Chinese Medicine (TCM) terms, there are three underlying causes of acne. Firstly, consuming too much spicy, sweet or oily food can lead to heat and dampness accumulating in the stomach and spleen. This disrupts the normal flow of ‘qi’, a person’s life force. “The damp-heat moves upward and outward instead. It gets trapped at the skin surface and manifests as acne,” says Eu Yan Sang physician Anita Pee.
Managing teen acne
Once the cause of the teen’s acne has been determined, TCM physicians will usually draw up an individualized treatment plan, taking into consideration the underlying cause of the acne as well as the teen’s physical constitution and any lifestyle or dietary factors that may be exacerbating the problem, says Ms Pee.
Chinese herbs have significant anti-acne properties, as a 2003 study by Korean researchers from the Skin Research Institute shows.
The study compared Oriental herb extracts with erythromycin, an antibiotic, and retinoic acid, both of which are commonly used to manage acne. It found that an herb called Angelica dahurica and erythromycin had comparable effects, while another herb, rhizoma coptidis, was more effective than retinoic acid3.
Other Chinese herbs that can help curb acne include:
- 连翘 (forsythia) and 蒲公英(dandelion): Manages acne caused by excess heat within the body by clearing heat and toxins, reducing swelling and dissipating nodules. Forsythia reduces oily secretions, while dandelion has anti-bacterial properties and contains vitamins that promote skin healing.
- 薏苡仁(coix seed): Manages acne caused by damp heat and more severe forms such as nodules and cysts. It strengthens the spleen, clears heat and drains pus.
- 赤芍(red peony root): Manages acne caused by damp heat such as cystic acne. It clears heat, cools blood and dispels blood stasis.
Other practical steps to manage acne include adopting a good skincare routine, consuming less fried, oily and sweet food, drinking at least eight glasses of water a day, having adequate sleep, managing stress well and exercising regularly.
In most cases, patience is key: “It will usually take about 3 months to manage normal acne. Serious cases will take about 6 months,” says Ms Pee.
How TCM diagnoses acne
In TCM, the areas on the face or body covered with acne serves as an indicator of the state of the person’s organs and meridian points4.
Lung heat manifests as acne on the forehead and nose. The person will show an aversion to heat and also experience chills because of his or her sensitivity to the wind. The tongue will appear red with a thin yellow coat.
If acne appears on the chest, shoulders, back and around the mouth, the person has stomach heat, which indicates stomach or constipation problems. He or she is likely to be thirsty all the time and have foul breath, and may have a big appetite. The tongue appears red with a thick yellowish coat.
Those with oily complexions and acne that is inflamed and pus-filled, meanwhile, may have damp heat. He or she experiences constant thirst with no desire to drink, and may be averse to heat. The tongue is red with a thick, yellow coating.
Blood heat may be the cause of mild to moderate acne, usually on the nose, around the mouth, and between the brows. Besides experiencing symptoms such as a flushed red face, extreme sensitivity to heat, dry stools and darker-coloured urine, the tongue is usually red with spots.
Toxic heat has similar symptoms to blood heat, but the acne in this case is more serious and pus-filled, and the skin around the inflamed lesions is usually red and painful. The tongue is red with a sticky yellow coating, and the teen may feel lethargic.
Excessive heat and wind in the lungs can also lead to a breakout. In TCM, wind is believed to have a pathogenic, or disease-causing, ability. “When pathogenic wind attacks, the uppermost part of the body, mainly the lungs, is affected first,” she explains. “Combined with excess heat, the wind-heat trapped in the lungs manifests as acne on the skin surface, and is often itchy.”
Finally, acne also develops when there is too much dampness in the body. A weak spleen impairs the body’s ability to process nutrients from food and water. This, in turn, disrupts the flow of qi, blood production and circulation. “Dampness and blood stagnation obstructs skin pores and causes the formation of deep-rooted and large acne,” she says.
1 Author unknown. (2017). Acne. Retrieved from American Academy of Dermatology website:
2 Author unknown. (2017). How to recognise all the different signs of acne. Retrieved from Acne.com website:
3 Nam, C. Kim, S. Sim, Y. Chang, I. (2003). Anti-acne effects of Oriental herb extracts: A novel screening method to select anti-acne agents. Retrieved from US National Library of Medicine website:
4 Author unknown. (2016). Skin health: Mirror to our internal health. Retrieved from Eu Yan Sang website:
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