Scratching, itching, oozing, crusting... Has the nightmare of eczema haunted you for years? Applying thicker layers of ointment only addresses the symptoms, not the root cause. What effective methods does Traditional Chinese Medicine (TCM) offer?
What Causes Eczema?
According to Dr. Que Poh Yuen Albert, a TCM dermatology specialist at Singapore Gong Fang Tang TCM, the causes of eczema in Singapore are multifaceted. These include:
Damage to the skin barrier from the tropical rainforest climate (high heat, humidity, and intense UV radiation).
Irritation from airborne pollutants and allergens like dust mites.
Effects of chlorinated water and everyday chemical products.
Genetic predisposition causing abnormal skin barrier genes and family history of allergies.
Immune system overreaction to harmless substances.
Dietary triggers such as seafood and spicy foods.
Poor lifestyle habits like frequent hot showers or wearing synthetic fabrics.
Underlying conditions like skin infections or atopic dermatitis.
What Chinese Herbs are Effective for Eczema?
For recurrent, stubborn eczema, Physician Dr. Que Poh Yuen Albert clinically recommends Gancao Xiexin Tang (Licorice Decoction to Drain the Epigastrium) – a formula from the "Sage of Medicine," Zhang Zhongjing – praising it as the top solution for "damp-heat toxicity in the mucous membranes and skin."
Gancao Xiexin Tang consists of: Gan Cao (Licorice Root), Huang Qin (Scutellaria Root), Gan Jiang (Dried Ginger), Ban Xia (Pinellia Rhizome), Da Zao (Jujube), Huang Lian (Coptis Root), Ren Shen (Ginseng).
Gan Cao (Licorice Root) serves as the sovereign herb, fortifying the spleen and stomach, boosting qi, and restoring the pulse.
Huang Qin (Scutellaria Root) and Huang Lian (Coptis Root), bitter and cold, clear and drain pathogenic heat from the stomach.
Gan Jiang (Dried Ginger) and Ban Xia (Pinellia Rhizome), pungent and warm, warm the middle to dispel cold, direct rebellious qi downward to stop vomiting. This "pungent-opening and bitter-descending" action regulates the spleen and stomach's ascending/descending functions.
Ren Shen (Ginseng) and Da Zao (Jujube), sweet and warm, supplement spleen and stomach qi. The whole formula combines cold and warm, attacking and supplementing simultaneously. It clears and drains damp-heat while harmonizing the spleen and stomach, improving the root cause of eczema.
Skillful Modifications:
For Acute Phase (Redness, Swelling, Numerous Blisters, Copious Oozing):
Add Ku Shen (Sophora Root) 6g, Tu Fu Ling (Smilax glabra) 30g, Bai Xian Pi (Dictamnus Root Bark) 15g: Strongly dry dampness, resolve toxicity, dispel wind, and relieve itching.
Add Ma Chi Xian (Purslane) 30g (60g fresh): Clear heat, resolve toxicity, cool blood. Effective both internally and externally.
External Use: Add Huang Bai (Phellodendron Bark) 20g and Di Fu Zi (Kochia Scoparia Fruit) 30g to the boiled herb dregs. Decoct again to make a concentrated decoction. Apply cold compresses to affected areas for 20 minutes, 3 times daily. Quickly astringes oozing and stops itching.
For Subacute Phase (Red Patches Darken, Less Oozing, Itch-Scratch Marks):
Add Dan Pi (Tree Peony Bark) 9g, Sheng Di Huang (Raw Rehmannia Root) 15g: Cool blood, invigorate blood, promote fading of red patches, prevent hyperpigmentation.
Add Chao Bai Zhu (Stir-fried White Atractylodes Rhizome) 15g, Fu Ling (Poria) 15g: Addresses spleen deficiency with damp encumbrance common among Southern Chinese populations. Fortifies the spleen to aid transportation, cutting off the source of dampness.
For Specific Areas:
Peri-oral, Peri-auricular eczema: Add Huo Xiang (Agastache/Patchouli) 10g, Pei Lan (Eupatorium) 10g (Aromatically transform dampness, guide herbs upwards).
Perineal, Perianal eczema: Add Long Dan Cao (Gentian Root) 6g, Che Qian Cao (Plantain Herb) 15g (Clear and drain damp-heat from the lower burner).
For Constitutional Regulation (Preventing Relapse):
Markedly swollen tongue with teeth marks (Severe Spleen Deficiency): Base formula + Sijunzi Tang (Four Gentlemen Decoction - Dang Shen, Bai Zhu, Fu Ling).
Consolidation during Remission: Switch to Shen Ling Bai Zhu Wan (Ginseng, Poria, Atractylodes Macrocephala Pill) to fortify the spleen and transform dampness, or Danggui Yinzi (Tangkuei Decoction) to nourish blood and moisten dryness (for chronic dry eczema).
Medical Case
Patient: Mr. Li, 45 years old.
History: Chronic eczema in bilateral elbow and knee creases, recurring for over 10 years. Major annual flare-ups: lichenified skin, dark red color, scratch marks with blood crusts, intense "heart-boring" itching at night, oozing yellow sticky fluid. Long-term dependence on steroid creams; rebounded immediately upon stopping. Accompanied by bitter taste in mouth, abdominal distension, sticky and foul-smelling stools.
First Consultation: Tongue red with thick, greasy, yellow coating. Pulse slippery and rapid. Reported frequent social engagements, fond of spicy crayfish and ice-cold beer.
TCM Diagnosis: Damp-heat toxin accumulation in the Spleen and Stomach, complicated by heat stagnation in the blood aspect (Damp-Heat Soaking type).
Treatment Principle: Clear heat and dry dampness, cool blood and resolve toxicity, harmonize the Spleen and Stomach.
Prescription: Modified Gancao Xiexin Tang:
Sheng Gan Cao (Raw Licorice Root) 15g
Huang Lian (Coptis Root) 6g
Huang Qin (Scutellaria Root) 12g
Gan Jiang (Dried Ginger) 8g
Fa Ban Xia (Pinellia Rhizome, Pinelliae Ternatae Praeparata) 10g
Dang Shen (Codonopsis Root) 15g
Da Zao (Jujube) 10g
Tu Fu Ling (Smilax glabra) 40g
Ku Shen (Sophora Root) 9g
Bai Xian Pi (Dictamnus Root Bark) 15g
Dan Pi (Tree Peony Bark) 12g
Sheng Di Huang (Raw Rehmannia Root) 20g
Ma Chi Xian (Purslane) 30g (added last) 7 doses.
Administration: Decoct in water, 1 dose daily, divided into 2 warm doses.
External Wash: Boiled herb dregs + Huang Bai (Phellodendron Bark) 30g, Di Fu Zi (Kochia Scoparia Fruit) 30g. Decoct again to obtain a concentrated liquid. Apply cold compresses to affected areas for 20 minutes, twice daily.
Medical Advice: Strictly avoid spicy foods, seafood, alcohol, mangoes; wear pure cotton clothing; sleep before 11 PM.
Second Consultation: Itching reduced by 50% after 3 days! Able to sleep peacefully at night. Oozing significantly reduced. After 1 week, erythema faded, thickened skin began to soften and desquamate. Stools formed. Formula continued unchanged.
Result: Skin lesions largely flattened, itching disappeared. Followed up for half a year with no recurrence.
