A Tale of 3 Herbs: Customizing a Formula for Acne

If you’ve spent any time on this site, you’ve probably seen references to “customized” formulas. Customizing involves choosing precise herbs that differ from person to person – treating not only the individual nature of their skin condition, but also their overall health and constitution.

At my clinic we have around 3 herbs on the shelves. How do I go about choosing which ones to prescribe? The process is very involved. But I’d like to highlight three herbs to show just how precise the treatment of acne can be.

When writing a formula, first I look at the condition. The best herbs for acne may not be the best herbs for rosacea. The best herbs for psoriasis differ from the best herbs for eczema.

Then I look at the Chinese medicine “patterns of disharmony” that cause the skin condition and other health imbalances. I won’t bore you with an entire theory lecture here, but I will say: most people present with 3, 5, 7 or more patterns at the same time. Generally speaking, the more complicated the health picture, the more patterns a person has. If you’ve heard terms like “the liver qi is stagnant” or the “stomach qi is hot” — these are examples of “patterns of disharmony.”

Within each “pattern of disharmony” there are a wide variety of herbs to choose from, each with different specific functions.

So when I go about writing a formula for acne, I will choose small groups of herbs to address each pattern. If someone presents with 5 different patterns, the formula may have 15 to 18 herbs in it. The three herbs we’re looking at here actually treat the *same* pattern — they all eliminate what Chinese medicine calls fire toxins. Yet each would be chosen for different circumstances in different cases of acne.

Pu Gong Ying - Chinese herb for AcneLet’s look at the first one – Pu Gong Ying (dandelion). It is cold, sweet and bitter, and is famous for removing swellings and nodules. I use it in acne when there are widespread whiteheads with some pustules that start under the surface of the skin. These aren’t deep cystic nodules, and they aren’t totally on the surface of the skin either. They are mid-level pimples that might be red and angry looking.

Jin Yin Hua - Chinese herb for acneThis differs from the second herb – Jin Yin Hua (honeysuckle). It is cold and sweet, and is in a famous cold remedy that treats sore throat. In acne, Jin Yin Hua is used for superficial whiteheads, blackheads and pustules that are on the surface of the skin. It is powerfully anti-bacterial and is effective against P. Acnes and Staphylococcus epidermidis, bacteria that are commonly involved in acne.

And finally let’s look at the third herb – Tu Fu Ling (Smilax). It is neutral, sweet and Tu Fu Ling - Chinese herb for acnebland. I use it in acne when there are widespread whiteheads in cases where the skin is greasy or oily.

As I mentioned, these three herbs all address just one pattern – fire toxins. Each formula I write for acne will include 2 to 4 herbs for fire toxins. But this is just the tip of the iceberg. There will be many other herbs necessary to address the various other patterns that a patient has at the same time. If a person presents with 5 patterns, fire toxins are just one of the five. In each of these patterns, herbs are specifically chosen (just like they are in the example above) – based on signs, symptoms and the precise look of the skin. When you look closely, you can see how different every person is. No two formulas will ever be identical.

On that note, I’d like to stress one point. Wherever you may be as you read this – if you are looking to heal your skin condition with Chinese herbs, seek out someone who specializes in treating skin disorders. Many herbalists, acupuncturists, naturopaths and homeopaths have never taken one single class in dermatology. Treatment with herbs is nuanced, and skin diseases can be particularly challenging, but they do respond very well to herbal treatment. As you can see with the example above, one strength of herbal medicine is the ability to be detailed and precise. But a practitioner needs to have the right education and experience to address the complexities of treating the skin.

Herbal medicine is a holistic system, treating the whole person and getting to the underlying root of skin conditions. Herbs don’t provide a “quick fix” but they do offer a complete means of healing when properly prescribed.


Learn more about our herbal treatment of acne

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