Acne, Acne Vulgaris

General

Clinical Manifestations	Open and closed pustules and cysts Worse in males Mild soreness, pain and itching The lesions occur mainly on the face, neck, upper chest upper back and shoulders Comedones are common Open comedones are known as blackheads Closed comedones are called whiteheads Over time the papules may become inflamed Severe cases may present deeply inflamed nodules and pus-filled cysts Preteens often present with comedones as the first lesions Younger teens may have inflammatory lesions in the middle of the face, extending outward as the patient ages Women in their thirties and forties often present with papular lesions around the chin and mouth
Treatment Principle
Herb Formulas	Gui Shen Wan Topical: 1. Dian Dao San 2. Jin Huang Gao 3. Qu Ban Gao 4. Rosacea Paste #1 5. Decoct 30g each, Galla Rhois Chinensis Wu Bei Zi, Fr. Chebulae He Zi  and Cx. Phellodendri Huang Bai in 4 cups of water until the water boils. Strain the decocted herbs, and wash the affected area two times a day. 6. Grind 30g Sm. Armeniacae Xing Ren  into a powder and mix with egg whites to form a paste. Apply to the affected area before bedtime. Chinese Patent Medicines: San She Jie Yang Wan Huang Lian Jie Du Pian
Points	LI-4, GB-12, DU-20, UB-2 For more comedones: + ST-45, ST-44 For pustules: + ST-36, ST-40 For more spots: + SP-6, LI-11 For more papulotubercules: + SP-6, SP-10 Sedate LI-12, UB-40 Purulent: + LI-4, LIV-8, UB-62 HT-9, KI-12, LIV-11, LU-11, SP-2, UB-40 KI-2, LU-1, LU-4, LU-5, LU-10, REN-13, UB-5, UB-12, UB-65 UB-13, UB-15, UB-18, UB-20, UB-23 Ear acupuncture: Endocrine, Lung, Shenmen, Subcortex, Sympathetic Cheek, Endocrine, Lung, Testicle

Tai Yang - Yang Ming - Shao Yin Heat

Clinical Manifestations	Dizziness Red, sore eyes Difficulty swallowing Nasal congestion and infection Thick, sticky nasal discharge and saliva Bitter taste in the mouth Dry mouth Focal distention in the chest and diaphragm Stifling sensation in the chest and diaphragm Manic behavior Carbuncles Heat rash Headache Acne Chills High fever Restlessness Urticaria Sore throat Swelling of the throat Coughing Reddish urine Dyspnea Vertigo Severe aversion to Cold Skin rashes Skin ruptures or ulcers Tense abdomen Shoulder stiffness Numb extremities Fatigue Constipation Dysuria with reddish urine Dark, rough urination Obesity Fullness of the abdomen Fullness of the epigastrium Heaviness in the head T: Red C: White or Yellow and greasy P: Flooding and rapid or Wiry and slippery or Floating, smooth and rapid or Floating, slippery, rapid and wiry or Floating, slippery, rapid and overflowing
Treatment Principle	Disperse Wind Release the Exterior Drain Heat Unblock the bowels
Herb Formulas	Fang Feng Tong Sheng San
Points

Shao Yang Fu With Congested Fluids

Clinical Manifestations	Alternating chills and fever (chills predominate) or Chills without fever Sensation of irritability in the chest Sweating from the head Fatigue Gastrointestinal weakness Heavy head Neuralgia Epigastric distension Lower abdominal pain Tension around pubic bone Periumbilical pain Urinary difficulty T: Moist C: White and slippery P: Superficial and wiry
Treatment Principle	Disperse Clumping Harmonize the Shao Yang Warm the Interior Dispel Cold
Herb Formulas	Chai Hu Gui Zhi Gan Jiang Tang
Points	GB-41, SJ-5, moxa or moxa needle REN-4, REN-6, REN-8, REN-12, SJ-6, ST-25, ST-36

Wind-Cold-Damp

Clinical Manifestations	Suppuration with severe chills Fever Headache Muscle spasms Inflammation Swelling Pain Anhidrosis Pain and stiffness of the head and neck Stuffy nose Swollen, blood shot eyes Sores that are red, swollen and painful Generalized body aches and pain Thirst or no thirst T: Normal C: Thin white P: Floating or Floating and rapid
Treatment Principle	Induce sweat Release the Exterior Dispel Wind Alleviate pain
Herb Formulas	Jing Fang Bai Du San
Points

Wind Damp-Heat

Clinical Manifestations	The condition is chronic Worse in the summer Excessive secretions Crustiness Lesions in the genital area Generalized body aches and pains Irritability Heavy sensation in the shoulder and back Discomfort or a constricted sensation in the area of the chest and diaphragm Multiple sores, carbuncles furuncles or abscesses Redness Itching Persistent swelling Chest pain Fever Thirst Aching and painful extremities Aching and painful joints Unbearable swelling and pain of the lower extremities Shoulder stiffness T: Normal C: Greasy and slightly yellow P: Wiry and rapid or Soft and moderate or Soft, superficial and slow or Slippery and rapid or Deep and tight
Treatment Principle	Resolve Dampness Clear Heat Disperse Wind Stop pain Activate the Blood Tonify Qi and Blood
Herb Formulas	Xiao Feng San Shi Wei Bai Du San Jing Jie Lian Qiao Tang Jing Fang Bai Du San Qing Shang Fang Feng Tang Chinese Patent Medicines: Armadillo Counter Poison Pill Huang Lian Shang Qing Pian Kai Yung Pill Lian Qiao Bai Du Pian Margarita Acne Pills Trisnake Itch Removing Pills
Points	DU-14, LI-11, SP-6, SP-10, HT-7, ST-36 Cutaneous: Tap area to bleed - may add cups Ear: Lung, Adrenal, Liver, Subcortex Moxa area

Qi Stage: Lung Heat

Clinical Manifestations	Blackheads and whiteheads that are papular and slightly itchy Most common on the forehead and adjacent to the nose Dry mouth Dry throat Thirst Sore throat Chest pain Headache General malaise Restlessness Constipation Dry stools Dark-colored, scanty urine Red swelling or erosion in the nostrils T: Red C: Thin and yellow P: Wiry or Rapid or Floating and rapid or Floating and slippery
Treatment Principle	Clear Heat Disperse the Lungs Stop bleeding
Herb Formulas	Xie Bai San Pi Pa Qing Fei Yin Liang Xue Qing Fei Yin Acne #6 For chronic, tenacious cases: Acne #5
Points	LI-19, LI-20, LU-1, UB-13, LI-4 + general points DU-14, LI-4, LI-11, PC-4, PC-7, PC-8 + general points LI-4, LU-1, LU-5, REN-24, SP-6, SP-10, ST-4, ST-5, ST-6, ST-36, ST-41 Ear: Bleed Heat, Endocrine, Subcortex, Lower Blood Pressure Groove

Lung Heat With Heat In The Blood

Clinical Manifestations	Red pimples with Heat and pain in the local area The lesions tend to appear on the face, shoulders, chest and back Red complexion The lesions are hot and maybe painful Pus eruptions Redness of the bulb of the nose The redness blanches upon pressure Red papules, tubercles and acne and inflammatory infiltration around them Whiteheads or blackheads May be itching Dry nose Dry mouth Burning sensation Constipation Dry stool T: Red or Red tip C: Thin and yellow P: Wiry and slippery or Slippery and rapid or Floating and rapid
Treatment Principle	Cools the Blood Eliminates Dampness Invigorates the Blood Clears Lung Heat
Herb Formulas	Pi Pa Qing Fei Yin    For marked Heat in the Blood: Liang Xue Qing Fei Yin For Lung Heat with Heat Toxins and Blood Stagnation: Acne#1
Points	DU-12, LI-11, UB-13 For more severe Blood Heat: + LI-4, SP-10 For Yin Deficiency: + KI-3, SP-6 For Liver Qi Stagnation Transforming into Heat: + GB-34, LIV-2 For Phlegm-Dampness: + SP-5, ST-40

Heat Excess On The Exterior And Interior

Clinical Manifestations	Dizziness Red, sore eyes Difficulty swallowing Nasal congestion Thick, sticky nasal discharge and saliva Bitter taste in the mouth Dry mouth Focal distention in the chest and diaphragm Stifling sensation in the chest and diaphragm Manic behavior Carbuncles Heat rash Headache Sore throat Skin ruptures or ulcers Tense abdomen Shoulder stiffness Numb extremities Fatigue Constipation Dysuria with reddish urine Dark, rough urination Obesity Heaviness in the head T: Red C: White or yellow, greasy P: Flooding and rapid or Wiry and slippery or Floating, smooth and rapid
Treatment Principle	Disperse Wind Release the Exterior Drain Heat Unblock the bowels
Herb Formulas	Fang Feng Tong Sheng San
Points	LI-4, GB-12, DU-20, UB-2 For more comedones: + ST-45, ST-44 For pustules: + ST-36, ST-40 For more spots: + SP-6, LI-11 For more papulotubercules: + SP-6, SP-10 Ear acupuncture: Endocrine, Subcortex, Sympathetic, Lung, Shenmen

Spleen Deficiency With Phlegm-Damp

Clinical Manifestations	Dull red complexion Deep eruptions Nodules Slow healing acne which leaves scarring Oily skin Maybe profuse Phlegm Maybe loose stools T: Thick C: Slimy and white P: Slippery or Moderate
Treatment Principle	Tonify the Spleen Eliminate Dampness Soften hardness Transform Phlegm Scatter nodulation
Herb Formulas	Shen Ling Bai Zhu San modified For scarring: + Hai Zao Yu Hu Tang modified Si Jun Zi Tang + Er Chen Tang For Phlegm-Heat: Liu Jun Zi Tang + Xiao Xian Xiong Tang
Points	LI-4, GB-12, DU-20, UB-2 For more comedones: + ST-45, ST-44 For pustules: + ST-36, ST-40 For more spots: + SP-6, LI-11 For more papulotubercules: + SP-6, SP-10 SP-5, ST-40 For marked Spleen Deficiency: + ST-36 To clear Heat from the Lung: + LI-11 For Liver Stagnation Transforming into Heat: + LIV-2 For Stomach Heat: + ST-44 For Lung Heat: + UB-13 For severe Heat: + LI-4 For Blood Stagnation: + SP-6, SP-10, UB-17 For Yin Deficiency: + KI-3, SP-6 Ear acupuncture: Endocrine, Subcortex, Sympathetic, Lung, Shenmen

Stomach Heat

Clinical Manifestations	Papular whiteheads and blackheads Most common around the mouth, chest and upper back The face is prone to oiliness Dryness with burning pain in the nose Possible epistaxis Dry mouth and throat Thirst with a desire for cold drinks Swift digestion with rapid hungering Acid regurgitation Bad breath Clamoring Stomach Constipation with dry stools Short voiding of dark urine T: Red C: Yellow and sticky P: Slippery and rapid or Deep, slippery and forceful
Treatment Principle	Clear and drain Stomach Heat
Herb Formulas	Qing Wei San Tiao Wei Cheng Qi Tang Acne #6
Points	LI-20, LI-19, REN-12, ST-44, ST-25, ST-37 LI-4, LU-1, LU-5, REN-24, SP-6, SP-10, ST-4, ST-5, ST-6, ST-36, ST-41 Ear: Bleed Heat, Endocrine, Subcortex, Lower Blood Pressure Groove

Stomach And Intestinal Damp-Heat

Clinical Manifestations	Red lesions with nodular papules Especially located along the course of the Yang Ming channels. Strong appetite Oily skin Hungers easily Bad breath Thirst with a desire for cold drinks Dry, bound stools Short, scanty urine Dark urine T: Red C: Greasy and yellow P: Slippery and rapid
Treatment Principle	Clear Heat Eliminate Dampness from the Stomach and Intestines
Herb Formulas	Dan Di Tang
Points	DU-10, LI-11 For more severe Blood Heat: + LI-4, SP-10 For constant Blood Stasis: + SP-6, SP-10 For Yin Deficiency: + KI-3, SP-6 For Liver Stagnation Transforming into Heat: + GB-34, LIV-2 For Phlegm-Dampness: + ST-40, SP-5

Liver Qi Stagnation Attacks The Spleen

Clinical Manifestations	Abdominal distention and pain Gas Borborygmus Diarrhea Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Xiao Chai Hu Tang
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

Liver Fire

Clinical Manifestations	Alternating fever and chills Fullness in the chest and hypochondrium (with or without pain) Bitter taste in mouth Nausea Continuous vomiting Hard focal distension in the epigastrium Fullness and pain in the epigastrium Burning diarrhea or no bowel movement Despondency Slight fidgeting Slight irritability Headache Constipation or discharge of fluids rectally Tinnitus Diminished hearing Diminished vision Red eyes Manic behavior Asthma Mental instability T: Normal or red C: Yellow or Thick and yellow P: Wiry and forceful or Wiry tight and forceful
Treatment Principle	Harmonizes and Disperses the Shao Yang Drains Internal Heat Retention
Herb Formulas	Dang Gui Long Hui Wan
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

Liver And Spleen Deficiency With Blood Stagnation Due To Dampness

Clinical Manifestations	Abdominal mass which is localized and hard Continuous cramping pain in the abdomen Pain is not severe Pain is relieved by pressure Edema of the feet Urinary difficulty Slight edema (primarily of the lower limbs) Symptoms generally occur during pregnancy Pale face Fatigue Heaviness of head Lassitude Lower abdominal pain Dizziness Tinnitus Lumbago Edema Abdominal pain with edema during pregnancy due to Blood Deficiency and abnormal water circulation	Oliguria Palpitations Cold feet Extreme coldness of the hands and feet Vertigo Weakness and numbness of lower back and legs during pregnancy or postpartum Mal position of the fetus Dysmenorrhea Irregular menstruation Right upper quadrant pain Hepatomegaly Anemia Lack of energy Sore back Thirst with no desire to drink T: Pale or pink maybe petechiae on margin C: Thin or Greasy white P: Deep and weak or Soft, floating, small and slow or Wiry and small or Wiry and rough
Treatment Principle	Nourish Liver Blood Soften the Liver Spread Liver Qi Strengthen the Spleen Resolve Dampness
Herb Formulas	Dang Gui Shao Yao San
Points

Kidney Yin Deficiency With Fire Rising

Clinical Manifestations	Small, light red papules spread diffusely Often primarily on the forehead Flushed, red face, especially in the afternoon or early evening Dry skin Dry lips A thin body Possible premenstrual acne in females A tendency to vexation and agitation Possible late menarche Scanty or delayed menstruation T: Red or Red tip C: Little or None P: Thready, wiry and rapid
Treatment Principle	Nourish the Kidneys Enrich Yin Clear Heat Cool the Blood
Herb Formulas	Zhi Bai Di Huang Wan
Points	KI-3, LI-11, SP-6, UB-17 For palpitations: + PC-5, PC-6 For vexation and agitation: + HT-7, PC-7 For Liver Blood deficiency: LIV-8

Blood Dryness

Clinical Manifestations	The eruption is dry Pallor Broken skin Dry skin Sometimes bleeding and pain Worse in cold weather Better during the summer T: Pale or pink C: Thin white P: Thin, or Weak and taut or Deep
Treatment Principle	Nourish Blood Dispel Wind Moisten Dryness
Herb Formulas	Yang Xue Run Fu Yin #2 modified
Points	DU-14, LI-4, LI-11, SP-10, SP-6 LI-11. LI-4, SP-6, SP-10, Ahshi DU-9, GB-34, SJ-6 UB-13, UB-16, UB-17, LI-11, SP-10

Blood Heat

Clinical Manifestations	Papules affect the areas around the nose and mouth and between the eyebrows Facial flush Premenstrual women often an increase in lesions Red, itchy eyes Red pimples on face, neck, armpits and external genitalia Suppuration Earache Swelling, inflammation and infection of the ears and nose Abdominal rigidity Dry stools Constipation Yellow urine Dark brown discoloration of the skin Perspiration and an oiling feeling on the palms and soles Abdominal tension Maybe otitis Rhinitis T: Deep red, dry or purple red or Red tip C: Thin or None P:  Rapid or thready and rapid or thready and feeble or Tight or Thready, slippery and rapid
Treatment Principle	Dispel Wind Disperse Stagnation Clear Heat Remove Toxins
Herb Formulas	Jing Jie Lian Qiao Tang Tao Hong Si Wu Tang Huang Lian Jie Du Tang Wen Qing Yin Liang Xue Wu Hua Tang Yin Hua Jie Du Tang For teenagers: Chai Hu Qing Gan Tang Xiao Chai Hu Tang
Points	DU-14, LI-11, ST-44, SP-10, UB-17 GB-34, GB-41, GB-43, LIV-2

Blood Stagnation

Clinical Manifestations	The lesions last for a long time The lesions are mostly on the face, neck and mandibular regions Purple scars Papules pustules and nodules are like beans Irregular menstruation with clots T: Red with echymosis or Purple with echymosis or maculae C: White P: Choppy or Wiry
Treatment Principle	Invigorate the Blood Relieve Stasis Soften nodules
Herb Formulas	Tao Hong Si Wu Tang Xue Fu Zhu Yu Tangmodified Da Huang Zhe Chong Wan With Phlegm-Heat: Tao Hong Er Chen Tang Jia Wei
Points	LI-4, GB-12, DU-20, UB-2 For more comedones: + ST-45, ST-44 For pustules: + ST-36, ST-40 For more spots: + SP-6, LI-11 For more papulotubercules: + SP-6, SP-10 Bleed and cup UB-17 For severe Blood Stasis: + sedate SP-10 For Phlegm: + ST-40 For Yin and Blood Deficiency: + SP-6 Ear acupuncture: Endocrine, Subcortex, Sympathetic, Lung, Shenmen

Damp-Heat

Clinical Manifestations	Red swollen eruptions with a shiny oily complexion The lesions occur mainly on the face, neck, upper chest upper back and shoulders Comedones are common Papules and pustules are seen The skin is oily, shining and greasy Nodules Itchiness Pain Constipation Decreased appetite Dry stool Short, dark, yellow urine T: Red C: Greasy P: Rapid and rolling
Treatment Principle	Clear Heat Relieve Dampness Cool the Blood Detoxify
Herb Formulas	Pi Pa Qing Fei Yin modified Yin Chen Hao Tang Long Dan Xie Gan Tang Chuan Shan Jia Qu Shi Qing Du Wan Acne #3 Topical: Jiu Zha Bi Gao San Huang Xi Ji Chinese Patent Medicines: Trisnake Itch Removing Pills
Points	HT-9, KI-12, LIV-11, LU-11, SP-2, UB-40 LI-4, GB-12, DU-20, UB-2 For more comedones: + ST-45, ST-44 For pustules: + ST-36, ST-40 For more spots: + SP-6, LI-11 For more papulotubercules: + SP-6, SP-10 Ear acupuncture: Endocrine, Subcortex, Sympathetic, Lung, Shenmen

Damp-Toxicity With Blood Stagnation

Clinical Manifestations	Deep, inflamed nodules and pus-filled cysts on an erythematous base The face, chest and back are generally involved Oily skin The residual scarring is generally pitted Headache A sensation of Heat throughout the body T: Purple C: Yellow or White P: Slow or Deep and choppy
Treatment Principle	Eliminate Dampness Relieve toxicity Invigorate the Blood Dispel Stasis
Herb Formulas	Chu Shi Jie Du Tang
Points

Phlegm-Heat

Clinical Manifestations	Acne Repeated relapse The rash is mainly nodes, cysts and scars Dizziness Vertigo Nausea and vomiting Insomnia Dream-disturbed sleep with unusual dreams Palpitations Anxiety Profuse white foamy sputum Restlessness Timidity Indecisiveness Indeterminate gnawing hunger Seizures accompanied by copious sputum Chest distention Expectoration of yellow Phlegm Bitter taste in the mouth Chills and fever Abdominal distention Frequent dark, scanty urine Irritability Depression Slight thirst Anorexia after serious illness T: Pink or Red tip C: Yellow and greasy P: Slippery and rapid or Wiry and rapid
Treatment Principle	Regulate Qi Transform Phlegm Harmonize the Stomach Clear Heat
Herb Formulas	Acne #4 Hai Zao Yu Hu Tang
Points	General points

Toxic Heat

Clinical Manifestations	Acne Pustules on an erythematous base Local inflammation with pus Deep-rooted, hard and painful boils Larger, more inflamed, angrier and more pus-filled lesions Erythema Swelling Lesions on the chest and upper back Residual scarring usually occurs after healing Heat Carbuncles Furuncles Fever and chills Pain Dry stools Constipation Scanty, yellow urine T: Red C: Yellow or Yellow and dry or Yellow and greasy P: Rapid or Wiry, slippery and rapid
Treatment Principle	Clear Heat Purge Fire Relieve toxicity Cool the Blood
Herb Formulas	Wu Wei Xiao Du Yin Shi Wei Bai Du San Jing Jie Lian Qiao Tang Huang Lian Jie Du Tang Zhen Ren Huo Ming Yin Acne #2 Cuo Chuang Jian Ji With Blood Stagnation: Xian Fang Huo Ming Yin Topical: Zi Yun Gao Chinese Patent Medicines: Margarita Acne Pill
Points	LI-4, GB-12, DU-20, UB-2 For more comedones: + ST-45, ST-44 For pustules: + ST-36, ST-40 For more spots: + SP-6, LI-11 For more papulotubercules: + SP-6, SP-10 LI-4, LI-11, SP-10, UB-17 For Phlegm nodules: ST-40 Ear acupuncture: Endocrine, Subcortex, Sympathetic, Lung, Shenmen

Disharmony Between The Chong And Ren Channels

Clinical Manifestations	Associated with menstruation
Treatment Principle	Harmonize the Chong and Ren
Herb Formulas	Jia Wei Xiao Yao San
Points	LI-4, GB-12, DU-20, UB-2 For more comedones: + ST-45, ST-44 For pustules: + ST-36, ST-40 For more spots: + SP-6, LI-11 For more papulotubercules: + SP-6, SP-10 Ear acupuncture: Endocrine, Subcortex, Sympathetic, Lung, Shenmen

Lower Jiao Blood Stagnation With Heat

Clinical Manifestations	Acute lower abdominal pain Incontinence of urine Night fevers Delirious speech Irritability Restlessness Thirst May be mania (severe) Dysmenorrhea Amenorrhea Hard stool Dark red complexion Headache Vertigo Tinnitus Insomnia Palpitations Constipation Frequent urination Emotional instability Chills in the waist and feet Tremors Excruciating abdominal pain with cold Black stool May be chills and fever Hemoptysis Hematuria Red eyes Pain and distention of the head Toothache Irregular menstruation Lochioschesis Severe wheezing Distention of the chest T: Red and dry C: Yellow P: Deep and forceful or Choppy
Treatment Principle	Drain Heat Break up Blood Stasis
Herb Formulas	Tao He Cheng Qi Tang
Points