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Types of Acne


Lesions begin with a sebum plug in the follicles of the face, chest or back. Sebum is the oily material supplied by the sebaceous glands, and it provides lubrication and water repellency in the skin. Production of this substance increases in adolescence, probably as a consequence of the activity of androgen, the male sex hormones.

As plugs of sebum become trapped in the follicles, they subsequently become inflamed by production and multiplication of bacteria. This leads to the typical red pustules and papules of common acne. Combinations of blackheads, white heads, painful nodules under the skin and cysts are frequently seen.

Teenage Acne

This is the easiest type of acne to treat with Chinese Herbs. Herbs which clear Heat (i.e redness, inflammation) and Fire Poison (i.e. pus, whiteheads), are used. Results usually come by week 3, and a cure (i.e. 85% reduction of pimples) by week 8 to 10, depending on the severity and duration of each case.

Adult Acne

There is often a digestive component to this type. If food is not properly broken down and bowel function is abnormal (i.e. constipation, diarrhea), then toxins are absorbed into the blood stream. Secondarily, excess mucus may be clogging the gastrointestinal tract. The skin may be trying to eliminate all of this build up through painful, big, pustular acne which often erupts on the cheekbones and temples. This is the trajectory of the Stomach meridian. TCM treatment focuses on the digestive dysfunction. Results will be seen by about week 5, with total treatment lasting up to 12 weeks.

Hormonal Acne

Many women are familiar with acne outbreaks that flare just before menstruation, or around ovulation. And as many have observed, such acne tends not to respond to any "cleansing" type of treatment. This is because there is really no accumulated toxin or Fire Poison to speak of, it is rather caused by hormonal fluctuations and imbalances. Chinese herbs with a broad hormone regulating effect are the mainstay of treatment. As such, not only can the acne be cured, but often menstrual pain, PMS and other hormonal manifestations are cured as well.

Cystic Acne

This is the most complicated type of acne, consisting of very large, nodular lesions under the skin, very slow to resolve and likely to cause scarring. TCM considers these to be accumulations of Phlegm, Stagnated Blood and Fire Poison. Treatment is much slower, as it takes time for herbs to break down these tenacious substances. Successful treatment can take 6 months or more, and patience and consistency are vital.


Rosacea is characterized by reddening and flushing of the face, and often accompanies acne, although it can appear on its own. Initially the flushing comes and goes, and at this stage it is easiest to treat, with herbs that "clear Heat" from the face. After some time, the redness is present all the time, without fluctuation. Congested capillaries may be visible on the skin. Severe cases may also present with papules, i.e. red bumps. At this stage, treatment is based on clearing Heat as well as assisting blood circulation in order to clear the congestion. Results with TCM treatment are very good. The milder, fluctuating form of rosacea might be cured in as little as 6 - 8 weeks, whereas the more severe forms, possibly accompanied by acne and pustules, takes from 10 to 16 weeks to treat completely.

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