Acne based on TCM
In Traditional Chinese Medicine (TCM), acne is considered a disease primarily related to the Pathogenic Influence of Heat on the meridians, Zang Fu, and Fundamental Substances. This Heat may be a product of poor diet, overwork, insufficient rest, intemperate sexual activity, or the natural ascendance of Yang energy, which is typical in adolescence. Heat may affect the Lung or Stomach Meridians, from where it is transmitted to the skin, causing the condition?s inflammatory response. Heat usually is exacerbated in the Lung Meridian by the External Wind Pathogen, which affects the skin as well; in the Stomach Meridian, it can be aggravated by a diet of greasy and spicy foods, which weakens and creates Heat in the Spleen Zang and the Stomach Fu.
Heat also may enter into the Blood or transmute into Toxic Heat, both of which can cause lesions. Finally, Heat may combine with Dampness to form a Damp-Heat complex, affecting the skin and sebaceous glands.

In TCM, Heat affects the different Meridians, Zang Fu Organs, and Fundamental Substances, providing the substratum that allows acne to occur. The different manifestations of Heat in these aspects of the body? energetics appear as different complexes of signs and symptoms. Acne requires a careful differentiation of Heat so that proper treatment can be formulated to match the Pattern of Disharmony.

The major signs and symptoms of the common Heat Patterns of Disharmony, differentiated by location on the body, are as follows:
Lung Heat: Symptoms include acne with a predominance of lesions on the forehead and near the nose. There may be slight itching as well. In cases with a rapid onset of new lesions, the patient may complain of chills or sensitivity to Wind. The patient may have an aversion to heat and feel thirsty. The tongue is generally red with a thin yellow coat, and the pulse may be rapid and floating.

Stomach Heat: Symptoms include acne with a predominance of lesions around the mouth and on the chest, shoulders, and back. The patient may have an aversion to heat; have a large appetite and thirst; and prefer greasy, spicy foods. There may be a tendency to pass dry stools as well. The tongue is usually red with a thick yellow coating, and the pulse is rapid and forceful.

Toxic Heat: Symptoms include severe acne, strongly inflamed with pus-filled nodules and much reddening of the skin around the lesions. The patient may have an aversion to heat as well and may complain of malaise. The tongue is generally red with a dry yellow coating, and the pulse is rapid.

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