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  • Writer's pictureJuliette Aiyana, L.Ac. MTCM

Resolve Acne Post-Inflammatory Hyperpigmentation with Blood-Moving Chinese Herbs

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White Peony

In Chinese herbal medicine holistic dermatology, we treat acne in stages. During the final stages we focus on the therapeutic effect of moving the blood to address post-inflammatory hyperpigmentation caused by acne. Herbs with blood-moving properties play a pivotal role in improving circulation, reducing dark discoloration, redness, inflammation, and promoting the healing process. 

This article will discuss:

What is Post Inflammatory Hyperpigmentation?

Post-inflammatory hyperpigmentation (PIH) is a common skin condition that occurs as a result of inflammation or injury to the skin, often associated with acne. It manifests as dark spots or patches on the skin that develop after an acne lesion has healed. These areas of hyperpigmentation are caused by an overproduction of melanin, the pigment responsible for skin color, in response to inflammation.

When acne lesions, such as papules, pustules, or nodules, heal, they can leave behind residual pigmentation in the form of PIH. This occurs as a result of the inflammatory response triggered by the acne lesion, which stimulates the melanocytes (melanin-producing cells) in the skin to produce more melanin than usual. As a result, the affected areas appear darker than the surrounding skin, ranging in color from pink, red, brown, to black, depending on the individual's skin tone and the severity of the inflammation.

It's important to note that post-inflammatory hyperpigmentation is not permanent scarring but rather a temporary discoloration of the skin. With time, PIH can fade on its own, although this process may take several months to years without treatment. Blood moving Chinese herbs can shorten the duration and eventually even prevent PIH. I also recommend topical treatments such as ascorbic acid. 

Differentiating Post Inflammatory Hyperpigmentation from Scarring?

Acne Post Inflammatory Hyperpigmentation (PIH) manifests as dark spots or patches on the skin that linger after an acne lesion has healed. These areas appear as flat, discolored patches ranging in color from pink, red, brown, to black, depending on the individual's skin tone and the severity of inflammation. Some people may mistakenly refer to these dark spots as scars; however, it's essential to clarify that PIH is not true scarring. Instead, it represents an overproduction of melanin in response to inflammation, resulting in temporary discoloration of the skin. 

In contrast, acne scars present as permanent indentations or raised bumps on the skin's surface. These scars result from the damage inflicted on the skin's deeper layers during the inflammatory process of acne. The most common source of damage is caused by picking at the acne lesions, popping pimples, and performing extractions at home. 

There are two primary types of acne scars: atrophic and hypertrophic. Atrophic scars, also known as depressed scars, appear as indentations or pits in the skin and are further categorized as icepick, boxcar, or rolling scars, depending on their shape and depth. Hypertrophic scars, on the other hand, are raised and thickened areas of scar tissue that develop when the body produces too much collagen during the healing process. These scars can vary in size and texture and may be pink, red, or flesh-colored. 

Drinking Chinese herbal teas won’t help these types of scars but cosmetic acupuncture, micro needling, lasers or some topical treatments ascorbic acid may be helpful. People with richly pigmented skin should be sure to consult with a practitioner who has experience using any of those methods on skin of color because some of them might make matters worse. 

The Role of Blood Moving Herbs

In Traditional Chinese Medicine (TCM), the concept of moving the blood is integral to addressing acne and post-inflammatory hyperpigmentation (PIH) due to its role in promoting circulation and resolving stagnation. When blood circulation is impaired or stagnant, it can lead to a variety of skin issues, including acne and PIH. Overall, the concept of moving the blood in Chinese herbal medicine addresses the root causes of acne and PIH by promoting circulation, resolving stagnation, nourishing the skin and supporting the body's natural healing processes. By restoring balance within the body, Chinese herbs offer a holistic approach to achieving clear, healthy skin.

  • Acne: Stagnation of blood and Qi (vital energy) can result in the accumulation of toxins and impurities in the skin, leading to the formation of acne. By promoting the movement of blood, Chinese herbs help to disperse these stagnations, reduce inflammation, and facilitate the elimination of toxins from the body. Improved blood circulation also ensures that essential nutrients reach the skin, supporting its health and vitality.

  • Post-Inflammatory Hyperpigmentation (PIH): PIH occurs when inflammation triggers the overproduction of melanin, leading to dark spots or patches on the skin. By promoting blood circulation, Chinese herbs help to resolve stagnant blood in the affected areas, facilitating the dispersion of melanin and promoting the regeneration of healthy skin cells. This can help to fade existing pigmentation and prevent the formation of new dark spots.

Common Chinese Herbs Used for Acne Post Inflammatory Hyperpigmentation

Let's delve into the qualities of a few specific herbs that I like to use in my clinical practice —Dang Gui, Hong Hua, Bai Shao, Chi Shao, Tao Ren, and Dan Shen—and how they contribute to this transformative aspect of acne hyperpigmentation treatment. (To learn about herbs that I use for acne types such as white heads, cystic acne, hormonal acne, read this article.)

This is not an exhaustive list, but they are some of my top favorite herbs to resolve PIH.

  • Dang Gui (Angelica Sinensis): Blood-Nourishing and Invigorating: Dang Gui is renowned for its ability to nourish and invigorate the blood. By doing so, it promotes optimal circulation, ensuring that essential nutrients reach the skin, aiding in the repair and regeneration of damaged tissues. Anti-Inflammatory Qualities: Additionally, Dang Gui exhibits anti-inflammatory properties, helping to soothe irritated skin and reduce redness or pigment changes associated with acne.

  • Hong Hua (Safflower): Blood-Activating: Hong Hua is a potent blood-activating herb, fostering circulation and preventing stagnation. Improved blood flow ensures that the skin receives adequate oxygen and nutrients, facilitating the healing of acne lesions. Anti-Inflammatory Effects: Its anti-inflammatory effects further contribute to calming skin inflammation, a crucial aspect of acne management.

  • Bai Shao (White Peony Root): Blood-Nourishing and Soothing: Bai Shao is known for its dual action of nourishing the blood and soothing the liver. This combination helps regulate hormonal imbalances that may contribute to acne, while also calming inflammation, redness and dark spots on the skin.

  • Chi Shao (Red Peony Root): Blood-Cooling and Invigorating: Chi Shao has blood-cooling properties, making it effective in reducing heat-related inflammation associated with acne. Simultaneously, it invigorates the blood, promoting a balanced and healthy complexion.

  • Tao Ren (Peach Kernel): Blood-Moving and Moistening: Tao Ren possesses blood-moving qualities and helps moisturize the skin. This dual action aids in preventing dryness and flakiness often associated with acne treatments, ensuring a more comfortable healing process. Anti-Inflammatory Benefits: Its anti-inflammatory benefits contribute to a reduction in the swelling and redness of acne lesions.

  • Dan Shen (Salvia Miltiorrhiza): Blood-Circulating and Anti-Inflammatory: Dan Shen is a very powerful herb for promoting blood circulation and has notable anti-inflammatory effects. It addresses both the root causes of acne, such as poor circulation, and the accompanying inflammatory responses.

Incorporating these blood-moving herbs into Chinese herbal formulas provides a holistic dermatological approach to acne treatment. By improving circulation, reducing inflammation, and addressing underlying imbalances, these herbs become essential allies on the road towards clearer, healthier skin. Consulting with a licensed practitioner of Traditional Chinese Medicine, such as Juliette Aiyana, MTCM who can provide personalized guidance for effective treatment tailored to specific needs. Here is one of her acne case studies. She takes her time to really understand your health, figure out what's causing your symptoms, and work out a plan for your long-term well-being. Plus, you can connect with her easily through video visits, no matter where you are. Herbs and supplements are mailed to you.

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Juliette Aiyana, is an internationally respected specialist in Traditional Chinese Medicine (TCM) and natural holistic health. She is a nationally board-certified and New York State-licensed acupuncturist with a Master's Degree in TCM. She is professional member of the National Eczema Association and trained in identifying skin disease in richly pigmented skin. Practicing since 2001, she specializes in treating chronic, stubborn and mystery diseases, including dermatology, autoimmune disorders, allergies, digestive disorders, chronic fatigue, viral diseases, menstrual and pelvic health, and more. She is dedicated to identifying the root cause of diseases, and empowering people to reclaim agency over their health. Juliette’s health consultations are available virtually via Zoom to people in the US and CA.

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