Wednesday, October 31, 2012

Balancing Stress to Benefit Your Skin

Here in the Pacific Northwest we were fortunate to have a long lasting stretch of warm and sunny days that seemed endless.  However, fall has come, and with the changing of the seasons comes the arrival of the holidays.  Often the arrival of these times of gathering and festivity brings an element of stress into our lives.  Whether it is the expectations we place upon ourselves or it's the last minute scramble to prepare for the upcoming holiday, the stress of the holidays is something that most everyone can relate to.  Unfortunately, when we are unable to manage our stress effectively it begins to take a toll on our health.  In addition, our eating habits over the holiday seasons typically worsen.  On top of this, with all the preparation for the gatherings we often find ourselves falling out of our typical fitness routines.  Between the poor diet, decrease in exercise, and stress, it is clear that the holiday season can have a negative impact on our health.  

These stress triggers in our lives can often be aggravating factors for new and pre-existing skin conditions.  This is especially upsetting during seasons when we want to look our best, as we get together to celebrate with friends and family.   In response to these stressors, the skin can flare.  So why is this?  Stress often disrupts our immune response and affects our adrenal glands.  Within our immune system there is an inflammatory response (innate immune response) and an adaptive immune response.  Often times stress can cause the immune response to fall in favor of a more intense inflammatory response leading to an aggravation of one's skin.  However, don't view inflammation as a negative process.  It is essential for an effective immune response.  Without it white blood cells wouldn't know where to go to fight off infections and repair damaged tissue.  Think of it as a signal to flag down the repair crew of our body.  The key is to have a balanced inflammatory response, rather than one that is over reactive. 

So where do the adrenal glands play in this picture?  With long-term stress and a high paced life, the adrenal glands can become weakened due to the continual demand that is placed on them.  Over time, they can't keep up and they begin to decline in function.  With this decline comes a decline in cortisol in the body.  Cortisol acts as an anti-inflammatory in our body and can thereby manage excess inflammation that may arise.  However, with a decline in this management system, the increase in inflammation in the body cannot be adequately controlled. When this occurs we begin to see the skin become more active with the appearance of new lesions. 

In Chinese Medicine, stress is also identified as a trigger for numerous skin conditions but is often discussed using different terminology.  When stress occurs, the liver Qi becomes stagnant or doesn't flow smoothly.  With impeded flow of Qi in the body, heat begins to generate.  Over time this heat builds up and creates stagnant heat which can be viewed as inflammation.  This is the very basic foundation of this concept of liver Qi stagnation generating heat.  There are many other elements that can play a role in this pathology which can further perpetuate this concept of stagnant heat or aggravate the condition.  A concept known as dampness which often arises from a weakened digestive tract, poor eating habits, or inactive lifestyle can often aggravate the presence of heat.  By adding an element of dampness, flow is impeded even further and leads to the generation of more heat, often described as damp heat.  This brief explanation of stress induced stagnant heat gives you an introduction to the concept in Chinese medicine.  Unfortunately, there isn't enough time in this article to discuss all the variants of stress induced stagnant heat.

From both a biomedical and Chinese medicine view, it is clear that stress can disrupt the balance of our body leading to inflammation or stagnant heat.  Conditions such as nummular eczema, pompholyx eczema, seborrheic dermatitis, lichen simplex, rosacea, acne, perioral dermatitis, psoriasis, herpes simplex, pityriasis versicolor, and even some forms of urticaria all have a connection to emotional stress.  This illustrates the vast array of conditions that can be affected by this omnipresent factor in our lives. 

With the trigger being stress, thinking of ways in which to reduce this element is crucial for effective and long-term management.  The number one self care tip is to maintain an active lifestyle by exercising for a minimum of 30 minutes a day.   Studies have shown that regular exercise has a favorable effect on the immune response and is an effective means of stress relief.  Second, trying to maintain a predictable sleeping schedule where you go to bed at the same time and wake at a similar time.  This goes for the weekends as well.  While sleeping our body produces growth hormone which not only assists with growth and development but also triggers a healing response in the body.  So it is essential to ensure that adequate sleep is a part of the daily regimen to encourage this natural healing process.  Third, diet should be considered, since a poor diet will lead to fatigue, poor health, and ultimately poor skin quality.  In particular, overconsumption of sugar has a suppressive effect on the immune system.  On top of the list of food items to avoid are excess sugar, processed foods, fried foods, greasy foods, hot and spicy foods, caffeine, shellfish, and alcohol.  Often times people will have particular food sensitivities as well, and it is imperative that these foods be removed from the diet to avoid any additional inflammation that may be triggered by the consumption of these items. 

For some, these fundamental changes make a big difference in skin quality.  However, sometimes strict adherence to these measures proves ineffective.  When these lifestyle changes prove to be inadequate in controlling a person's dermatological complaint then further intervention is warranted.  The use of Chinese herbs is a safe and effective treatment approach that is often overlooked when seeking help for skin problems.  Herbs are used both internally and externally to address the affected areas.  Before formulating a treatment approach the skin is closely examined and a thorough history is taken to determine the root cause of the disease.  Each person will require an individualized treatment designed to meet their own skin needs.  For example, if the lesions on the body are showing more weeping or erosion, then the formula is directed at addressing more damp heat and if the lesions present with more dryness and erythema then a blood heat treatment is necessary.  Lesions that are very active and present with vesicles or pustules would require the addition of herbs to address more fire toxin in the presentation.  The treatments can become very refined, as no two individuals have exactly the same skin concerns. 

During the course of treatment with Chinese herbs, the formula will need to be modified to address changes in the skin.  As the lesions begin to clear, the formula will be changed to correctly address the current presentation.  It can almost be viewed as guiding heat out of the body.  So as the damp heat is cleared, there may be more blood heat present that must then be cleared using different herbs.  If dryness plays a part in the picture, then specific nourishing herbs would be introduced only after the heat has been removed.  If the dry element is addressed too early the skin may become irritated.  It is these individualized and fluctuating treatment approaches that make Chinese medicine so powerful in addressing these acute and chronic skin conditions. 

If you or someone you care about is struggling with a skin condition, try to think about the ways in which stress, diet, exercise and sleep can be improved.  Assess your level of stress.  Whether it is a family reunion, holidays, weddings, or just day to day stressors, think about how stress may be impacting your health and skin.  Are you getting enough exercise?  Are you sleeping adequate hours and soundly?  How is your diet, and are you eating too many of the foods that can cause problems for your skin?  If you already have these lifestyle elements in place, or if you get them into place and are still having problems with your skin, then consider implementing a supportive treatment such as Chinese herbal medicine.  Your skin is a reflection of your underlying health, and working towards achieving clear skin in a holistic way will help you take steps toward overall wellness, improved self esteem, and stress reduction.   


Wednesday, May 2, 2012

I've tried Chinese herbs for my skin

Chinese medicine is a vast and complex form of medicine.  The treatment approaches with Chinese herbs can be very complex and require much training and skill to properly formulate an effective treatment.  So going to any acupuncturist in your area to address your skin complaint isn't a wise decision.  Dermatology in Chinese medicine requires specific training and knowledge to properly diagnosis and treat the condition.  So if your intentions are to treat your skin naturally, seek out a skilled practitioner, such as myself, that has specialized in this field of study in order to receive an appropriate herbal treatment.

Just as the allopathic medical community has specialization, so does the field of Acupuncture and Chinese medicine.  Some practitioners have a practice focusing more on fertility and gynecology, some men's health, others more pain management, or dermatology; the list goes on.  But the thing to remember is don't just assume that the Acupuncturist or Chinese medicine practitioner you go to see has training or specializes in dermatology.  And don't assume that all Acupuncturists practice Chinese herbal medicine, for many have minimal training in the the use of herbs.  So, you may have tried Chinese herbs to address your skin but did you seek out a qualified Chinese medicine practitioner that specializes in Dermatology?

Friday, March 23, 2012

Evolving Traditional Chinese Medicine Treatments

Last month I traveled to London to study with my mentor Mazin Al-Khafaji.  It was interesting to note the ways in which his treatment approaches have shifted ever so slightly.  Even with his already highly effective treatments, he was finding that certain herbal combinations and their use in particular dermatological presentations could produce a more desirable outcome.  It goes to show that attention to details in the progress of our patients is a must to maximize the treatment results.  Not only this but it gives us insight into what herbs are helping with a particular aspect of the skin presentation.  Once we find a result that can be repeated, we can evolve our medicine to better address the pathology of modern day skin disorders.

I often find myself reviewing and comparing my formulas in clinic to look at how the skin is shifting in relation to modifications made to the formulas.  This is often enlightening and gives me a better understanding of when the formula needs a shift in focus so that the patient can continue on the path of healing.  This process is necessary to continue to benefit our patients and to evolve our medicine.  Just as disease evolves and shifts, so do our bodies and so should our medicine.  If we rely solely on classical formulas and never question the efficacy of our treatments we will fall behind.  I would like to quickly say that the classics are full of wealth and we often look to them for guidance, but we still must follow the progress of our patients so that the treatment is properly tailored to the current presentation.  Even the herbal formulations of Zhang Zhongjing shifted over the years as different treatment approaches evolved in Chinese medicine.   This is a trend that should continue so that we can optimize the efficacy of Chinese medicine.