Acne has many faces. Why does it land on us? Our faces and backs, upper or lower back? Why for some of us is it itchy, while not for others? For some it is painful. Some women get flares on their cycle, or just after. Why?
The Jue Yin-Yang Ming mechanism is one of the most important connections in Chinese medicine. It dictates that our body must have enough healthy fluids and inhibitory substances in reserve, such as estrogen, dopamine, etc., to mitigate inflammatory heat from flaring upward in the body, whether vertically up (to the face and head) or simply upwards from the “organ layer” to the skin.
For those not prone to “heat pathologies” (approximately half the population) this “flare” will likely manifest in different ways—if it does so dermatologically the skin is less likely to be red and/or angry.
If you’re like myself the skin is likely to turn red. If there is itchiness it indicates damp fluid retention (often sebum oil) trapped on the surface—the itching being its attempt to vent (follicular hyper-keratinization)—and/or some central nervous system dysregulation, i.e. a potential stress component. The reason scratching ultimately makes things worse is because the manual aggression ends up pushing the fluid retention a tad bit deeper beneath the surface, no doubt to resurface soon thereafter. Although scratching to bleed is not advisable, it does generally provide longer-lasting relief via its ability to vent some of the pathogenic fluids within the blood. If there is pain at the site, there is probably some degree of local blood stagnation. This often coincides with the week leading up to one’s menses, whereas symptom flares on the heels of one’s menses points more to “Jue Yin” fluid and/or blood deficiency.
Dermatologists often recommend Spirinolactone, which works by stopping aldosterone from signaling the kidneys to reabsorb sodium. This might be a wonderful Band-Aid for some, but unfortunately over time can cause issues as sodium is an essential mineral for transporting nutrients across cell membranes, also for regulating blood pressure. This might explain why two of its most common side effects are dizziness and gastrointestinal issues.
In the treatment of acne it is first important to rule out itching—whether there are oily pathogens beneath the surface and/or an emotional component, that needs our attention. Most important is the Jue Yin-Yang Ming axis. How much heat must our acupuncture and herbal medicines stop from flaring to the person’s skin and how much blood and/or inhibitory substances must we generate to prevent further flares? Dosages or points might be modified on a weekly basis. Striking this prescriptive balance is the key to optimize clinical outcome.
As for self-care, it is advisable in almost all skin conditions to go off dairy for the lifecycle of a red blood cell, or 120 days. Dairy contains the hormone, IGF-1, which increases sebum production. Many people can resume in moderation afterwards. Red meat can go either way as it helps to generate blood and fluids, but can also generate bodily heat. Where one falls along the Jue Yin-Yang Ming imbalance will decide how much steak is advisable. As far as protein goes eggs, fish, and tofu are ideal, as they don’t generate as much heat in the body.
