Topical Chinese herbal medicines that benefit epidermal permeability barrier function

Exciting stuff huh! Firstly, let me very briefly explain what the skin barrier is and why it is so important. The skin barrier acts as the bricks and mortar of the skin, it protects and provides homeostasis of the inner and outer workings of the body. If the skin barrier becomes damaged and ‘leaky’, a high ‘TEWL’ trans epidermal water loss can occur. Skin can then become dehydrated and susceptible to inflammation and what I like to term malnourished.

There are countless detrimental internal and external factors that can contribute to degrading of the skin barrier. Hereditary, diet, stress, medications, UV exposure and ill matched cosmetics, just to name a few.

From a Chinese medicine perspective, the skin is the organ of the Lung, but it can be influenced by any of the Zang Fu organs and the nature of Qi, Blood, Yin and Yang. So from the very superficial layers which are under the influence Wei Qi, the protective energy, the Lung which oxygenates Qi through the breath, to the Heart organ system which pumps the blood and nutrients to all tissues, the Spleen and Stomach provide nutrients through the food and drink they process, the Liver provides smooth flow of Qi and cleanses the blood, and the Kidney, a reflection of our Jing and heredited energy. The Qi, Blood, Yin and Yang in balance provide warmth, cooling, nourishing and protecting attributes to all cells, to promote vitality and homeostasis.

 The article I am referring to was published in 2015 and featured in Dermatological Sinica. The authors were Lizhi Hu, Huibin Man, Peter M. Elias and Mao-Qiang Man, and the full article name was Herbal medicines that benefit epidermal permeability barrier function.

 The overall conclusion of the article demonstrated that herbal ingredients had beneficial action on the varying function of the epidermis. My focus was definitely on the benefits of Chinese herbal medicines.

Chi Shao, Huang Bai, Ze Xie, Dang Gui and Tu Fu Ling in combination, were shown to benefit barrier recovery and lipid production. 

 Another study showed a topical application of 0.1% apigenin from Jin Yin Hua accelerated barrier function recovery. Zi Cao lowered TEWL and increased stratum corneum hydration. He Zi had a positive effect on barrier function, TEWL, stratum corneum hydration, as well as a reduction in melanin index.

 

Insert happy emoji here x

 

Acne...a Chinese Medicine Perspective

CHINESE MEDICINE PERSPECTIVE ON ACNE… IS DEEPER THAN WHAT YOU SEE AT THE SURFACE

Acne is a skin disorder, that affects mostly adolescents and young adults. Pimples develop in areas of the body where sebaceous glands are larger and more numerous such as the face, shoulders and back. Pimples can come in varying sizes and degrees of severity, from comedones (blackheads) to papules and pustules, to more severe inflammatory lesions such as cysts and nodules. The placement and degree of severity can be a good indicator of internal and external causes.

 The actual site of a pimple involves pilosebaceous units (hair follicle and their accompanying sebaceous gland), that become congested and blocked with dead skin cells and excess sebum. A blocked gland promotes the overgrowth of the bacteria Propionibacterium acne (P. acnes), the bacteria responsible for Acne, which leads to inflammation and infection. 

 The increase in skin cell turn over and increase sebum production can be triggered by rising levels of the androgen hormone, as seen in adolescence, and can affect some women premenstrually.  A diet with a high glycaemic load and its effect on insulin resistance, has been shown to increase cell turnover and congestion. Some studies have shown a diet with a high carbohydrate load can disturb the diversity of skin flora, resulting in an increase in P. acnes.  A nutritional status and diet low in Zinc, Vitamin B6 and Essential Fatty Acids are also contributing factors to Acne.

 Interesting research has shown that Acne is ‘Disease of Civilisation’, meaning that the lifestyle and diets of Western society is a contributing factor to Acne, in comparison to non-Western civilised populations (Campbell & Strassmann, 2016). 

 Skin conditions have been identified by Chinese Medicine for thousands of years.  Chinese characters describing skin conditions have been discovered and dated as early as 1700B.C. (De-Hui, Xiu-Fen & Wwang, pg.1). 

Chinese Medicine views all disease in context of the person, and the interplay of internal and external factors. A disease may develop when there is an imbalance of Yin and Yang, the fundamental energy the body. Internal factors that may cause these imbalances include our emotions, diet, lifestyle and hereditary predisposition, while external causes can include climatic and environmental factors.  

 Acne or ‘White Thorns’ as it traditionally termed in Chinese Medicine, in its initial presentation, always involves a degree of ‘Heat and Damp’. For example, Lung Heat Acne presents with a few white and black heads in the nose area with some redness, while Stomach Heat Acne, the distribution and severity of pimples is more diffuse affecting the mouth, chest and upper back. A diet with too much ‘heating’ foods such as chilli and deep-fried food is a common contributing factor. 

 The multitude of Acne types according to a Chinese Medicine is well demonstrated by a quote from the text ‘The Cosmetology in Chinese Medicine’, which states ‘over 18 years of practice and a review of 723 Ancient texts, there are 23 different types of Chinese Medicine patterns that can be used to give a differential diagnosis of acne.’ (Fei-li, Parker & Hai, 2011, p.297).

Chinese Medicine approach to skin health takes on a multifaceted wholistic approach. 

  1. The external factors such topical products like creams, makeup and hair conditioners that may be cosmogenic and congesting the skin. Harsh chemicals found in some cosmetics may be creating undue dryness. Corneotherapist and Pastiche Method Pioneer Florence Barrett-Hill states “The skin acid mantle in Acne sufferers is often compromised by the use of harsh cosmetics that strip away the protective flora. This resulting excessive dryness triggers the skin into keratinisation, the production and build-up of keratin, which further blocks the pores and creates a perfect storm for P. acne to develop.” (p. 155)

  2. Nutritional deficiencies can leave the skin vulnerable to certain conditions. Zinc and Essential Fatty Acids are often found to be deficient in Acne sufferers. Zinc plays an important role in cell health and repair, while Essential Fatty Acids have a major role cell membrane health and reducing inflammation. 

  3. Less stress, more relaxation. The emotions play an important role in health and illness alike. Emotional factors that ‘Bind Qi’ ‘disturb the balance of Yin and Yang’ and create ‘Heat’ such as prolonged periods of stress, frustration and anger, are often seen contributing to disruption of hormones, sleep and digestion. Relaxation to promote stress relief can be incorporated into everyday living such as meditation and yoga.

  4. The diet comprising of whole, seasonal and organic foods, are the building blocks to health and wellbeing.  A Westernised Diet high in refined sugar, dairy and soy, poor quality fats and oil, high in preservatives, chemicals, additives, are well known for their inflammatory action on the body.

  5. Foods that are high in the nutrients to fend of inflamed skin include carrots, winter squash, pumpkin, spinach and kale.

  6. Chinese Medicine such as Acupuncture, Cosmetic Acupuncture, Jade Gua sha and Facial Massage, Chinese Herbal Topical applications and Chinese Herbal formulations, are all designed to reduce the ‘Heat’ and inflammatory response in the skin, improve digestion and detoxify the lymphatic system. Supporting hormonal and emotional balance, and to restore good circulation in the skin microenvironment. 

 

 Reference

 

Barrett-Hill F. Pastiche Advanced Skin Analysis, 2011, Virtual Beauty Corporation Ltd.

 Campbell, Christine E., Strassmann, Beverly I. The blemishes of modern society? Acne prevalence in the Dogon of Mali, 2016,Evol Med Public Health.

 De-Hui S., Xiu-Fen W. & Wwang N., Manual of Dermatology in Chinese Medicine, 1995, Eastland Press Inc. 

 Fei-li H., Parker R. & Hai, C., Cosmetology in Chinese Medicine, 2011, Peoples Medical Publishing House.