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Can Acupuncture and Moxibustion help manage this emotive skin disease?
The emotional burden of skin diseases such as Acne Vulgaris and its related inflammatory acneiform conditions of Rosacea and Perioral Dermatitis, has a profound effect on a patient’s health related quality of life, impacting on self-esteem and body image due to sufferers being unable to hid their visible condition from public scrutiny or attentional bias.
Even the medical name ‘Acne Vulgaris’ is mercilessly judgemental.
I have experienced exactly how it feels to be bare-faced and living with a spotty identifier of ‘the one with bad skin’. It hurts to feel unclean, dirty, imperfect. I know how it is to feel the heat of anxiety rising with each new painful breakout and the excuses made to avoid facing people, even family and friends. The deep emotional scars are so much slower to heal.
What is the Root Cause?
The pathological mechanisms for the primary development of acne are not well understood and notoriously difficult to evaluate, which is unhelpful for those who suffer. To compound this problem, the medical diagnosis of acne and acneiform conditions is usually based on a doctor’s visual observation only. There are inadequate severity-grading guidelines fundamentally based on clinical signs and symptoms exclusively of Caucasian patients only, with little understanding about skin conditions as they appear or differ in patients of Black or Brown skin. Diagnosis takes a uniform approach without considering a patient’s unique constitutional symptoms, increasing the risk of compromised medical care which could potentially lead to incorrect treatment intervention.
Taking human diversity into consideration, most Dermatologists agree there are several complex factors that may contribute to the progression and fluctuating severity of acne lesions including oily sebum induced follicular blockage, increased microbial infection by viruses, bacterium, fungi and parasites, genetics, hormones, allergy or intolerance, the potential role of the Gut-Brain-Skin partnership and high anxiety or stress levels to name a few.
Additionally, both internal and external causation can contribute to an increased acne inflammatory response and each patient maybe susceptible to their own unique sequence of comorbid triggers, further exacerbating any attempt to control, alleviate or cure their condition.
‘What!’... I hear you exclaim. ‘I have shocking, painful, itchy, inflamed skin and now you’re telling me I have all these extras! How is that possible when I’m constantly washing and applying blemish control products to help clear it?’
Acne is not an indicator of poor hygiene protocols, in fact excessive cleansing and exfoliation of the epidermis actually exacerbates the condition. The primary function of skin is to provide a symbiotic interface between the internal and external. The epidermal resident microbial communities of bacteria, viruses, fungus and parasites in balance, work together to activate and support our immune system, protecting us from infection. Cosmetic lotions and creams work well to minimise acne breakouts by unclogging pores and slothing off dead skin cells. Products containing ingredients such as Glycolic Acid or Salicylic Acid applied in moderation, are indicated to minimise breakouts. However, the over-use of these safe products combined with facial scrubbing can over-thin the skin, weakening or rupturing the epidermal layer and leaving it vulnerable to further microbial infection and acne relapse.
When the new, essential ‘accessory’ of mask wearing in public spaces become mandatory, it brought with it an opportunity to hide the hyperpigmentation, scarring and skin damage. By covering their affliction, you would think acne sufferers would gain some minimal relief, but sadly not so. In the absence of peer reviewed research, it’s becoming increasingly obvious the wearing of face masks is aggravating the pre-existing skin disease of many, triggering new breakouts and leading to a rise in acne relapse or unrelated skin conditions such as Peri-oral and contact Dermatitis. Coining a new diagnosis... ‘Maskne’.
Skin disharmony is classically worsened by a rise in heat and humidity causing an increase in bacteria, inflammation, anxiety and stress. The facial location covered by a mask is predominantly associated with oily sebum producing sebaceous glands and the follicular areas most commonly vulnerable to acne breakout, all exacerbated by an increase in surface skin temperature, thus providing a perfect environment for microbial flourish. It’s a party under there and microbes don’t do social distancing!
Acupuncture for Treating Acne – Can it Help?
In my personal experience, yes it can help, but don’t take my word for it. The World Health Organisation (WHO) states; ‘Acupuncture has been shown to have a therapeutic effect on acne vulgaris’
There is a vast library of new global, peer reviewed research to support acupuncture as a safe and effective treatment method. The British Acupuncture Council (BAcC) has undertaken extensive research into the efficacy of acupuncture in treating acne and the anxiety response, finding evidence pooled together has shown:
Acupuncture plus Moxibustion is safe and effective for the treatment of acne and possibly better that routine western medicine.
Reduces inflammation by promoting release of vascular immunomodulatory factors.
Enhances natural killer cell activities.
Modulates the number and ration of immune cell types.
Increases local microcirculation, which aids dispersal of swelling.
Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry.
Regulating levels of neurotransmitters (or their modulators) and hormones such as serotonin, noradrenaline, dopamine, hence altering the brain’s mood chemistry to help to combat negative affective states and symptom triggers.
Activates the opposing parasympathetic nervous system, which initiates the relaxation response, reducing stress induced changes in biochemistry.
Reversing pathological changes in levels of inflammatory cytokines that are associated with anxiety.
Is Acupuncture safe?
Acupuncture is a supportive therapy and can be safely combined with conventional treatments and medication, possibly increasing the benefits, while reducing the risk of side-effects.
As an acupuncture practitioner, dermatology and all skin diseases are my area of special interest. I am constantly researching how best to treat and alleviate my patients’ symptoms including; Acne in all forms, Rosacea, Eczema, Psoriasis, allergy reactive Urticaria, contact Dermatitis, inflammatory Perioral and Periorbital Dermatitis.
Over the last twelve months I have been treating patients with many varying complaints and within that there has been an obvious increase in patients seeking to reduce the symptoms of their skin problems and particularly acne relapse. Many of them, despite being prescribed appropriate medication, were experiencing inconsistent results and in some cases a worsening or spreading of lesions.
Is There a Cure for Acne?
I personally don’t believe there is a definitive cure for acne, I think it’s an affliction you are either susceptible to, or rarely suffer from and despite tireless researching, I cannot find anything to dispute or prove that very personal opinion. Being an acne sufferer myself, I do believe acne can be alleviated and successfully controlled, minimising breakouts and the subsequent scarring. It’s just a question of understanding your unique triggers and working to eliminate them.
While western modern science takes a more prescriptive and standardised analytical approach to diagnosis, chinese medicine and acupuncture characterises acne as a pathological symptom of a patient’s constitutional imbalance. Acupuncture is not a cure, but its theoretical basis identifies a patient’s unique symptoms of acne variations, considers their lesion category or fluctuation in inflammation and addresses any internal or external excess or deficiency. That language may seem very confusing, but this safe and minimally invasive therapy of inserting very fine, single-use sterile needles at a specific therapeutic acupuncture point may work really well at alleviating your symptoms.
I am an acne sufferer of 30 years who never experienced the disease in puberty or early adulthood. I developed acne in my late twenties following the birth of my first child and like many sufferers, I self-treated with topical cosmetic agents and over-the-counter medication until they became ineffective. At that point I finally sought medical advice and pharmaceutical intervention. But despite being prescribed a dual combination of topical and oral antibiotics, my acne was non-responding and flaring with increasing severity.
Frustrated by inconsistent treatment outcomes and suffering side effects to the prescribed medication, I turned my attention to alternative therapies and specifically acupuncture. After a course of six, one-hour treatments all my symptoms were alleviated and my acne was finally under control. It was this experience that specifically led me to a complete career change and qualify as an acupuncture practitioner.
I am not cured, but I am now empowered to understand my unique combination of comorbid triggers and can effectively enjoy greater periods of clear skin, with less risk of relapse.
I can help you do the same.
If you would like any further information and are interested in understanding how acupuncture may help you manage your skin condition, you are welcome to contact me for an informal chat, or send an email if you prefer.
Where can I get more unbiased information?
Alternatively visit the British Acupuncture Council (BAcC) website for more information. The BAcC is the acupuncture practitioner’s regulator and governing body, with defining principles in the code of safe practice and hygienic standard for public protection.
Visit the BAcC website by following the link below to find more information in the evidence A-Z section; Acne. These fact sheets are produced to provide accurate evidence based and unbiased general information for a variety of conditions and how acupuncture may be beneficial for you.
You can also use the ‘Find an Acupuncturist’ section to locate the contact details of a qualified practitioner in your area by following the link below.
References:
Agnew, T., Furber, G., Leach, M. and Segal, L. (2016) A comprehensive critique and review of published measures of acne severity. The Journal of Clinical and Aesthetic Dermatology, 9(7), 1-14. Available online via PubMed.
Barnard, E., Shi, B., Kang, D., Craft, N. and Li, H. (2016) The balance of metagenomic elements shapes the skin microbiome in acne and health. Scientific Reports, 10(1), 1-12. Available online via PubMed.
Bowe, W.P., Doyle, A.K., Crerand, C.E., Margolis, D.J. and Shalita, A.R. (2011) Body image disturbance in patients with acne vulgaris. The Journal of Clinical and Aesthetic Dermatology, 4(7), 35-41. Available online at PubMed.
British Skin Foundation (2021) News: About us.
Cao, H., Yang, G., Wang, Y., Liu, J.P., Smith, C.A., Luo, H. and Liu, Y. (2016) Complementary therapies for acne vulgaris: Acupuncture. A Cochrane Database Systematic Review. Available online at PubMed.
Dessinioti, C. and Katsambas, A. (2016) Difficult and rare forms of acne. Clinics in Dermatology, 35(2), 138-46. Available online at PubMed.
Fabbrocini, G., AnnunZiata, M.C., D’Arco, V., De Vita, V., Lodi, G., Maurello, M.C., Pastore, F. and Monfrecola, G. (2010) Acne: Pathogenesis, classification and treatment. Dermatology Research and Practice, 2010, September 20101-13. Available online at PubMed.
Image: ‘Struggle’ (Sharon McCutcheon, Pixabay).
Liu, L. (1989) The english-chinese encyclopaedia of practical chinese medicine. Volume 16: Dermatology. Bejing: Higher Education Press.
Mind the Gap (2021) A handbook of clinical signs and symptoms in Black and Brown skin.
The World Health Organisation. WHO. (2021) WHO: Benchmarks for the practice of acupuncture.
Xu, Y. (2004) Dermatology in traditional chinese medicine. St Albans: Donica Publishing.