It is often said that you can’t judge a book by its cover, but what about the human “cover,” your skin? Doctors recognize many varieties of problems and diseases of the skin. Although we can visualize the skin (in contrast to, say, the liver), it is often difficult to determine whether a problem is due to attack from various fungi and bacteria or to an internal process such as psoriasis or eczema, or from factors within and without such as an allergic reaction to an ingredient in your soap.
I have come to the conclusion that even when the skin is seemingly attacked by an external pathogenic (disease-causing) agent such as a fungus, this is usually preceded by an internal process of imbalance. For instance “liver heat,” or inflammation due to chronic doses of aspirin, chronic stress, overuse of alcohol, and immune weakness because of improper nutrition can all contribute to a major outbreak of athlete’s foot. This is a manifestation of the important principal in Traditional Chinese Medicine (TCM), “treating the branch, treating the root.” Treating the branch is like applying a calendula cream to an itchy, scaly patch on the arm. Treating the root is taking a closer look at the inner world of the body through the traditional principles of asking a patient about their health habits, smelling the breath and skin, feeling the quality of the pulse, looking at the tongue, and of course, closely examining the skin. My point is that treating both the branch to relieve symptoms and treating the root to bring increased health and prevent future problems is the way to go.
I have worked with patients with various skin problems in my clinic— everything from skin cancer, psoriasis, acne, and boils to burns and fungal infections. Skin problems are common and always surprise me with their many manifestations. People come in with itchy, scaly, red, white, dry, festering, burning areas on the skin, wondering what is going on.
A dermatitis case
Marjorie came in with red, itchy patches on her hands, arms, and feet. She told me her doctor had diagnosed her with atopic dermatitis. Atopic dermatitis affects more than one out of ten people in North America. It often shows up in infancy and in children, but many are affected throughout life. People who are affected are also prone to allergic reactions such as food allergies, allergic rhinitis (hay fever), asthma, and eczema. The rashes result from a complex interaction involving many immune processes in the skin with contact allergens and internally with foods and perhaps metabolic waste products. Marjorie began scratching the spots on her arms as if unable to resist. “I can’t help scratching sometimes, especially when I’m nervous, but it usually makes things worse,” she said. Scratching often compromises the protective barrier of the skin, allowing a secondary bacterial infection to become established. She had tried every kind of medicine the doctor prescribed, even steroids, but while these would sometimes reduce the symptoms, they always returned.
I examined her tongue and found it to be swollen and with “scallops” or indentations around the edges. This meant she might be suffering from what is known in TCM as “spleen qi deficiency,” or weak digestion and immune dysfunction. Her pulses were generally weak, emphasizing the “deficient” nature of her internal environment. Digestive problems and food allergies are often related to atopic allergies.
These simple observations led me to recommend tonic herbs to build up Marjorie’s immune system and enhance her digestive strength. But first things first—that is, treating the branch. Marjorie wanted some relief of itching and a reduction in the number and size of the lesions. I noticed her skin was dry. Dry skin can come from spleen qi deficiency because it is the digestion that distributes water around the body. A number of topical herbs can be used to reduce skin inflammation, diminish itching, and help promote healing of the lesions. These herbs are called vulneraries and they can generally ease itching, redness, pain and inflammation of many kinds of skin problems. I recommend applying them several times a day.
I have found that all herbal products are not equally effective for individuals. Differences exist in manufacturing care and the freshness of the herbs that go into preparations. Because we make some of our own preparations in the clinic, I was confident in the potency of the creams we use. I often encourage patients to make their own creams. This can be fun to do at home and provides some of the best preparations. I gave Marjorie a red cream made with St. John’s wort oil, but the oil itself will also work in many cases. These should both be available in many herb shops. I also had her buy an aloe plant for home use. With the aloe plant we keep in the clinic, I showed her how to cut a three-inch piece of the succulent leaf in half and squeeze out the gel as she applied it to the lesions. She said she would apply it two to three times during the day. Aloe vera gel has proven immunomodulating, antihistamine, and anti-inflammatory effects. I said that she could use commercial gels, but to avoid products that contain diluted aloe gels with other ingredients. These are fine to help soothe dry hands but are not potent enough for therapeutic use.
I started her with aloe and St. John’s wort, with the idea that I had other healing herbs waiting if she didn’t find these effective. As it turned out, Marjorie had about a 50 percent reduction in itching, redness, and frequency of the lesions within a week to ten days. As she continued to use the herbs topically the results were less dramatic, but still significant, even after six months, as long as she kept applying them regularly. I have observed that regular use of herbs or products made from fresh, vital herbs will consistently give good results for many skin ailments.
For internal use, I wanted to strengthen Marjorie’s “digestive fire,” so that she could digest her food more completely. When proteins and carbohydrates don’t break down completely and quickly, they can interact with immune tissue in the gut, leading to heightened immune reactivity to other allergens, such as detergents, shampoos, and known food allergens such as eggs and dairy.
She started with a bitters formula made with gentian (Gentiana lutea), ginger (Zingiber officinale), cardamom (Elettaria cardamomum), orange peel (Citrus sinensis), fennel (Foeniculum vulgare), and a little licorice (Glycyrrhiza glabra). Many bitters formulas with gentian are available commercially. They are taken ten to fifteen minutes before meals for several months at a time. Gentian is known to increase hydrochloric acid output from the stomach, leading to better protein digestion, and has an immunomodulating effect.
One of the few Chinese patent formulas I use is one that has potent digestive-enhancing effects. The tablets are uncoated and contain no dyes or waxes. Three to four of the tablets can be added to warm water to make an instant tea, or chewed before meals. The product is called Liu Jun Zi, and it comes in a yellow-and-green box. It is quite cost- effective to use for several months.
Marjorie had positive results from the herbs and some of the dietary recommendations I suggested. The program was not a panacea, though, and she continued to have some itchy areas on her skin from time to time. After two years, she is still using the program and branching out to try other herbs as well. She feels the beneficial side effects of sticking to a natural program—better energy, better weight balance, and a healthier-looking complexion—is worth the effort as well.
Christopher Hobbs’s case studies are gleaned from his thirty years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is the creator of the new correspondence course Foundations of Herbalism. Visit his website at www.christopherhobbs.com.
“Case Studies” is not intended to replace the advice of your health-care provider.