Singapore has a high incidence of eczema. Eczema skin itch is extremely uncomfortable; the more you scratch, the itchier it gets. Scratching until it breaks causes oozing. Blindly applying ointments only provides temporary relief. Does Traditional Chinese Medicine (TCM) have any good treatment methods?
Dr. Que Poh Yuen Albert, a TCM Dermatology Specialist from Singapore's Gong Fang Tang TCM, states that many people think skin problems are only diseases of the skin's surface. However, from a TCM perspective, skin diseases are never just about the "skin". TCM believes that "skin diseases have roots both inside and outside". Internal causes involve dysfunction of the internal organs, while external causes involve invasion by pathogenic wind and dampness.
Problems like eczema, urticaria (hives), and itching are almost all related to "dampness". Heavy dampness and toxin accumulation lead to poor circulation of Qi and Blood, naturally causing skin inflammation, rashes, and intense itching.
The brilliance of TCM lies in the fact that it doesn't just treat the symptoms (branch), but addresses both the root and branch simultaneously. It can even help the body completely break free from this "entanglement with dampness".
The ancients long ago summarized the pathogenesis of such skin diseases: internal exuberance of damp-heat, external invasion by wind evil, and wind generation due to blood deficiency.
Does that sound very mysterious? But it's actually quite easy to understand. Internal exuberance of damp-heat is like the body being piled high with garbage; when dampness stagnates, heat is generated, and toxins rush to the skin. External invasion by wind evil is like external allergens such as dust, pollen, or cold wind invading when the body is weak. Wind generation due to blood deficiency means insufficient Qi and Blood; without nourishment, the skin naturally becomes dry and itchy.
These three causes are often intertwined, creating these stubborn, recurring skin diseases that torment people.
At this point, you might ask, since there is an ancient famous formula, what exactly is this formula? The answer is – Xiao Feng San (Wind-Dispersing Powder). This formula is known in ancient TCM texts as the "Sacred Formula for Stopping Itch". It can clear heat and resolve toxins, dispel wind and stop itching, nourish blood and moisten dryness. It is extremely effective against eczema, urticaria, and skin itching, almost sweeping away this category of skin disease.
Xiao Feng San consists of 13 herbs: Danggui (Chinese Angelica, Angelica sinensis), Shengdi (Rehmannia Root, Rehmannia glutinosa), Fangfeng (Saposhnikovia Root, Saposhnikovia divaricata), Chantui (Cicada Molting, Cryptotympana pustulata), Zhimu (Anemarrhena Rhizome, Anemarrhena asphodeloides), Kushen (Sophora Root, Sophora flavescens), Humaren (Hemp Seed, Cannabis sativa), Jingjie (Schizonepeta, Schizonepeta tenuifolia), Cangzhu (Atractylodes Rhizome, Atractylodes lancea), Niubangzi (Burdock Fruit, Arctium lappa), Shigao (Gypsum, Gypsum fibrosum), Gancao (Licorice Root, Glycyrrhiza uralensis), and Mutong (Akebia Stem, Caulis Akebiae).
The monarch herbs (Jun) in the formula use Jingjie, Fangfeng, Chantui, and Niubangzi. These four herbs are all acrid in nature and dispel wind.
Where does the wind evil go? They are slightly warm, moving outward, letting it exit through the pores (cou li). We call this "releasing the exterior". Isn't it stagnated inside and not leaving? These herbs can dispel wind and release the exterior.
From a modern perspective, generally speaking, wind-dispelling herbs have anti-allergic effects. For example, urticaria (wind rash), eczema – especially urticaria – can be intensely itchy. If you go to a dermatologist, the doctor might prescribe some antihistamines: cheap Chlorpheniramine (Phtrimine), slightly more expensive second-generation drugs like Astemizole (Hismanal), or even better ones like Cetirizine (Zyrtec) or Cyproheptadine (Periactin).
They might prescribe all these, and what do these drugs do? They are all anti-allergic medications. Fangfeng, Jingjie, and Chantui themselves have anti-allergic effects. Ordinary people know that Chantui can dispel wind and stop itching.
The formula also uses Cangzhu and Kushen. Cangzhu has the function of dispelling wind and drying dampness. Kushen is a very bitter herb; bitterness can clear heat and dry dampness. Kushen indeed doesn't taste very good.
The formula also uses Mutong. Why use Mutong? What to do when there is heat in the blood aspect? Promote urination – drain the pathogenic factors out through urine; this is called "seeping". Moving downward is called "draining". Moving downward can drain damp evil and also eliminate heat evil. We call this "seeping and draining damp-heat". These three herbs serve as minister herbs (Chen) in the formula.
Look, what's still missing? Red color indicates heat, right? Heat needs to be cleared. So, Shigao and Zhimu are used to clear heat and purge fire. Simultaneously, these two herbs can also generate fluids.
The formula uses Shengdi and Danggui. Shengdi cools the blood and clears heat, Danggui nourishes blood and invigorates blood circulation; both enter the blood aspect. "To treat wind, first treat the blood; when blood moves smoothly, wind extinguishes itself."
Humaren is also used. This herb can nourish Yin and moisten dryness. For example, if someone has slightly dry stools, Humaren can nourish Yin and moisten dryness, helping to keep bowel movements smooth.
The last herb is Gancao. It can clear heat and resolve toxins, harmonize the middle (Jiao) and moderate the effects of other herbs, serving as an assistant and envoy herb (Zuo Shi).
The combined herbs achieve the effect of dispelling wind, eliminating dampness, clearing heat, and nourishing blood. They have significant therapeutic effects on symptoms of eczema such as skin itching, erythema (red patches), and exudation (oozing).
Modifications for Specific Symptoms:
Dryness and scaling in air-conditioned rooms: Add Yuzhu (Solomon's Seal Rhizome, Polygonatum odoratum) 12g (increases moisture in the superficial layer)
Red rash triggered by seafood: Add Zisuye (Perilla Leaf, Perilla frutescens) 10g (neutralizes fish/crab toxins)
Insomnia leading to scratching: Add Yejiaoteng (Fleeceflower Stem, Polygonum multiflorum) 15g (calms spirit and suppresses scratch reflex)
Medical Case:
Patient: Ms. Li, 26 years old.
Chief Complaint: Erythema and papules on the trunk and limbs, accompanied by itching for over half a year. Symptoms improved slightly after previous treatment with Chinese and Western medicine but still recurred. Later, the condition worsened, with erythema and papules slightly extending to the trunk and both upper limbs, accompanied by intense itching, prompting her to seek treatment.
First Visit: Erythema and papules on trunk and limbs, intense itching (worse at night). Tongue: Red body, thin, yellow, greasy coating. Pulse: Wiry and rapid.
Diagnosis: Eczema.
Pattern: Wind-Damp-Heat exuberance.
Treatment Principle: Nourish blood, dispel wind, clear heat, dry dampness.
Formula: Modified Xiao Feng San.
Prescription: Jingjie 15g, Fangfeng 15g, Chantui 10g, Humaren 15g, Kushen 10g, Cangzhu 15g, Chao Zhimu (Stir-fried Zhimu) 20g, Sheng Shigao (Raw Gypsum) 45g, Niubangzi 15g, Mutong 10g, Danggui 15g, Gancao 10g, Shengdihuang (Raw Rehmannia) 30g. 7 doses, decocted in water for oral administration.
Second Visit: The patient reported significant relief of itching and obvious regression of the rash after the above treatment. Appetite and sleep okay, bowel movements and urination normal. Tongue: Red body, thin white coating. Pulse: Wiry. As the formula was effective, no changes were made. Added Baixianpi (Dictamnus Root Bark, Dictamnus dasycarpus) 30g. 7 doses, decocted in water for oral administration.
Outcome: The rash subsided significantly and did not recur.
