TCM and Skin Care: an Interview with Diana Hermann, Founder of Zi Zai Dermatology

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Traditional Chinese Medicine and Skin Care

I learned about Diana and her company, Zi Zai Dermatology through researching about herbal dermatology. Diana has a very informative blog (link is at the end of interview) which covers Traditional Chinese Medicine and how it is related to various skin conditions. I am so excited to share this interview with you, as it is a really insightful look of TCM and the process of working with skin issues.

1) I am so intrigued by your use of Traditional Chinese Medicine for skin care. Could you give a brief overview of the TCM philosophy on skin care?

Our skin is an organ, just like our liver or lungs or heart. But this organ lies on the outside of the body and acts as the first line of defense for the body. It is a protective barrier between the outside world and your insides. The health of the body depends on the health of the skin and the health of the skin reflects the health of the body.

Thus, unhealthy skin is a sign that there is imbalance within the body as a whole. And unhealthy skin can eventually lead to other internal health conditions. So it is vital to take good care of your skin, but just as important to take good care of your body if you want to maintain the health of your skin.

Good nutrition, adequate exercise, and ample sleep are important to a healthy body and thus to healthy skin. According to TCM, everything should be done in moderation. Regarding nutrition, overindulgence in alcohol, sweets, dairy, greasy and/or spicy foods will lead to imbalance of the skin. Also, eating at irregular times or eating too much or too little will lead to imbalance of the skin.

In regards to general lifestyle, overworking, excessive sexual activity and overexposure to the elements (heat/sun, cold, wind, dampness) will lead to imbalance and affect the skin. Emotional imbalance such as excessive anger, excessive fear, excessive worry/over-thinking, or sustained grief will compromise the health of the skin (especially the skin of the face since we express so much of our emotion with our facial expressions).

Though I don’t think TCM specifically addresses topical skin/beauty products in its medical theory, I would certainly say it follows TCM philosophy to use only natural products on the skin when possible and to avoid exposure to harsh or toxic chemicals/substances.

In short, to maintain healthy skin, take good care of your body as a whole and live a healthy lifestyle. Easy, right? Well, even the best efforts don’t prevent disease. When an imbalance in the skin develops, then we can look to TCM to treat this imbalance with natural methods (such as acupuncture or other techniques) or with natural substances (internal and external herbal medicine).

2) I have been reading through your blog and see that many of the common skin problems (rosacea, acne, etc) are caused by “Heat”. What is Heat according to TCM and can you elaborate on how it produces certain skin issues?

Great question. Let me first make note that “Heat” (with a capital “H”) is used to denote the form of energy as understood by TCM and may differ in certain contexts from the generic term “heat”.

According to TCM, all of the energy and the substances in the body need to stay in relative balance in order to maintain health. When any of the forms of energy in the body become out of balance (too much or too little) symptoms will arise. Too much Heat can accumulate in the body if it enters the body directly (from the external environment) or if it arises from other internal imbalances.

External pathogenic Heat can invade the skin directly from overexposure to sun, from prolonged exposure to hot climate, or from respiratory viral or bacterial infections. Excess Heat can also develop over time from unexpressed emotions, poor diet (esp. overconsumption of greasy/spicy foods) or from imbalances in other organs in the body.

Basically, Heat that develops in the skin can be considered inflammation. However, in TCM there are different degrees of Heat (Warmth, Heat, and Fire) and we further classify Heat into additional subcategories to be able to more appropriately choose substances from the TCM Materia Medica to treat the specific form of Heat. For example, Heat can combine with Dampness to form pathogenic Damp-Heat. This is what you would see in skin conditions that are not only red, but also moist or weeping, like eczema when it presents as small vesicles (fluid-filled bumps).

Heat with Fire Toxins may present as an abscess, or inflammatory skin lesion with pus or infections. Fire, the most extreme degree of Heat, tends to flame upward, and so skin conditions that are caused by Fire tend to be located in the upper part of the body, the face and the head. Like the element of fire, skin diseases caused by pathogenic Fire tend to have rapid onset and flare quickly and the skin will be bright red and hot and may even have a burning sensation.

To successfully treat a skin disease that arises from Heat, we must consider not only the degree of Heat we are seeing in the skin, but also the source location of the Heat. In which organs or tissue is the Heat accumulated? For example, acne and rosacea are conditions affecting the skin of the face. Clearly there is inflammation of the skin (heat, redness, and even possibly swelling) and we can treat some of that with topical herbs. But these two skin conditions commonly develop as a result of accumulated Heat in the Lung and Stomach.

So if we only treat the skin of the face, we will never cure the disease because the Heat will continue to rise up from the Lung and Stomach. We must address the Heat that is in the other organs. And we treat this aspect of the condition with internal herbal medicine (in the form of teas, powders, or pills/tablets/capsules).

3) With that being said, what are some simple ways to clear Heat (i.e., diet, exercise or something else)?

Clearing Heat can be challenging to do without the help of medicine. It is best then, to avoid accumulating too much Heat in the first place.

Diet and lifestyle directly affect the health of one’s skin and both of these things can be controlled. If I had to pick only ONE thing a person could do to improve their skin’s health, it would have to be to avoid overexposure to the sun’s rays (this should be obvious, I hope).

The second most important choice someone can make to keep their skin healthy is to stop smoking. Smoking cigarettes and/or marijuana will not only directly introduce Heat and Toxins to the Lung (which will then go to other tissue including the skin), but it also depletes the body of Yin (the moistening, cooling energy that nourishes the skin and helps keep the Heat in balance). Depletion of Yin leads to dry skin that ages rapidly and wrinkles quickly. Once your Yin becomes deficient, it is challenging to add enough back into the body.

Avoiding or minimizing alcohol consumption is also vital to the health of the skin. This is especially true for those who suffer from rosacea and acne. Alcohol directly introduces Heat into the body and also creates Damp-Heat (more stubborn to treat than Heat alone).

Damp-Heat is also generated from the consumption of spicy and greasy foods, so it is best to eat those only in moderation. Too much dairy (and wheat for some people) will also create Dampness. The Dampness can combine with Heat that was formed elsewhere or if it stays in the body long enough, the Dampness will develop into Heat (forming Damp-Heat) all on its own (sort of like a stagnant pond will begin to heat up the longer it sits there stagnant).

Overworking and having too much sexual intercourse can also deplete the body’s store of Qi, Yin, Yang and Jing (energetic substances that one’s vitality depends upon). This will rapidly be reflected in the health of the skin and once lost, is very difficult (if not impossible) to regain. Without sufficient Yin, Yang, Qi and Jing, one’s body is much more susceptible to invasion of external Heat (or other pathogens) and to the imbalance of internal organs that can give rise to internal Heat.

My top 12 tips for maintaining healthy skin:

1. Avoid sun exposure when possible
2. Don’t smoke (any substance)
3. Avoid or minimize alcohol intake
4. Avoid or minimize consumption of spicy/greasy foods
5. Avoid or minimize consumption of dairy and wheat
6. Drink plenty of water
7. Exercise regularly
8. Get enough sleep each night
9. Express your emotions in healthy ways (don’t stuff them)
10. Don’t overwork
11. Have healthy sex but don’t indulge in excessive sexual activity
12. Use natural skin care products and avoid exposure to harsh or toxic chemicals

About Diana: Diana Hermann received her Master’s Degree in Acupuncture and Oriental Medicine after completing a four-academic-year graduate program at the Oregon College of Oriental Medicine (OCOM) in Portland, Oregon. Diana has been in private practice since 1999 and has much experience treating a vast array of illnesses and conditions. Her specialties include, but her skills are not limited to: dermatological conditions, autoimmune diseases, pain and injuries, respiratory and other infections, and general wellness. In 2009, Diana founded Zi Zai Dermatology, a company that hand crafts topical herbal ointments and other skin care products based upon the principals of Traditional Chinese Herbal Medicine.

You can read more about TCM and its use in dermatology on the Zi Zai Dermatology blog.

Find all natural skin products on the Zi Zai Dermatology store website.

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