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Issue #5: Eczema

Dear Friend,

As the school year is coming to a close, we would like to reminisce of the regulation of our profession by the Ontario and Canadian government. As of April 1 of this year, acupuncture, Chinese herbal medicine, and Traditional Chinese Medicine was regulated. This ensures  that all practitioners practicing these modalities are qualified, and that patients receiving these treatments are all getting a certain standard of care.

     Not only is it good for the patients, it is good for people who are interested in getting into the profession as well! TSTCM offers professional training programs in Acupuncture and Traditional Chinese Medicine and provides supervised health services in Traditional Chinese Medicine, acupuncture, Chinese herbal remedies, and Tuina massage. We are dedicated to ensure our students get the best education and to go beyond the basic standards to better the skills of our students, to prepare them for the workforce, to care for their patients, and to pass the regulatory exams. If you or someone you know are interested in learning acupuncture, Chinese herbal medicine, or Traditional Chinese Medicine, please call 416-782-9682 to get more information about our programs, or to make an appointment to see our open house! 

Sincerely,
Mary Xiumei Wu, President

Toronto School of Traditional Chinese Medicine


 

TCM Treatment of Eczema

By: Katherine Chekhter (Specialized Honors B.A. (Psychology), R.Ac.)

 

Introduction

Eczema

Eczema is a generic term used to describe inflammatory conditions of the skin and is the most common skin condition. The most common form of eczema is atopic eczema, where the skin rash is caused by an allergic reaction. Eczema can affect people of all ages, but is most common in young children, typically starting within the first 12 months of life.Eczema most commonly appears on the face, neck, and the insides of the elbows, knees and ankles.  Symptoms vary depending on the person and type of eczema, but typically include:dry, reddened skin that itches or burns, blisters and/or oozing lesions, dry and/or scaly, thickened skin and moderate to severe itching

Eczema can be caused by substances that come in contact with the skin, causing irritation and immune activation (e.g. soaps, cosmetics, jewellery, detergents, certain types of clothing), environmental allergens (e.g. pollens, dust, animal dander), changes in climate, psychological stress, foods,particularly chemical food additives (such as preservatives and colourings), dairy, wheat, eggs, nuts, seafood and/or citrus fruits.

Eczema from a Western Medicine Perspective 

Eczema is considered to be an allergic condition, with abnormal function of the immune system being the major pathophysiological driver of this condition. Patients suffering from eczema often have a personal and/or family history of eczema, asthma and/or hay fever, as these are all allergic conditions associated with similar immunological dysfunctions. Western medical treatment focuses on controlling the inflammation caused by this immunological disturbance.  Therefore, patients with eczema are treated with topical corticosteroids (this is the most common form of eczema treatment), sedating antihistamines that induce sleep and reduce itchiness, antibiotics that treat secondary infections, oral corticosteroids, systemic immunosuppressants. Most Western treatment methods treat the symptoms of eczema and do not prevent its recurrence; they also tend to have side effects.

Eczema from a Traditional Chinese Medicine Perspective 

From TCM perspective eczema is caused by three main pathogenic factors:

  • Wind: Skin disorders caused by wind are characterized by sudden onset and development, change from one place to the other, and generalized itching.
  • Dampness: Manifests as puffiness of skin, vesicles or papules and oozing of fluid.
  • Heat: Tends to manifest as a burning sensation, redness and swelling.

Various combinations of these pathogenic factors produce different forms of eczema.  For example, acute eczema often results from damp heat in the lung and spleen channels, brought on by invasion of external pathogenic wind. Chronic eczema is a progression from acute eczema and tends to be complicated by retained dampness. Infantile eczema has a dry and a wet type, but the overall pathogenesis is brought about by a combination of weakness of spleen and stomach, damp heat and exposure to external pathogenic wind. Eczema of the scrotum is caused by damp-heat in the liver and kidney or invasion of damp toxins due to sitting on damp ground. Eczema around the eyes is caused by wind heat in the spleen channel, or damp heat.

Efficacy of TCM for Treating Eczema 

Various studies have proven efficacy of TCM treatment for eczema patient in both acupuncture and herbal therapies.

One study showed that TCM herbal treatment was efficacious for the treatment of Acute Dermatitis. Randomized placebo-controlled double-blind trial of a specific herbal prescription formulated for widespread non-exudative atopic eczema. Forty-seven children were given active treatment and placebo in random order, each for eight weeks, with an intervening 4-week wash-out period. Thirty-seven children received all the treatment and completed the study. Active treatment was more effective than the placebo. There was no evidence of hematological, renal or hepatic toxicity. The authors concluded that the Chinese medicinal herbs under their trial have a therapeutic potential in treating eczema and other skin diseases. ("A controlled trial of traditional Chinese medicinal plants in widespread non-exudative atopic eczema." Sheehan MP, Atherton DJ. Br J Dermatol. 1992;126:179-184. doi: 10.1111/j.1365-2133.1992.tb07817.x.)

In another study combination of acupuncture and herbal therapies was suggested to be even more beneficial for eczema treatment. Twenty mild-to-severe atopic dermatitis patients aged between 13 and 48 years were given a combined treatment of acupuncture and Chinese herbal medicine and were followed prospectively. The patients received acupuncture treatment twice a week and the Chinese herbal formula three times daily for a total of 12 weeks. Assessments were performed before treatment, and at weeks 3, 6, 9 and 12 of treatment. The primary outcomes were defined as the changes in the Eczema Area and Severity Index (EASI), Dermatology Life Quality Index (DLQI), and patient assessment of itch measured on a visual analogue scale (VAS). After 12 weeks of treatment, an improvement in EASI over the baseline was noted in 100% of patients. The mean EASI fell from 4.99 to 1.81; the median percentage of decrease was 63.5%. Moreover, 78.8% of patients experienced a reduction in DLQI and VAS, as compared with the baseline. The mean DLQI decreased from 12.5 to 7.6 at the end of treatment, with 39.1% improvement. Mean VAS decreased from 6.8 to 3.7, with 44.7% improvement. No adverse effects were observed. ("The effectiveness of combined Chinese herbal medicine and acupuncture in the treatment of atopic dermatitis." Salameh F, Perla D, Solomon M, Gamus D, Barzilai A, Greenberger S, Trau H. J Altern Complement Med. 2008;14:1043-1048. doi: 10.1089/acm.2008.0162)

One more study assessed the efficacy and safety of TCM herbal treatment for very young children. Children aged 4 to 7 years with diagnosed eczema were recruited. The clinical severity of AD was evaluated according to the SCORing Atopic Dermatitis (SCORAD) index, and all subjects had an objective SCORAD score of ≥15 (moderate-to-severe disease) at the entry into this study.  All participants received Chinese herbal medicine syrup 20 ml daily for 12 weeks. Enrolled subjects were followed up at two weeks (visit 2), seven weeks (visit 3), 12 weeks (visit 4) and four weeks after completion of treatment (visit 5) for the control of their skin condition. Each patient was given an Eczema Diary for recording daily symptom during the period prior to each visit. The severity of AD and quality of life as assessed with the SCORAD index and Children's Dermatology Life Quality Index (CDLQI), respectively at every visit were used as the primary outcome measures. The individual components that constitute SCORAD, such as disease extent, intensity, pruritus and sleep loss formed the secondary outcome measures. All children conditions improved over the period of study. The therapeutic effects persisted one month after treatment had stopped. ("Prospective self-controlled trial of the efficacy and tolerability of a herbal syrup for young children with eczema." Hon KL, Lo W, Cheng WKF, Leung TF, Chow CM, Lau CBS, Fok TF, Ng PC, Leung PC. J Dermatolog Treat. 2011.)

Conclusion 

Therefore we can conclude that TCM provide a beneficial alternative to convention Western treatments of eczema without side effects and with proven efficacy.

 

About Us

TSTCM offers professional training programs in Acupuncture and Traditional Chinese Medicine and provides supervised health services in Traditional Chinese Medicine, acupuncture, Chinese herbal remedies, and Tuina massage to our local community and beyond.

 

Toronto School of Traditional Chinese Medicine | 700 Lawrence Avenue West, Suite 433 | Toronto | Ontario | M6A 3B4 | Canada

 

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