Acne is a common skin condition that many patients are struggling with. However, numerous patients find little success with countless acne products because we always overlook the most critical factor: hormonal imbalance and underlying body constitution. Effective treatment to recurring acne requires a dual approach of internal regulation and external treatment. Identify the root cause of acne breakout, especially for women, is the key to healthy and smooth skin.
Real Case Study: Chinese Herbal Medicine and Acupuncture to Treat Hormonal Acne, Red Marks, and Cystic Acne
Patient Quote: “I need help with my acne. It always flares up right before my period, and the red marks just don’t seem to fade…”
Patient History: Our patient, “Ms. Wong”, experienced regular breakouts of stubborn, deep “cystic acne” before her period. The post-acne red marks (PIE) persisted for a very long time. This cycle repeated continuously, and trying various acne products had failed to address the root cause. (See photo 1 on the left).
TCM Diagnosis: I analyzed that Ms. Wong’s acne was strongly linked to her endocrine system (hormonal imbalance). Furthermore, her habit of frequently staying up late, sleeping around 1-2 am, led to insufficient rest, resulting in “deficiency-fire” type acne. Additionally, her menstrual cycles were not smooth; she discharged large blood clots each period, indicating Qi stagnation and Blood stasis in her body.
Treatment Plan & Results: I prescribed a tailored Chinese herbal formula designed to tonify Qi, nourish Blood, clear heat, activate blood circulation, and resolve stasis. This was combined with facial acupuncture (beauty acupuncture) to improve local Qi and blood circulation.
- After one treatment, the bright red, active acne was getting smaller and flatter, with no new breakouts forming. (See Photo 2).
- After over one month of combined herbal and acupuncture treatment, along with guided skincare advice, Ms. Wong’s acne marks had faded significantly. Her previously uneven skin texture became smooth again (See Photo 3 on the right). She also reported improvements in her menstrual cycle, sleep quality, and digestion.
TCM Hormonal Acne Face Map – Meanings and causes of Different Acne Breakout Area
The location of persistent acne often indicates different underlying causes according to TCM principles.
Forehead Acne: Emotion and Stress
Acne on forehead often related to emotional stress. Commonly worsens around the menstrual period in women.
Chin/Jawline Acne: Hormonal imbalance
Acne around the chin and jawline typically reflects hormonal imbalance (endocrine issues). Frequently seen in individuals who stay up late and is often “deficiency-fire” type. Ironically, drinking cooling herbal teas (liang cha) or using heat-clearing herbs can sometimes worsen this type.
Nose/Perioral Acne: Gut and digestion
Acne around the nose and lip are strongly linked to gut health. Heat and dampness accumulation in the digestive system usually cause this type of acne. Dietary changes, like reducing fried, spicy, and excessive meat foods, are crucial.
Back Acne (Bacne): Internal Heat
Dense, red acne on the back often signifies internal heat. Incomplete cleansing after sweating can also lead to oil and bacteria buildup, causing inflammation.
Is Hormonal Acne Always ‘Heat’? Should You Drink Herbal Tea? TCM Categorization to Avoid Side Effects
Every individual’s constitution and acne cause is different. Even acne appears as inflammation, only a small fraction of patients have the excess heat constitution suited for drinking “cold” herbal tea. For those with weaker constitutions, consuming these can cause side effects like diarrhea or digestive discomfort, further weakening the body’s function and impairing facial circulation, making acne harder to resolve. Here’s a basic TCM guide to acne types:
- Bright Red Acne: Indicates the presence of internal Heat.
- Dark Red Acne or Persistent Red Marks: Suggests poor Qi and Blood circulation (Blood Stasis). Cold herbal tea may worsen facial blood circulation.
- Pus-filled Acne, Oily Skin: Points to excessive Dampness internally, which can be further differentiated into Damp-Heat or Cold-Damp.
How Does Traditional Chinese Medicine Treat Hormonal Acne and Post-Acne Red Marks?
TCM treats acne by identifying each patient’s unique body constitution, differentiating factors like heat/cold, and pinpointing the root cause of recurring breakouts. Common root causes include digestive system dysfunction, hormonal imbalance, Qi and Blood deficiency from lack of sleep, etc.
- Internal Herbal Medicine: Custom formulas are prescribed to correct the underlying imbalance and adjust the constitution.
- Acupuncture: Promotes Qi and blood circulation in the face, speeding up acne metabolism and fading red marks. TCM is particularly effective for stubborn cystic acne.
For women, special attention is paid to pre and post-menstrual regulation:
- Pre-Menstrual: Focus on balancing hormone by soothing the Liver to regulate Qi, alleviating emotional stress, and improving sleep.
- Post-Menstrual: Focus on nourishing and supplementing Blood and Qi, which aids skin renewal, fades acne marks, and reduces pigmentation.
Skincare is also an essential component. Some topical Chinese herbal washes or masks can help reduce inflammation and purge pus. Practitioners also guide patients on selecting skincare products that help reduce acne and fade marks while controlling oil production.
TCM Dietary Advice for Improving Hormonal Acne
Patients with acne should try reducing:
- Sweets & Refined Sugar: Can worsen dampness and inflammation.
- Dairy Products: Can exacerbate dampness and heat for some individuals.
- Fried & Greasy Foods: Increase pore oil production.
- Icy/Cold Drinks & Food: Impair circulation and hinder the skin’s repair processes.
In conclusion, Traditional Chinese Medicine offers a holistic solution for stubborn and recurring acne by addressing the internal root causes—such as hormonal imbalance, Qi stagnation, or blood stasis—rather than just the symptoms. As demonstrated in the case study, a personalized approach combining internal herbal medicine and acupuncture can clear active breakouts, fade persistent red marks, and restore overall skin health from within. If over-the-counter or retinoid products have failed you, Chinese medicine may provide the tailored treatment for your skin needs to heal deeply and lastingly.
