Rosacea According to Chinese Medicine

The 3 main TCM (Traditional Chinese Medicine) patterns seen in rosacea are Accumulation of Heat in the Lungs and Stomach, Heat in the Blood, and Blood Stasis.  Let’s examine each one individually.

Accumulation of Heat in the Lungs and Stomach

Mild Rosacea (I’m not wearing any makeup here)

In the earlier stages of rosacea, the most common TCM pattern is simply Accumulation of Heat in the Lungs and Stomach.  Heat begins accumulating in the Stomach often due to overindulgence of spicy foods, alcohol or strong tea (this isn’t always the case, though).  The Heat in the Stomach can go directly to the cheeks via the Stomach Channel and/or it “steams” to the Lungs where it eventually rises to the face via the nose.  

At first, when the Heat is just beginning to accumulate, the face flushes easily but it is only temporary.  This redness blanches upon pressure (i.e. it becomes white when you press on it).  Eventually the redness becomes persistent erythema that never goes away entirely and gets worse upon exposure to heat (hot water, hot air, rise in body temperature due to exertion or fever).  Patients often report that their face flushes almost immediately after drinking alcohol or eating spicy foods.   Other accompanying symptoms may include dry mouth and nose, thirst, and constipation.  The tongue will likely be red with a thin yellow coat and the pulse will be rapid.  If tiny papules or pustules form (usually on the cheeks or nose) this often indicates Heat Toxins are also present.

Heat in the Blood

Increased redness, more papules, and dilated capillaries

As the condition progresses, the erythema (redness) becomes darker and capillaries become dilated (called telangiectasia).  This is the development of Heat in the Blood.  Pinpoint papules or larger pustules form more frequently (sometimes rosacea and acne are difficult to differentiate, but acne will not have the diffuse erythema or the telangiectasia).  

In addition to the redness in the cheeks (and possibly forehead), the bulb of the nose may become red.  In rosacea, this Heat in the Blood is often secondary to Disharmony of the Ren & Chong Vessels.  [According to Traditional Chinese Medicine (TCM) the energy (Qi) in the body circulates through a network of vessels (also called “channels” or “meridians”).  The Chong and Ren vessels are particularly important in woman’s health because fertility and the menstrual cycle depend on the flow of Qi and Blood through these channels.]  When the Chong & Ren Vessels are involved, women will often experience worsening of symptoms or have sensitive facial skin right before or during their periods.  Accompanying symptoms can include drier stools, yellow urine, and irregular menses in women.  The tongue most likely will be the same as in Heat in the Lung and Stomach (red with a thin yellow coating).  The pulse will be rapid and possibly even slippery.

Blood Stasis

Rhinophyma, a.k.a “W.C. Fields nose”

When the bulb of the nose becomes chronically inflamed and darker red, Blood Stasis has become the predominant pattern.  The skin on the nose may become thicker with more dilated blood vessels, enlarged pores and oily skin.  Rhinophyma might eventually develop (this is irreversible hypertrophy of the nose); this can be very disfiguring and cosmetic surgery is often the only treatment.   There will likely be more papules and pustules on the nose and cheeks and forehead with generally more oily skin. 

From the TCM perspective, this Blood Stasis develops from pre-existing Accumulated Heat in the Lungs and Stomach or the Disharmony of the Chong & Ren Vessels.  If Cold or Wind-Cold invades the face (from exposure to cold air or cold water), the skin’s exterior defenses become blocked and the Cold settles in the skin preventing the ventilation of accumulated Heat in the face.  This combo causes local Stasis of the Blood (and Qi).  The patient’s tongue will be dull red or purple and may even have ecchymosis (dark purple spots) with a sticky yellow coating.  The pulse will likely be choppy or wiry.

So how do we treat rosacea with Chinese Medicine?  And what can YOU do to improve your rosacea?  You will have to wait for the next posts to find out!

Tags: Chinese herbal medicine, Chinese medicine, dermatology, face care, face rash, Facial care, rosacea, skin care

Topics: Beauty, Chinese Medicine, Facial Care, Rosacea

Publish Date: May 25, 2011     *Articles may include updates since original publishing.

About the Author ()

Diana Hermann is a licensed acupuncturist and board certified in Chinese Herbal Medicine. She received her Master Degree in Acupuncture and Oriental Medicine from the Oregon College of Oriental Medicine in Portland, OR and trained in China at the Nanjing University of Traditional Chinese Medicine. Diana treats patients in her Fort Collins, Colorado clinic and hand crafts herbal skin care products for her company Zi Zai Dermatology. In 2015, she completed the Diploma In Chinese Medicine Dermatology program from Avicenna in London, UK. She completed the program for a second time in 2019 in Chicago.

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  1. Hello Dianna! I just discovered your blog and can feel a sense of relief that to your expertise and willingness to share it. I have rosacea and have trying to manage it homeopathically and with acupuncture for about 3 years now. Recently, I’ve developed an angry looking rash around my eyes that my dermatologist says is Periorbital Dermatitis and is related to rosacea. She wants me to begin taking Tetracycline for a month and possibly ongoing!! Needless to say, I do not want to do this. I’m grateful to have found you and very much look forward to your next post on rosacea.

    • If it is perioral dermatitis (which shows up around the mouth and also under the eyes), look for the cause before going on prescription meds like that. Although sometimes the cause is unknown, it can be a reaction to something you are coming into contact with (makeup, topical steroids) or aggravating foods. Steroids are a very common cause, so if you are using a steroid cream to reduce blemishes from the rosacea, that may be causing the perioral dermatitis. It will also will be important to avoid spicy and greasy foods.

      • Michelle LaBorde says:

        Thank you so much for responding. I do not use topical steroids so I’ll try eliminating spicy and greasy foods and see if that helps. How about hormones? Could they be a factor?

      • Jennifer Ryan says:

        Hi there. I had perioral dermatitis and my dermatologist also told me to stay away from flouride toothpastes. When I stopped using it the rash went away. Hope this helps!

  2. A lot of our customers have stated that a shower filter has helped with milder cases of rosacea. At the very least, filtering out some of the chlorine will help the skin be less dry.

  3. Bob Heinlein says:

    Traditional Chinese Medicine is immoral. It drives poaching of endangered animals because it relies on nonsensical animal parts such as the rhinoceros horn, bear bile, and tiger bones. Discuss.

    • {This is not the proper place for this discussion, so any further comments will be deleted from this forum. However, I must answer this accusation as it is very dear to my heart.} True Traditional Chinese Medicine as it is practiced today is NOT immoral – those of us who are licensed practitioners would NEVER EVER use any parts from endangered species. Those who are as ethical as I am, would never ever use or condone the use of bear bile (the farming practice is hideous and inhumane), we would never use or condone the use of tiger bones, and would never ever use or condone the use of rhinoceros horn. In this day and age, we know better about the global impact we humans have on this planet and all of its creatures and the vast majority of us in this field are committed to promoting the PROPER use of medicinals and we support the legislation that bans poaching and farming of these animals. Zi Zai Dermatology actually donates EVERY MONTH to the World Wildlife Fund, specifically to their Save Tigers Now fund. Zi Zai Dermatology fully believes that it is our responsibility as stewards of this medicine to also be stewards of the earth that gave us this medicine and we must stand firm as an industry to protect the plants and animals of this planet from poaching and inhumane treatment. And frankly, it pisses me off when poachers kill tigers for their penises, which are sold on the black market in Asia as an aphrodisiac, because this is not TCM and it is deplorable and it should be stopped. So if you want to have a bigger impact on stopping poaching, donate money to the WWF instead of commenting on the blogs of people like me who practice this medicine ethically and responsibly.

      Donate to World Wildlife Fund here.

      • Caroline says:

        Thank you for taking the time to explain what we do not have nor use in our profession. This is today’s world and not the world when Chinese medicine began. I am pleased we have moved a long, long way to help patients to better health without endangering neither animals nor patients! I hope he reads your reply and starts to understand what our medicine is. I can’t speak to other countries, but in America these “herbals” are not allowed nor used. Yes, we also contribute to WWF and love the calendars we receive annually.

    • Devaron says:

      I have read several of the comments and most are obviously very good and supportive. once in a while i have read a comment that is way out of balance, for example the comment that states Chinese Medicine is Immoral… Immoral is a huge statement that the person using it seems to have no real understanding of its meaning… in fact I found the statement to be offensive. Western Medicine is certainly no better then Chinese medicine and is by comparison the new kid on the block… Western Medicine has been known for decades to be great at diagnosing but poor at curing, and surgery (which is common practice for western medicine)is not the answer to most disease or body aliments.
      Americans in general are good people but are isolated from the old world and it shows.
      in truth there is no immorality to healing or medicine no matter where it is practiced or how it is administered. The indigenous people and the ancient people have been practicing medicine from the dawn of time.

      • See my reply above, too.

      • Inatorquisemood says:

        I beg to differ – western medicine has a hopeless track record of diagnosis and scores even less on integrity. It is extremely corrupt. For more on this read Corporate Crimes of The Pharmaceutical Industry by John Braithwaite. I particularly recommended World Without Cancer by Edward Griffin. Your jaw will drop at the scale of corruption and incompetence within the pharmaceutical western medicine paradigm highlighted in these books.

  4. Anne Marie says:

    Thanks so much for sharing this valuable information. I live in Singapore and was diagnosed with rosea about four years ago. My dermatologist offered me very little other than antibiotics and rosea cream. I am done with the antibiotics and had not found another alternative treatment. For me the trigger factor is heat, particularly from exhersition and alcohold. We are smack bang in the middle of the tropics and it is hot and humid here all year round. I have now taken to exercise in the evenings when is cooler and avoid drinking red wine and liquiour though the occational white wine is necessary. No spicy food but coffee. I hate it and feel very sefl contious. Although I don’t seem to have the redness of the skin I have the pimples that accompany it. I am going to see a TCM here and take your herbal recipe to show him. I hope he can recognize and help. I don’t see many local people with this condition so I hope he recognizes what it is. Many thanks again for sharing your knowledge and views. As I final note, the TCM is strictly regulated and the use of unethical animal parts not only is forbidden and penalized by law but also the practitioners are aware of the need to act in an ethical way. I think the Mr Bob just made a sweeping statement and should know that yes there are still unscrupulous people out there but it is not everyone that practices and comsumes traditional medicine.

  5. lena murray says:

    Dear Diana, thank you for the detailed explanation of what rosacea is. I have a pretty mild case so far but would like to tackle it. I have been prescribed a variety of creams containing metronidazole, and they have temporary effect, but it’s an antibiotic, and I hate to use it too much. I live in Maryland, Washington DC area. do you know any Chinese doctor/healer here that you could recommend? Or should I just purchase your herbs? how should I go about it? thank you so much.

  6. Cynthia says:

    I feel very grateful for TCM for many reasons.

    Still watching what makes my tiny pimples show up. It’s not consistent. Feels as if I have fire that I delay or hold back, that builds up and needs to move/act more without holding on. Otherwise, i’m very healthy. Colon involved?

  7. Wee says:

    Can you recommend a good TCM for acne rosacea in Singapore please? Thanks.

  8. Natosha says:

    My skin has cleared up mostly. I still get some rosacea around my nose that seems to keep coming back but I Dermalmd Rosacea Serum definitely helps it not flare up as much and as noticeable.

  9. Arlene says:

    Hi I too have the scaly pimply on my forehead, cheeks and sometimes around lips. Can you tell me what’s happening in my body or someone in the south Florida area, I live in Ft Lauderdale. Thank you.

  10. Vern Hoggatt says:

    Good Morning!
    I have the pimples on my nose from rosacea. My rosacea never was a big problem until I retired. When I was working I could manage the flare-ups. Lately the problems seems to escalade. I do my best to control foods that I eat and alcohol, mostly red wine.
    I need some type of natural medicine vs prescribed.

    Can you help? Would going to acupuncturist help? Thank you, Vern

  11. Jbird says:

    Wanted to share with people on here that many cases of rosacea can be attributed to a facial mite called Demodex folliculorum. It burrows down into the sebaceous glands in the face, and when it dies, the bacteria it harbors in its gut, called B.oleroneous leaks out into the surrounding tissue and causes localized inflammation. Some researchers think that some of the bacteria on our face ends up on our fingers, goes into our mouths, and then to our gut, where the bacteria multiplies and somehow causes a cycle of inflammation that shows up specifically on the face . Ivermectin is a miticide that has shown great promise in treating people with rosacea. There is also very likely a gut health component, so TCM isn’t wrong there. People with rosacea have been shown to have low stomach acid and overgrowth of bacteria in the small intestine (SIBO)- I personally have been taking ivermectin topically (FDA approved Soolantra) and have added a stomach acid supplement, (betaine HCL) probiotics, kimchi (eww, but works) and a beneficial yeast called S. Bouliardi that’s been researched and proven to control SIBO. I hope to help anyone who wants to get to the root cause of their rosacea rather than just treating the symptoms. I’ve only been doing my new routine for 12 days but I am seeing some definite improvement already. Take care.

    • Yes, we always want to address the root cause of any disease we treat in TCM. The debate regarding demodex mites is not new. The fact is that there has been shown in most cases of rosacea to be an elevated population of demodex mites on the faces of rosacea patients compared to other humans without rosacea symptoms. The debate remains as to which came first – the demodex mite overgrowth and that triggered the rosacea, or did the rosacea create an environment that allows the demodex mites to thrive.

    • SonofGod says:

      IVERMECTIN in your case is what did the job!
      Oral IVERMECTIN works much efficiently and is only one single pill. Stop adding things to your face

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