Traditional Chinese Medicine
Alternative Acne Treatments
Acne has many faces. Why does it land on us? Our faces and backs, upper or lower back? Why for some of us is it itchy, while not for others? For some it is painful. Some women get flares on their cycle, or just after. Why?
The Jue Yin-Yang Ming mechanism is one of the most important connections in Chinese medicine. It dictates that our body must have enough healthy fluids and inhibitory substances in reserve, such as estrogen, dopamine, etc., to mitigate inflammatory heat from flaring upward in the body, whether vertically up (to the face and head) or simply upwards from the “organ layer” to the skin.
For those not prone to “heat pathologies” (approximately half the population) this “flare” will likely manifest in different ways—if it does so dermatologically the skin is less likely to be red and/or angry.
If you’re like myself the skin is likely to turn red. If there is itchiness it indicates damp fluid retention (often sebum oil) trapped on the surface—the itching being its attempt to vent (follicular hyper-keratinization)—and/or some central nervous system dysregulation, i.e. a potential stress component. The reason scratching ultimately makes things worse is because the manual aggression ends up pushing the fluid retention a tad bit deeper beneath the surface, no doubt to resurface soon thereafter. Although scratching to bleed is not advisable, it does generally provide longer-lasting relief via its ability to vent some of the pathogenic fluids within the blood. If there is pain at the site, there is probably some degree of local blood stagnation. This often coincides with the week leading up to one’s menses, whereas symptom flares on the heels of one’s menses points more to “Jue Yin” fluid and/or blood deficiency.
Dermatologists often recommend Spirinolactone, which works by stopping aldosterone from signaling the kidneys to reabsorb sodium. This might be a wonderful Band-Aid for some, but unfortunately over time can cause issues as sodium is an essential mineral for transporting nutrients across cell membranes, also for regulating blood pressure. This might explain why two of its most common side effects are dizziness and gastrointestinal issues.
In the treatment of acne it is first important to rule out itching—whether there are oily pathogens beneath the surface and/or an emotional component, that needs our attention. Most important is the Jue Yin-Yang Ming axis. How much heat must our acupuncture and herbal medicines stop from flaring to the person’s skin and how much blood and/or inhibitory substances must we generate to prevent further flares? Dosages or points might be modified on a weekly basis. Striking this prescriptive balance is the key to optimize clinical outcome.
As for self-care, it is advisable in almost all skin conditions to go off dairy for the lifecycle of a red blood cell, or 120 days. Dairy contains the hormone, IGF-1, which increases sebum production. Many people can resume in moderation afterwards. Red meat can go either way as it helps to generate blood and fluids, but can also generate bodily heat. Where one falls along the Jue Yin-Yang Ming imbalance will decide how much steak is advisable. As far as protein goes eggs, fish, and tofu are ideal, as they don’t generate as much heat in the body.
Herbal Profile: British Yellowhead
Meet “Xuan Fu Hua,” or the British Yellowhead flower, an herb commonly used to treat acid reflux, cough, or allergies, outlined in the Divine Farmer’s Materia Medica as “salty, warm, and slightly toxic,” originally indicated for fullness below the rib sides and fright palpitations.
Why? How does the Yellowhead flower achieve this?
Salty flavors and their chemistry have a descending action in the body—one that revolves around the manipulation and distribution of fluids—that is so pathogenic fluids can be purged, allowing for healthy fluids to be re-directed, steamed upwards where they belong.
When the heart lacks blood it is more susceptible to fright and palpitations (it isn’t only your anxiety). When the neuromuscular vessels that traverse the ribs lack fluids, we feel pain or tightness. And in many cases of acid reflux the root of the problem is not an abundance of acid, but a lack of fluids and/or electrolytes around our metabolic organs.
Yellowhead flower is not always the magic bullet for all these conditions; but when their root cause is one of gases and fluids in the body failing to descend, perpetuating a vicious cycle that is due to a void of fluids below in the first place, its formulas are a primary route we’ll hope and suspect to be effective. The opposite physiological patterns of GERD will instead be aggravated, because holistic medicine.
The chemical composition of Yellowhead flower includes quercetin, which comes from the white part of grapefruits and oranges and is often sold as a supplement to treat seasonal allergies; caffeic acid, a polyphenol found in coffee beans; and chlorogenic acid, an antioxidant that is also found in coffee beans. This makes sense as the diuretic effect of coffee is obviously a downward one in the body that subsequently lifts functional chemicals upward in turn.
Acid Reflux
There is a concept in Chinese medicine called “Counterflow qi,” which is in reference to when bodily gases or fluids move in the opposite direction from how they are intended. In the digestive process everything is supposed to move down. Don’t get me wrong—not too quickly—but down nonetheless. Any symptom of movement to the contrary is evidence of metabolic dysfunction.
Belching and burping are generally not perturbing to most of their sufferers, possibly apart from the occasional social embarrassment for loved ones. Nevertheless, they are indicative of some degree of weakness and/or inadequacy of vital substances failing to fully process something in the gut.
Vomiting is the extreme version of this, but the principle is the same. Somewhere in between is acid reflux, or “GERD” (gastro-espophageal reflux disease), which usually manifests as symptoms ranging from a burning sensation in the gut, chest, or throat, to a trapped feeling “below the heart,” as Classical Chinese texts would say. Patients experience this anywhere from once or a few times a week if they “eat something wrong,” to incessantly in every waking moment, understandably prompting them to somehow medicate, one way or another.
What causes this? Frankly, metabolic weakness and/or a lack of functional organ fluids, both of which can be caused by all the usual suspects: poor diet, stress, genetic predispositions, and long-term use of pharmaceutical medications.
Ironically, the drugs most commonly prescribed by conventional medicine for GERD, proton pump inhibitors, work by blocking stomach acid, thereby causing more physiological dryness, aggravating the root cause of the condition while muting its branch. This might be okay for a little while for those suffering from “excess patterns,” where the GERD truly is caused by excessive acid—but for those whose symptoms are due more to weakness, such medications will most likely yield a short leash.
Chinese medicine first attempts to distinguish the pattern—which kind of reflux are you? Then we treat accordingly, using acupuncture points and herbal formulas to calm the metabolic organs by imbuing them with more strength, mucosal fluids, and blood, and over time proper directionality of gases and fluids should follow suit.
In the meantime, it is advisable to eat foods that are easy to digest, such as sweet potatoes, steamed vegetables, eggs, fish, tofu, white rice, and/or pasta. Obviously, avoid as much as possible spicy foods and alcohol, refined sugar, dairy, and raw, uncooked foods. (Deep) breathing can be helpful for its inherent function to descend, as can massaging the stomach with both palms of your hands in 36 clockwise circles around the belly button. Empirical symptom management en route to unearthing the root cause of your unique pattern include DGL licorice pills if your pattern is one of weakness, or mint tea if you produce too much acid.
Happy New Year, from DFA!
A quick re-cap on the year 2025 in the rearview, the “year-view,” if you will, otherwise “year in review” (clearly being a dad is impacting my jokes)!
A lot of business as usual in the way of business—my same schedule of 3 days a week in the office, plus one supervising in the school clinic at Pacific College, partially highlighted by our appearance on Ben Aaron’s PIX-11 News segment.
I also gladly welcomed my first ever part-time assistant, Kira Schneider, a great acupuncturist in her own right, with a private practice in Princeton, New Jersey.
This year’s continuing education was also more of the same, as Chinese medicine’s foundational text, the Shang Han Za Bing Lun, takes a lifetime to study and master. In addition to reading my nightly passages, I credit Genevieve Le Goff of California, with most of the knowledge I gained last year.
In the first week of this new year I’ve added to my repertoire, virtually lecturing 2 courses per week on Classical Chinese herbal medicine with the Virginia University of Integrative Medicine, which happens to have a New Jersey campus located just a few miles from my mom.
Speaking of which, Mom’s hangin’ in there, my wife, Dr. Jillian Cohen, just got the first ever fellowship at Hackensack Meridian Health’s Integrative Medicine department approved, and daughter Peyton has since turned 4 and 4 1/4, rapidly approaching 4 1/2, and has not been made aware that she’s about to have her second trip to Disney in two years (hopefully this time sans coronavirus). She remains infatuated with everything princesses and drawing (including occasional household furniture vandalism), and her bilingual Spanish abilities are improving, inevitably to surpass my own.
Curious to hear if anyone has any exciting news from last year and/or regarding the year to come—especially if it’s something I should be sharing on my newsletter to benefit fellow clients and friends.
To Morning Exercise or Not to Morning Exercise
Patients (and students) can be good teachers, and one recently reminded me of an important premise, as she reported feeling much better since beginning to exercise in the morning upon waking, before breakfast, before doing anything else. For her, this made sense. For approximately the other half of the population it would not.
Sunrise in Chinese medicine is Shao Yang time, the time of day that corresponds, logically, with the body’s pivot, that is the system whose responsibility it is to use cortisol to bring vital substances, such as immunological or hormonal, upwards in the body. For those of us whose cortisol spikes too quickly or too early, exercise is one way to temper this surge. Interestingly, healthy food is another way. While physical movement can clear some of the inflammatory heat associated with morning cortisol, a proper breakfast of protein, unrefined sugars, and/or healthy fats can also act as an anchor to prevent it from spiking so much in the first place. For the types of people more prone to insomnia, hyperactivity, and fast metabolisms, it seems a moderate morning workout shortly followed by breakfast might be ideal.
For the opposite body type, prone to hypersomnia, chronic fatigue, and/or weight gain, a better time to exercise might be the time of day associated with the most “yang qi,” or warmth, closer to 12 noon, as these people tend to be more lacking in cortisol, as well as other excitatory chemicals, and therefore will benefit more by moving in accord with the environmental nature around them.
For those of us with small children at home, who cannot exercise upon waking, or those with jobs that preclude us from exercising just before lunch, I recommend doing what you can. Everyone is busy, but if you can find 15-30 minutes/day to get in your preferred form of movement, almost every scientific study on the subject since the beginning of scientific studies corroborate the benefit.
