Acne

inflammatory pilosebaceous disorder

Etiology
1. interaction between hormones, keratinization, sebum, bacteria

Signs & Symptoms
1. characterized by comedomes, papules, pustules, inflamed nodules, superficial pus-filled cysts 2. most common on face but also on neck, chest, upper back, shoulders

Treatment
1. tetracyclines 2. tretinoin (retinoic acid) [derivative of vitamin A, hepatotoxic] 3. isotretinoin (accutane) [derivative of vitamin A, hepatotoxic] 4. hygiene 5. food allergies 6. low fat diet 7. zinc 90-150 mg/d 8. vit. A, beta carotene 9. micronutrients 10. chromium and selenium

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During Puberty:
male hormone levels increase which stimulate the oil gland attached to hair follicles. This increases oil production and makes the pores and hair follicles predisposed to clogging. Clogs will cause the follicles to enlarge, producing bumps.

TCM Etiology
1. Constitutional Kidney Yin Xu 2. Lung & Stomach heat: poor diet -> heat stagnation -> Stomach & Large Intestine -> Stomach & Lung Heat 3. Phlegm & Blood Stasis: Lung Yin Xu + Lung/Stomach Heat -> congealed body fluids -> Phlegm Stagnation & Blood Stagnation 4. Disharmony Between Chong & Ren meridians: Kidney Yin xu -> water fails to nourish wood -> affects Liver soothing Qi

Pattern Differentiation
Forehead: Heart & Stomach Cheek: Liver [Right side liver, left side Lung?] Around mouth & nose: Spleen & Stomach Lower Jaw: Disharmony of Chong & Ren [Treat Liver& Kidney] Upper chest: Chong meridian Upper Back: Du meridian
 * Location**

Three Types
-red skin -whitehead (damp-heat, heat predominant) -blackhead (damp-heat, damp predominant)
 * 1.Non-inflammation**

-papules -nodules (Qi & Blood stagnation) -pustules (Phlegm & Blood Stasis) -cysts (Phlegm & Blood Stasis, more blood stasis)
 * 2. Inflammation**

-Scars -Pigmentation (Blood Stasis)
 * 3. Chronic**

Heat in the Blood in the Lung Channel
papules with areolas around, black heads Pi Pa Qing Fei Yin modification [Sang Bai Pi, Pi Pa Ye, Huang Lian, Huang Qin, Da Huang, Zhi Zi, Zhi Mu, Jing Jie, Chan Tui, Mu Dan Pi, Huo Xiang Pustules/toxic heat: Zi Hua Di Ding, pu Gong Ying, Bai Hua She She Cao, Jin Yin Hua, Lian Qiao

Damp Heat in the Spleen-Stomach
Skin oily, pustules, blackheads, bad breath, dry stools or constipation Tongue: yellow sticky coat Pulse: fast, soft Qing Pi Chu Shi Yin + Yin Chen Huo Tang modification [Zhu Ling, Fu Ling, Bai Zhu, Cang Zhu, Huang Qin, Yin Mu Cao, Mai Men Dong, Ze Xie, Gan Cao, Lian Qiao, Yin Chen Hao, Zhi Ke, Da Huang]

Phlegm Accumulation and Blood Stagnation
Chronic with nodules/cysts/scars, prolonged course of treatment Hai Zao Yu Hu Tang modification [Dang Gui, Chuan Xiong, Qin Pi, Chen Pi, Kun Bu, Hai Zao, Chuan Bei Mu, Ban Xia, Lian Qiao, Du Huo, Gan Cao, Chi Shao, Dan Shen]

Stagnation of Qi and Blood
Red or Dark red eruptions on the face that persist for several years. In women, eruptions are usually aggrivated during menstruation and are alleviated after periods. May also include irreghular menses, menstrual clots and abdominal pain. In men the complexion may be dark red or purplish-red. T: dark red or with stasis marks P: deep, thready & rough Treatment Principles: Move Qi & regulate the Blood, relieve toxicity and dissipate lumps Herbal Treatment: Liang Xue Qing Fei Yin Jia Jian [Sheng Di (30g.), Jin Yin Hua (30g.), Yin Chen Hao (30g.), Bai Hua She She Cao (30g.), Mu Dan Pi (10g.), Huang Qin (10g.), Chi Shao (10g.), Tao Ren (10g.), Yi Mu Cao (12g.), Zhe Bei Mu (12g.), Lian Qiao (12g.), Zi Hua Di Ding (12g.), Zhi Mu (6g.), Pi Pa Ye (6g.)]

For menstrual irregularities or increased severity of eruption prior to period: + Yi Mu Cao, Wu Yao, Xiang Fu, Yin Yang Huo, Bai Shao, Dang Gui
 * General Modifcations:**

Kampo Herbal Treatment
occurs pre-menstrually: Cinnamon & Hoelen Combination + Coix [Gui Zhi (4g.), Fu Ling (4g.), Mu Dan Pi (4g.), Tao Ren (4g.), Shao Yao (4g.), Yi Yi Ren (10g.)]

Herbs to balance Hormones
increase females hormones & decrease testosterone Bu Gu Zhi (30g.), Fu Pen Zi (10g.), Ge Gen (10g.), Ze Xie (30g.), Shan Zha (30g.) Plus herbs per differentiation

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Dietary Recommendations
Eliminate fatty foods, fried foods, chips spices, coffee, salt, alcohol, mustard, vinegar, mayonaise, oxalic acid found in chocolate, spinach, cocoa, rhubarb

Recommended Minerals
-Potassium -Sulfur -Zinc

Orthomolecular Treatment
-Betain HCl (Rosacea)

Basic Gemmotherapeutic Treatment
Morning: Ribes D1, 30-50 drops Noon: Ulmus D1, 30-50 drops Evening: Juglans D1, 30-50 drops Bedtime: Platanus Orientalis D1, 30-50 drops