Chinese Medicine Differential Diagnosis of Acne

This is a page for Chinese medicine professionals who are interested in the traditional disease diagnosis and differentiation of acne. If you are a patient, and would like to know more about the way I use acupuncture and herbal medicine to treat acne, please visit the Acne Page.

There are 5 main types of acne (Fen Ci, or “white thorn”) in Chinese medicine. These types, or patterns, are explained in the language of Chinese medicine. Be sure to have a licensed practitioner diagnose your acne pattern. Do not take any of the herbal formulas listed without the guidance and supervision of a licensed practitioner.

Differential diagnosis

  • Lung Heat: Invasion of External Wind with pre-existing Heat in the Lung to accumulate in the skin and tissues. This causes acne lesions (whiteheads and blackheads) which are papular (small, solid elevation of the skin that does not contain pus) in nature and slightly itchy. The forehead and areas directly around the nose will be affected. Other symptoms may include dry mouth and nose and dry stool/constipation. Acupuncture treatment will clear heat from the Lungs and protect the Lung Yin. The pulse will be floating and slippery. The guiding herb formulas are Pi Pa Qing Fei Tang and Liang Xue Qing Fei Yin.
  • Stomach Heat: This pattern is largely due to a diet heavy in rich, high-fat, greasy foods. Spicy and fried foods will also induce this pattern. These foods lead to an accumulation of heat in the digestive system. Heat rises and produces papular acne lesions (whiteheads and blackheads) in the skin of the upper body. The skin will be oily, and acne will appear mostly around the mouth and on the chest and back. Other symptoms will include vigorous appetite, halitosis, dry mouth, thirst for cold drinks, and dry stool/constipation. Acupuncture will focus on draining heat from the stomach. The guiding herbal formulas are Tiao Wei Cheng Qi Tang and Qing Wei San.
  • Blood Heat: Qi stagnation from disorders of the Seven Affects creates Heat in the Blood. This heat then lodges in the skin, creating papular lesions (whiteheads and blackheads). Areas around the nose, mouth and between the eyebrows are affected. There may be facial flushing as the Blood Heat has caused blood vessel dilation. Women may experience a worsening of their acne prior to menstruation each month. Dry stool/constipation and yellow, hot urine may also be an issue. The tongue will have a red tip and a thin coat. Acupuncture treatments will clear heat from the blood. The guiding herb formulas are Tao Hong Si Wu Tang and Liang Xue Wu Hua Tang.
  • Heat Toxin: This pattern is due to Lung and/or Stomach Heat combining with Heat Toxin affecting the skin in the upper body. Heat Toxin acne lesions are commonly pustules (small, inflamed, pus-filled, blister-like lesions) with redness of the skin around the lesion’s base. Lesions are often painful and nodules/acne cysts are not uncommon. Other symptoms may include dry stool/constipation and scanty, yellow urine. Acupuncture will relieve toxicity and clear heat. The guiding herbal formula is Cuo Chuang Jian Ji.
  • Damp Toxin with Blood Stasis: This type of acne is due to pre-existing internal Dampness combining with an attack of external Toxin. This congeals to make Damp Toxin, which creates stasis in the channels and collaterals. This creates Blood stasis and Qi stagnation. Acne lesions are nodular, deep, inflamed and painful nodules under the skin. The acne nodules are painful and red. Acne appears on the face, chest and back. Nodules created pitted scars when they heal. Other symptoms include headache and heat sensation in the body. Acupuncture treatments will transform dampness, relieve toxicity and invigorate blood. The guiding herb formulas are Chu Shi Jie Du Tang and Wu Wei Xiao Du Yin.

External (topical) herbal application: Dian Dao San, Qu Ban Gao.

Rule-out Diagnosis: Rule out rosacea. In rosacea, comedones are not present.

To make an appointment with for treatment, please go to the Appointments page.