Acne - Traditional Chinese MedicineTraditional Chinese Medicine Summary

Traditional Chinese Medicine

TCM Summary

Just as there are many different types of acne, Traditional Chinese Medicine (TCM) understands that people develop acne from different underlying causes. Chinese medicine doctors consider the appearance of the skin such as the location of the acne, the presence of white heads and black heads, inflammation, cysts, and overall health to determine the root imbalance of acne. Heat, toxicity, dampness, Qi and blood stagnation are all common causes of acne.[1,2]

Treatment Philosophy

Concepts that are common in TCM, such as dampness and blood stagnation, are not common in western medicine. However, it’s important to understand some of the basics to have a better understanding of the pathophysiology and treatment of conditions like acne.

  • Heat: Just as in nature, heat rises upwards, moves quickly, and changes quickly. Heat (and fire) pertains to many skin conditions in which you see redness and inflammation, and feel heat.
  • Dampness: Just as in nature, damp pools and is heavy. It commonly affects the lower body and is difficult to resolve. Dampness appears on the skin as edema, pus, crusting, and serous fluid in vesicles.
  • Qi and blood stagnation: Qi and blood stagnation leads to lack of circulation and the development of dark spots. It can be due to injury, trauma, stress, or lack of sufficient energy to move the Qi and blood through the body.

Symptoms and Causes

Acne is a very common condition that involves the formation of comedones (“pimples”) in the skin. The known causes of acne in western medicine are summarized as the “four pillars of acne”: clogged pores, as well as increased oil, bacteria, and inflammation.

Chinese Herbs

Chinese herbal medicine focuses on correcting the underlying imbalance which is causing the acne. Contemporary research shows herbs that common treat acne may also work through antibiotic, anti-inflammatory, antioxidant, and anti-sebum properties.

Acne from lung heat is often treated with herbs that release the exterior and clear heat from the lungs such as herbal formula Pi Pa Qing Fei Yin.[1] Niu bang zi (burdock seed) is an herb commonly used for for clearing lung heat and it has also shown an antibacterial effect on the bacteria Propioni bacterium acnes the bacteria that causes acne.[4]

When the heat in the stomach is more pronounced, the formula may include huang lian (coptis rhizome) which clears heat, toxicity, and dampness from the stomach. This herbs are well known for their anti-inflammatory and has show antibacterial capabilities against C. acnes, the bacteria that is related to acne.[5]

Heat toxicity is a reflection of acne inflammation. Herbal formula Wu Wei Xiao Du Yin (Five Ingredient Decoction to Eliminate Toxicity) has herbs that attack p. acnes such as zi hua di ding as well as herbs that reduce inflammation such as jin yin hua (honeysuckle) and ye ju hua (wild chrysanthemum).[5,6] 

For acne that worsens with your periods, herbs to move Qi and blood stagnation such as yi mu cao (Chinese motherwort), dang gui (Chinese angelica root) and dan shen (saliva miltiorrhiza) are great for moving blood and balancing hormones.

Herbs may also be used topically in creams, washes, and herbal facials. Dian Dao Shui (Upside down cream) is a classical topical formula which includes huang lian (coptis rhizome) and sulfur (liu huang).[1] Topically, huang lian and its active ingredient berberine, has also been shown to reduce the production of sebum that leads to the clogged pores.[4,7] Green tea has also been shown to topically fight acne bacteria.[8]


Acupuncture is very common method of addressing the acne. Acupuncture may be located around the acne or throughout the body to address specific imbalance.[2] It is often combined with herbal therapies to enhance the effect of treatment. Electro acupuncture has also been shown to reduce androgen hormones which have been associated with acne.[9]

Diet and Lifestyle

Nutrition and diet

  • Diet: Eating less refined sugars and low glycemic foods have been shown to help acne.[10,11] Eating high glycemic index foods, those that are sugary and simple carbohydrates, too many dairy products, and polyunsaturated fats, has been shown to worsen acne.[10,11] In Chinese medicine eating too many sweet foods and dairy leads to the development of dampness. Omega 3 fatty acids from fish such as salmon and sardines and walnuts are also beneficial to acne.


  • Stress reduction: Stress and frustration cause Qi stagnation, which is why periods of stress can cause a break out.
  1. Xu Y. Dermatology in Traditional Chinese Medicine. United Kingdom: Donica Publishing Ltd; 2004.
  2. Cao HJ, Yang GY, Wang YY, et al. Acupoint Stimulation for Acne: A Systematic Review of Randomized Controlled Trials. Med Acupunct.2013;25(3):173-194; PMID: 24761172 Link to research.
  3. Bowe W, Patel NB, Logan AC. Acne vulgaris, probiotics and the gut-brain-skin axis: from anecdote to translational medicine. Benef Microbes.2014;5(2):185-199; PMID: 23886975 Link to research.
  4. Nam C, Kim S, Sim Y, et al. Anti-acne effects of Oriental herb extracts: a novel screening method to select anti-acne agents. Skin Pharmacol Appl Skin Physiol.2003;16(2):84-90; PMID: 12637783 Link to research.
  5. Muluye RA, Bian Y, Alemu PN. Anti-inflammatory and Antimicrobial Effects of Heat-Clearing Chinese Herbs: A Current Review. J Tradit Complement Med.2014;4(2):93-98; PMID: 24860732 Link to research.
  6. Chen HY, Lin YH, Chen YC. Identifying Chinese herbal medicine network for treating acne: Implications from a nationwide database. J Ethnopharmacol.2016;179:1-8; PMID: 26721214 Link to research.
  7. Seki T, Morohashi M. Effect of some alkaloids, flavonoids and triterpenoids, contents of Japanese-Chinese traditional herbal medicines, on the lipogenesis of sebaceous glands. Skin Pharmacol.1993;6(1):56-60; PMID: 8489776 Link to research.
  8. Li Z, Summanen PH, Downes J, et al. Antimicrobial Activity of Pomegranate and Green Tea Extract on Propionibacterium Acnes, Propionibacterium Granulosum, Staphylococcus Aureus and Staphylococcus Epidermidis. J Drugs Dermatol.2015;14(6):574-578; PMID: 26091382 Link to research.
  9. Jedel E, Labrie F, Oden A, et al. Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: a randomized controlled trial. Am J Physiol Endocrinol Metab.2011;300(1):E37-45; PMID: 20943753 Link to research.
  10. Melnik BC. Linking diet to acne metabolomics, inflammation, and comedogenesis: an update. Clin Cosmet Investig Dermatol.2015;8:371-388; PMID: 26203267 Link to research.
  11. Paoli A, Grimaldi K, Toniolo L, et al. Nutrition and acne: therapeutic potential of ketogenic diets. Skin Pharmacol Physiol.2012;25(3):111-117; PMID: 22327146 Link to research.