As we enter the period of Great Heat, the weather becomes increasingly humid and hot. At this time, the human body's pores open up and sweating increases, making it easier for summer dampness and heat to invade. Combined with factors such as ultraviolet radiation, mosquito bites, and large temperature differences between indoor and outdoor environments, various skin diseases such as sunburn rash, eczema, and prickly heat become highly prevalent. How does Traditional Chinese Medicine (TCM) view these skin diseases, and what are some simple prevention and treatment methods? This edition features renowned TCM physician Dr. Du Zhongping, head of the outpatient department at the China Academy of Chinese Medical Sciences, who will provide answers.
Insect-Bite Dermatitis Occurs After Insect Bites
Insect-bite dermatitis, also known as pruritic urticarial papules, is a condition that typically presents as recurrent itchy papules after being bitten by insects (such as mosquitoes, fleas, etc.). It is more common during wet and hot seasons like spring and summer, manifesting as erythematous papular lesions on the trunk and limbs. The papules are usually the size of mung beans to peanuts and often accompanied by severe itching, which can affect sleep and quality of life. The papules generally subside within 1-2 weeks, but new lesions can recur, often coexisting with old ones. Treatment should target the cause, aiming to shorten the course of the disease and reduce recurrence.
Affected Populations
This condition is more commonly seen in infants and children, although adults can also be affected. Sometimes family members or roommates may develop the condition simultaneously.
Pathogenesis
Pruritic urticarial papules fall under the category of “water scabies,” “earth wind sores,” “water sores with stubborn dampness,” and others in TCM. The pathogenesis involves a combination of inherent spleen deficiency and accumulation of dampness, invasion of wind toxins from external sources, or internal injury due to food stagnation transforming into dampness and heat. Insect bites and internal invasion of toxins can also contribute, leading to a complex of wind, dampness, insects, and toxins that accumulate in the skin, causing the onset of disease. Based on clinical presentation, the condition can be roughly categorized into two types: wind-heat type and damp-heat type.
Wind-Heat Type: Lesions typically appear on the limbs and consist of scattered erythematous wheal-like papules with central papules or vesicles, accompanied by severe itching. Other symptoms include aversion to wind, fever, thirst, yellow urine, red tongue, thin white or yellow coating, and floating rapid pulse.
Damp-Heat Type: Lesions predominantly occur on the lumbosacral area, characterized by numerous vesiculopapules and vesicles. Some lesions may break down, become infected, and form pus crusts. Patients experience pain and itching, along with fever, constipation, and loss of appetite. Symptoms include a red tongue, yellow and slightly greasy coating, and rapid pulse.
Herbal Wash
The principle of TCM treatment for this condition includes dispelling wind and clearing heat, detoxifying and relieving itching, and promoting lung function while resolving dampness. Commonly used herbs include Schizonepeta tenuifolia, Sileris Radix, and Honeysuckle. Additionally, topical herbal washes have excellent effects in preventing and treating this condition. Here is a recommended formula for an herbal wash:
15g Prunella vulgaris, 20g Sophora japonica flower, 15g Sophora flavescens, 6g Sichuan pepper, 10g Phellodendri Chinensis Cortex, 10g Rhubarb, 15g Polygonum multiflorum, 20g Hedyotis diffusa, 15g Tribulus terrestris. Boil these herbs three times, each for half an hour, to obtain approximately 1000 ml of decoction. While the liquid is still warm, use it to fumigate and wash the affected areas for about 15 minutes. This can help clear heat and dampness, dispel wind and relieve itching, improving itching symptoms and reducing recurrence.
Home Care
To prevent this condition, pay attention to personal and environmental hygiene, such as frequently airing out bedding, keeping the bed tidy, and promptly eliminating potential insect pests like mosquitoes and fleas. Additionally, you can make herbal sachets (10g Atractylodes lancea, 10g Kaempferia galanga, 10g Agastache rugosa, 10g Eupatorium fortunei, 10g Amomum villosum, 10g Angelica dahurica, 5g Asarum sieboldii, 10g Dichroa febrifuga, 10g Mentha, ground into powder and sieved through a 60-mesh sieve, divided into two sachets, one to wear and one to hang beside the bed), which can help resolve dampness and exogenous pathogens, eliminate foul odors and toxins, and repel insects.
If the condition is severe, in addition to TCM oral and topical treatments, antihistamines and topical corticosteroid creams can be used in conjunction with Western medicine, providing a simple and effective solution that is well-tolerated by children.
Urticaria: Intense Itching from Small “Wheals”
Urticaria, also known as “wheals” or “urticarial plaques,” is a common skin disease. Lesions are typically intensely itchy erythematous patches, sometimes accompanied by angioedema. Common symptoms include the appearance of varying-sized wheals on the skin, accompanied by itching, occurring in unpredictable locations and appearing and disappearing intermittently. Patients often experience very intense itching, which generally worsens at night, affecting sleep. Severe cases may be accompanied by fever, shortness of breath, abdominal pain, diarrhea, and other symptoms. Its causes are complex, including food, drugs, contact with animal hair, among others, and the pathogenic mechanism is not yet fully understood.
Affected Populations
Urticaria is a common dermatological condition. According to reports, 10% to 20% of people experience at least one episode of urticaria in their lifetime.
Pathogenesis
In TCM, urticaria falls under the categories of “urticaria,” “wind nodules,” “red and white wandering wind,” and others. Most practitioners believe that the occurrence of urticaria is related to “wind.” TCM holds that wind is the leader of all diseases, capable of moving rapidly and changing frequently, which aligns with the clinical presentation of urticaria, where lesions appear and disappear suddenly, change location unpredictably, and cause intense itching. The renowned modern TCM dermatologist Zhao Bingnan proposed that treating urticaria cannot be separated from managing wind, establishing formulas such as the Schizonepeta-Sileris Formula, Ephedra Formula, and Chrysanthemum Powder Formula, referred to as the “Three Wind-Treatment Formulas.” Additionally, the condition is also associated with stagnation in the zang-fu organs, retention of pathogenic factors on the defensive exterior, disharmony of ying and wei, blood deficiency and wind dryness, among others.
Herbal Wash
TCM treatment of urticaria emphasizes syndrome differentiation and focuses on principles such as dispelling wind and toxins, activating blood circulation, cooling the blood, and nourishing the blood. Commonly used herbs include Schizonepeta tenuifolia, Sileris Radix, Ephedrae Herba, and others. In addition, topical herbal washes, acupuncture, and bloodletting can also be used to treat this condition. Here is a recommended formula for an herbal wash:
15g Carthamus tinctorius, 20g Broussonetiae Radix, 10g Scutellariae Radix, 25g Duhuo, 40g Spina Gleditsiae, 15g Paeoniae Rubra, 20g Arctii Fructus, 25g Sileris Radix, 20g Clematis chinensis, 20g Gentianae Macrophyllae Radix, 25g Schizonepeta tenuifolia, 25g Astragali Radix, 15g Angelica Sinensis, 15g Schisandrae Fructus, 10g Agrimoniae Herba. Soak these herbs in 2500 ml of water, bring to a boil, and let cool to approximately 37°C before washing the affected areas for 30 minutes.
Home Care
Urticaria is extremely prone to recurrence. To prevent it, try to minimize