Understanding Eczema Part 3: Etiology According to TCM

My last post discussed the causes of eczema (atopic dermatitis) from the scientific medical perspective.  Here I will talk about the causes of eczema as we understand them according to Traditional Chinese Medicine (TCM).  Some of the terminology will be unfamiliar to you if you are not a practitioner of TCM.  As this post is for both practitioners and patients, I will do my best to bridge any gaps in understanding.

Before we begin, you must accept the idea that the body has energy flowing through it.  (Well, I suppose you don’t have to accept the idea, just understand that those of us who study and practice TCM accept this concept).  We call this vital life force energy Qi (pronounced “chee”).  In TCM, we believe that Qi (in various forms) flows throughout the body and is the basic underlying layer of functioning responsible for the proper functioning of all other biological systems in the living body.  Disruption of Qi circulation causes disruption of various functions in the body.  Each organ has its own Qi and we describe illnesses in terms of imbalances of this Qi.  Diseases, esp. of the skin, can have complicated underlying energetic imbalances that involve the Qi of more than one organ.  Such is the case with eczema.

According to TCM, eczema begins with constitutional inefficiencies that quickly become complicated by exposure to pathological energies.  Eczema most often develops at a very young age (in infancy).  It can begin with the mother when she eats too many fatty, spicy, fried or sweet foods, or overindulges in fish/seafood.  She will develop a deficiency of her Spleen Qi.  Spleen Qi Deficiency may exist before pregnancy or can develop during pregnancy or while breast-feeding.  Either way, this insufficiency of Qi is passed on to the baby.  When the Spleen’s Qi is compromised, the Spleen’s function becomes impaired and it cannot take the food and fluids that are consumed and transform them into usable energy.  Instead, Dampness and Heat will begin to accumulate internally (in the Spleen and Stomach).  Dampness and Heat (called “Damp-Heat” when they combine) are pathogenic forms of energy (unhealthy, capable of causing disease) that eventually get pushed outward and get trapped in the skin and cause eczema lesions.  This often happens more quickly if the baby is improperly fed after birth, such as when the baby consumes too much dairy or too many spicy or sweet foods (the baby started off with weakened Qi from its mother and then perpetuates the impairment of its Spleen Qi with unhealthy diet that directly creates more Dampness and Heat).  This internal development of pathogenic factors is one direct way eczema can develop.  But it isn’t the only way.

Deficiency of Spleen Qi leads to impairment of the body’s ability to absorb nutrition as well as leading to Lung Qi Deficiency, thus further weakening the immune system.  The Lung is the source for Wei Qi (Defensive Qi), which is the first line of defense against external pathogenic factors such as pathogenic energy or germs or allergens.  So when the infant’s Wei Qi is compromised, it is easier for external pathogenic factors to invade the infant’s body.  Such external factors include environmental energies such as Wind, Dampness, Heat; or Toxic substances (dust mites, pollen, other allergens).  Initially these things get caught in the skin.  Wind causes itching (like a breeze that blows across the skin tickling it and drying it out).  Heat causes redness and swelling (inflammation).  Dampness is a pathogenic factor that results in oozing of lesions (like wetness or liquid that exists where it shouldn’t accumulate).  The longer these pathogens are trapped in the skin, the deeper they penetrate and the more energetic damage they cause.  Over time, they can consume Yin (the moistening & cooling substance in our bodies) and dry up Blood (nourishes and moistens the tissues) thus leading to leathery, rough, thick skin (lichenification).

Other factors can speed up this process or further complicate it.  For example, congenital (genetic) problems can affect Liver and Kidney Qi.  This results in immune dysfunction and also leads to Yin and Blood being damaged even faster.  Stress (emotional and physical) causes the energy of the Liver to stagnate.  Liver Qi Stagnation easily affects the Blood causing Blood Deficiency and Blood Stasis (poor circulation).  This makes the eczema a much more stubborn condition, with lesions that take a long time to heal.

In a future post, I will explain the different patterns of eczema and the phases in which they appear.  Eventually (once we have a deeper understanding of eczema), I will offer a list of tips to improve your eczema.

Tags: allergic reaction, atopic dermatitis, atopic eczema, Chinese herbal medicine, Chinese medicine, dermatitis, dermatology, eczema, herbal medicine, herbal skin care, rashes, skin rash

Topics: Allergies, Chinese Medicine, Eczema, Rashes

Publish Date: October 15, 2010     *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.

Comments (6)

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  1. Padme says:

    What you posted made perfect sense and is the best explanation I have come across. My 6 month old developed eczema one month ago and a month before, had dark green stoool that would not resolve. Now it is still greenish though more yellow now and thin. Has not gone back to its healthy state since. And before that I had a lot of fish as I thought would boost breastmilk supply and I also took fish oil supplements without checking source or dosage. So I guess my baby’s liver must have been damaged. My biggest worry/ question now is : is this reversible? How can I reverse it?

    • When we speak of the Liver (capital “L”) in TCM, we are referring to the energetic functioning of the liver organ. If the Liver Qi (energy) is imbalanced, this does not necessarily equate to actual liver damage. So don’t be too worried. I cannot exactly advise you about what to do on this forum, especially since I have not examined your baby and do not have enough information such as diet (eating lots of vegetables can cause green stool). And generally speaking, high quality fish oils are an excellent thing to consume for both you and your baby. Some cases of infant eczema develop from a lack of healthy fats in the diet. Visit our referral page to find a TCM practitioner near you who may be able to help you further:

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