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Q: I am a 26-year-old man who would like to seek help for my skin condition – eczema.
Several months ago, I began having dry lips. Weeks later, the skin above the upper lip became so painful that I had to visit a skin specialist, who provided me with steroid medication and moisturising cream.
The eczema gradually spread from my neck to my hands and legs. The itchiness made it unbearable.
Recently, a red patch began to form around my lips. Again, steroid medication was used to treat it.
This red patch still occurs occasionally, and disappears only after I apply steroids. The time span between each flare-up is about three weeks.
What can I do to be less reliant on steroids? Also, what kind of moisturiser would be the most suitable?
In traditional Chinese medicine (TCM), what is the rationale behind eczema and are there ways to prevent flare-ups?
A: Eczema is an inflammatory, non-contagious skin disease. It can affect the face, lips, scalp, neck, buttocks and the area behind the knees.
Symptoms typically include dry, reddened skin that itches or burns; blisters or oozing lesions; dry or scaly, thickened skin; and moderate to severe itching.
Eczema on the lips, as you have described, is medically known as eczematous cheilitis. The major causes are atopic dermatitis and exposure to irritants or allergens.
In TCM, eczema and eczematous cheilitis are likely caused by deficiencies in the spleen and liver, a lack of yin and blood, and pathogenic factors of wind, heat and dampness.
According to TCM principles, the spleen is responsible for converting nutrients into qi (vital energy) and blood.
It can be weakened by an unbalanced diet, tiredness and excessive worrying. When this happens, nutrients are transformed into internal dampness, instead of qi and blood. Internal dampness will create internal heat when it is accumulated in the body over a prolonged period.
A combination of internal heat and dampness can then circulate to the head and trigger eczema that surrounds the eyes, ears, lips, nose and scalp. There may be redness and oozing of fluid with pain and itchiness, dry mouth and lips, and bad breath.
A weak spleen, coupled with keeping late nights, can further lead to a lack of blood to nourish the skin.
When the skin’s defences are down, external pathogenic factors, such as wind, dampness, dryness and heat, can invade the body through the skin and give rise to eczema.
Depending on the type of pathogens that are affecting you, the characteristics of eczema may differ. For example, skin disorders caused by wind are generally associated with itchiness and a sudden onset of symptoms that vary as you move from one place to another.
A combination of wind and heat causes eczema with red papules all over the body, with severe itchiness. Wind, dampness and dryness usually lead to eczema on the face, lips and limbs. The rashes tend to be dry and itchy, and one may also have dry lips and throat.
Finally, the source of your skin woes may be a weak liver. In TCM, this organ stores blood and regulates the circulation of qi.
When it is not functioning optimally, liver qi stagnates and creates liver heat and fire.
Dampness can combine with this liver heat and fire to induce an eczema flare at the nipples and genital area. One may get red rashes and papules with a little fluid, itchy skin and a bitter taste in the mouth.
Chinese medicine, both oral and topical, can help to improve your condition by strengthening organs and dispelling pathogenic factors.
To boost the spleen and eliminate dampness, try cablin patchouli herb, fortune eupatorium herb and Indian bread.
Liver health can be improved with Chinese thorowax root, tree peony bark and liquorice root.
To enhance liver qi circulation and dispel wind, which will reduce severe itching, try gambir plant and puncturevine caltrop fruit.
Fineleaf schizonepeta herb and divaricate saposhnikovia root can also be used to address wind-related symptoms.
As for heat and dampness, taking belvedere fruit, alum and pricklyash peel will help. This will reduce the redness of the rashes. You may also try acupuncture and cupping therapy.
As eczema can be aggravated by allergens, you may wish to identify these factors and avoid them as far as possible.
Some common allergens in food include chemical additives, dairy products, citrus fruits, seafood, tea, coffee and alcohol.
Other possible factors include lip care products and lifestyle habits, such as excessive washing or bathing and a lack of sleep. Being angry, depressed or anxious may also trigger an eczema reaction.
As a general guide, take showers at room temperature and apply moisturiser afterwards to minimise skin irritation. Chinese medicine that can be applied as a moisturiser includes amur cork-tree, dandelion and lightyellow sophora root.
Eat food that is easily digestible, such as green bean soup, lotus seeds, winter melon and warm barley water. Stay away from oily, spicy or sour food.
Doing so will help to strengthen your spleen and reduce internal dampness.
LIM LAY BENG
Traditional Chinese medicine practitioner at YS Healthcare TCM Clinic
A version of this story was originally published in The Straits Times on February 2, 2016. For more stories like this, head to www.straitstimes.com/lifestyle.