Rosacea, Acne Rosacea

General

Clinical Manifestations	Sensitive, easily irritated skin The skin feels hot to the patient, particularly during episodes of flushing Redness affects the central area of the face, often including the forehead and chin The area blanches upon pressure Acne-like papules Pustules resembling acne appear but without comedones (blackheads) In severe cases, the pustules may evolve into cystic or granulometous nodules Telangiectasias or amniocentesis (small dilated blood vessels near the surface of the skin or mucous membranes) Flushing Rhinophyma (enlarged nose - brandy nose)
Treatment Principle
Herb Formulas	Si Wu Tang External: Rosacea Paste #1 For Heat patterns: Jiu Zha Bi Gao For papular or pustular lesions: Dian Dao San
Points	Yintang, DU-25, LI-20, LI-11, LI-4, ST-4, ST-5, REN-24, SI-18 Tonify HT-2, LIV-5 Ear: External Nose, Lung, Endocrine, Adrenal

Wind-Heat

Clinical Manifestations	Cough with thick sticky, yellow sputum Sore, red, swollen throat Thirst, with a desire to drink cold liquids Runny or blocked nose with thick yellow discharge Fever with perspiration Slight chills Aversion to Wind Headache Maybe dyspnea with flared nostrils Maybe chest pain T: Red tip C: Thin and yellow P: Superficial and rapid
Treatment Principle	Clear the Lungs Clear Heat Expel Wind
Herb Formulas	Qing Shang Fang Feng Tang
Points	DU-14, LI-11, SP-6, SP-10, HT-7, ST-36

Lung Heat

Clinical Manifestations	Redness of the bulb of the nose The redness blanches upon pressure Dry nose Dry mouth Constipation T: Red C: Thin and yellow P: Wiry and slippery
Treatment Principle	Clear Heat Cool the Blood
Herb Formulas	Pi Pa Qing Fei Yin modified External: Rosacea Paste #1 For Heat patterns: Jiu Zha Bi Gao For papular or pustular lesions: Dian Dao San
Points	Yintang, DU-25, LI-20, LI-11, LI-4, ST-4, ST-5, REN-24, SI-18 Ear: External Nose, Lung, Endocrine, Adrenal

Latent Fire In The Spleen And Stomach

Clinical Manifestations	Sensitive, easily irritated skin The skin feels hot to the patient, particularly during episodes of flushing Redness affects the central area of the face, often including the forehead and chin The area blanches upon pressure Acne-like papules Pustules resembling acne appear but without comedones (blackheads) In severe cases, the pustules may evolve into cystic or granulometous nodules Rhinophyma (enlarged nose - brandy nose) Mouth ulcers Bad breath Thirst Frequent hunger Dry mouth and lips Tongue thrusting in children Irritability T: Red C: Normal or Yellow P: Rapid
Treatment Principle	Drain Latent Fire from the Spleen and Stomach
Herb Formulas	Xie Huang San modified
Points	Yintang, DU-25, LI-20, LI-11, LI-4, ST-4, ST-5, REN-24, SI-18 Ear: External Nose, Lung, Endocrine, Adrenal

Qi And Blood Stagnation

Clinical Manifestations	The bulb of the nose is dark red or purple The bulb of the nose is enlarged and moist Telangiectasis Hypertrophy Enlarged openings of the sebaceous follicles Severe cases: Nodules Rhinophyma T: Purple C: Sticky and yellow P: Wiry and slow
Treatment Principle	Invigorate the Blood Dispel Blood Stasis Soften masses Dissipate nodules
Herb Formulas	Tao Hong Si Wu Tang For predominant Blood Stasis: Tong Qiao Huo Xue Tang modified For severe Blood Stagnation: Da Huang Zhe Chong Wan External: Rosacea Paste #1 For Heat patterns: Jiu Zha Bi Gao For papular or pustular lesions:Dian Dao San
Points	Yintang, DU-25, LI-20, LI-11, LI-4, ST-4, ST-5, REN-24, SI-18 Ear: External Nose, Lung, Endocrine, Adrenal

Blood Heat

Clinical Manifestations	Redness of the bulb of the nose Scattered red papules surround the areas proximal the nose and mouth Telangiectasis (permanent dilation of the Blood vessels) is evident on the cheeks Constipation Irregular menstruation T: Red C: Thin and yellow or Thin and white P: Wiry and slippery
Treatment Principle	Clear Heat Cool the Blood
Herb Formulas	Liang Xue Wu Hua Tang Liang Xue Si Wu Tang For Blood Heat in the Lungs and Stomach: Xie Bai San modified External: Rosacea Paste #1 For Heat patterns: Jiu Zha Bi Gao For papular or pustular lesions: Dian Dao San
Points	Yintang, DU-25, LI-20, LI-11, LI-4, ST-4, ST-5, REN-24, SI-18 Ear: External Nose, Lung, Endocrine, Adrenal

Damp-Heat

Clinical Manifestations	Lesions are distributed on the face, forehead, neck, chest and back Comedones are common Papules Pustules The skin is oily, shining and greasy Dry stool Short, yellow urine T: Red C: Greasy P: Rapid and rolling
Treatment Principle	Clear Heat Eliminate Dampness Cool the Blood Detoxify
Herb Formulas	Pi Pa Qing Fei Ying Long Dan Xie Gan Tang Topical: Rosacea Paste #2 San Huang Xi Ji
Points

Toxic Heat

Clinical Manifestations	Redness of the bulb of the nose Edema, pustules and pain affecting the proximal areas of the nose, if severe Sensation of Heat of the nose Thirst Dry stools Yellow urine T: Red C: Yellow P: Wiry and slippery
Treatment Principle	Clear Heat Cool the Blood
Herb Formulas	Wu Wei Xiao Du Yin Long Dan Xie Gan Tang External: Rosacea Paste #1 For Heat patterns: Jiu Zha Bi Gao For papular or pustular lesions: Dian Dao San
Points	Yintang, DU-25, LI-20, LI-11, LI-4, ST-4, ST-5, REN-24, SI-18 Ear: External Nose, Lung, Endocrine, Adrenal

Damp-Heat Stagnation In The Channels

Clinical Manifestations	High fever No chills Aversion to Heat Cough, asthma Restlessness Thirst Dark yellow urine Dyspnea Chest pain Shortness of breath Phlegm (thick yellow) T: Red C: Thick yellow, maybe dry and sticky P: Rapid, maybe slippery, maybe forceful
Treatment Principle	Clear Heat Eliminate Dampness
Herb Formulas	Qing Fei Ying External: Rosacea Paste #1 For Heat patterns: Jiu Zha Bi Gao For papular or pustular lesions:Dian Dao San
Points	Yintang, DU-25, LI-20, LI-11, LI-4, ST-4, ST-5, REN-24, SI-18 Ear: External Nose, Lung, Endocrine, Adrenal External: For Heat patterns:Jiu Zha Bi Gao For papular or pustular lesions:Dian Dao San