Acne is an inflammatory skin condition that happens when the hair follicles under the skin become clogged. It is the most common skin condition, affecting roughly 40 to 50 million individuals annually.  Acne is usually caused by excess build up of oil, dead skin cells, and bacteria in the pore.
Common areas of acne occurrence include:
- Facial acne
The face is the most common area for acne. Adult acne tends to occur on the lower half of the face (U-zone) around the cheeks, jawlines and chin area, while adolescent acne tends to appear on the forehead and nose area, also known as the T-zone. 
- Body acne
Apart from the face, acne can also appear on other areas of the body, including the back, the buttocks and even the limbs. Back acne, also known as Bacne, is one of the most common forms of acne and can cause significant discomfort. Body acne arises from the same reasons as facial acne, but can also happen due to wearing tight clothing and excessive sweating.
A term newly-coined since the pandemic, Mask-ne has affected many of us as we grow accustomed to wearing masks indoors and outdoors. Having to wear a mask over long periods of time can irritate our skin and clog our pores, leading to skin issues such as redness, bumpiness and itchiness.
Acne in TCM terms
In TCM, acne is most closely associated with Heat in the Lungs and Stomach. This is often caused by excessive consumption of spicy, oily and flavorful foods which causes an accumulation of Damp Heat in the body. In TCM, acne in different parts of the face and body could be an indication of poor health of their corresponding organs.
Bacne and Chestne
Acne that happens on the back or chest, accompanied by oily skin is believed in TCM to be caused by Heat Dampness in the Spleen.
Acne is a condition that affects all ages, but individuals that experience fluctuating hormonal levels are more prone to suffering from it. As such, teens and working adults with a stressful lifestyle are more likely to suffer from acne. However, there are other factors that can also lead to facial and body acne.
TCM and Non-TCM Acne myths
- Chocolate and other “heaty” foods cause acne – Fact
In TCM, “heaty” foods like chocolate, snacks, and fried foods are believed to cause acne. This is true as overconsumption of these foods can lead to Lung and Stomach Fire, which are the two main causes of acne in TCM. This corresponds to modern knowledge as these foods belong to a group of high Glycemic Index (GI) foods, which are commonly associated with acne. Consuming high GI foods can lead to a rise in blood sugar, which triggers a series of reactions that lead to skin inflammation and overproduction of skin oil. 
- Staying up late causes acne – Fact
You may realize that you break out more easily or have dull-looking skin after staying up late. That is because research has shown that sleep disturbance does impact skin disease.  Having an irregular sleep schedule causes fluctuation in brain chemical and hormonal levels, resulting in excessive oil production and clogged pores. In TCM theory, 1am to 3am is the time period where our liver detoxes, a process that can only take place when you are asleep. As such, staying up late beyond that time may hinder the liver’s detox process and cause an accumulation of “toxins” in the body. These “toxins” are essentially the body’s metabolic wastes that may accumulate in the organs if not properly removed from the body, resulting in acne breakouts on the corresponding areas on the face and the back.
- You will get acne if you don’t wash your face often enough – Myth
If you suffer from acne, you may have been told that it’s because you haven’t washed your face enough. This is a myth that has been debunked by many experts as washing your face in excess may actually cause more breakouts.  Excessive scrubbing and cleaning can strip your skin of moisture and essential oils, causing dryness which could lead to excess sebum production. Excessive face-washing can also interfere with the good bacteria on our skin that is necessary to keep our skin barrier healthy. As such, washing your face in moderation is key to preventing acne. In general, washing your face once in the morning and once at night is sufficient to keep your skin feeling clean and healthy.
ORG treatments that can help prevent acne
In TCM, herbs are usually the first line of treatment against acne as they can address the body’s underlying imbalance, which is the root cause of acne outbreaks. Patients that suffer from acne due to Lung Heat or Stomach Heat will benefit from Wind Heat-dispelling herbs like Loquat Leaves, Mulberry Bark and Raw Licorice. On the other hand, patients with Damp Heat in their body can take Damp Heat-dispelling herbs like Yin Chen Hao Soup and Huang Lian Jie Du Tang.
Facial acupuncture is a treatment that involves the insertion of needles on the face. It is commonly used to treat acne and other facial skin conditions like skin sagging, dull skin, and even paralysis. As the needles used are thinner than regular acupuncture needles, there is minimal discomfort in the process.
Facial acupuncture can help to improve local microcirculation and remove heat from the face and body. This helps to calm down acne flare-ups and prevent acne outbreaks. A 2018 study showed that a patient with rosacea who was treated with acupuncture 3 times a week experienced a significant decrease in symptoms.  Acupuncture can also speed up the healing of acne scars by inducing an accelerated wound-healing response, as shown in a 2020 study performed on diabetic patients. 
If you suffer from hormonal acne or are experiencing breakouts caused by periods of stress, acupuncture on other parts of the body can also help to restore hormone balance. Studies have shown that acupuncture can help to reduce stress hormone levels, promote circulation to tissues and glands, and reduce inflammation and toxins.  Patients that suffer from bacne and acne on other parts of the body can also benefit from body acupuncture.
Daily maintenance tips to prevent growth or worsening of acne
- Have a healthy and nutritious diet
Having a diet with the right nutrition and avoiding sugary, spicy, and processed foods is key to having clear skin. If you are suffering from acne, here are some foods you may want to eat/avoid.
CONSUME MORE OF:
- Low GI, non-processed foods such as whole grains, legumes, fruits and vegetables
- Foods that are high in vitamins and antioxidants, such as blueberries, blackberries and strawberries
- Dark green, leafy vegetables such as spinach
- Stay hydrated. Drinking plenty of water helps your body detox while ensuring your skin barrier stays strong and healthy!
CONSUME LESS OF:
- Processed foods like potato chips and biscuits
- Sugary and high GI foods like chocolate and sweets
- Dairy products like milk, ice cream and cheese
- Oily, fried, and spicy foods that may place a burden on your digestive system and cause inflammation on the gut-skin axis
- Go to sleep before 11pm each night
Having a regular sleep schedule keeps your hormone levels healthy and allows the body to renew itself. Sleeping before 11pm each night can help with liver detox, enhance cell renewal and slow down ageing!
According to the Chinese organ clock, 11pm to 1am is the time of the Gallbladder, while 1am to 3am is when the Liver reaches its peak detoxification process. This process can only take place during sleep, so it is advisable to go to sleep before 11pm so that you are fully asleep by the time of Liver detoxification. Sleeping early also ensures that you get sufficient rest and reduces stress levels to prevent acne outbreaks.
- Herbal teas that can cool Lung and Stomach Fire
Here are some herbal tea recipes that can help clear your acne from the inside out by dispelling Wind-Heat from the Lungs and purging Stomach Fire from within.
a) Peppermint tea with lemon
Recipe: Boil a cup of peppermint tea, strain the leaves and add a teaspoon of lemon juice
Benefit: Peppermint boosts digestion and clears heat from the Stomach, while the vitamin C in lemon boosts immunity and clarifies skin
b) Lily bulb tea
Recipe: Use 1 handful of dried lily bulb, 2 honey dates, 2 dried sugar tangerine and 2-3 cups of hot water. Boil ingredients for 3 hours in the slow cooker on high heat.
Benefit: Sweet and cooling by nature, lily bulb helps to clear heat from the Lungs and the Heart.
c) Rose tea
Recipe: Add a few dried rose buds to a cup of hot water and steep for 5 minutes.
Benefit: Rose tea improves mood, hormone balance and endocrine function for clear skin.
- Lifestyle habits
For Bacne: Avoid wearing tight clothes, and change out of your sweaty clothes as soon as possible after a workout. Try a tea tree-containing body wash to help combat bacne.
For Mask-ne: Change your disposable mask regularly (1 – 2x a day) and wash your reusable mask with anti-bacterial detergent daily. Anti-acne mask sprays with natural ingredients may also help with mask-ne by combating bacteria growth.
- Consider probiotics for skin health
Poor gut health may also lead to acne as inflammation in the gut causes acne to flare up. Probiotics promote healthy gut health for clear skin and stronger immunity. For best effect, choose a brand of probiotics that contain skin health-boosting probiotic strains like Lactobacillus acidophilus, Bifidobacterium infantis, or Bifidobacterium lactis. We recommend Gut Essentials, a product specially formulated with probiotic strains that promote skin health for healthy digestion, clear skin, and strong immunity.
Your healing is the most important!
At Oriental Remedies Group, our physicians are trained in both Biomedical Science and TCM at Nanyang Technological University (Singapore) and China for a minimum of 5-8 years before being certified to practice in Singapore.
If you or a loved one is suffering from health conditions in relation to Acne, we would like to help. Please contact us at +65 8742 2163 for a personalized consultation.
This article is written by Physician Foo Shan Ju.
Physician Foo Shan Ju (Oriental Remedies Group, Singapore), a registered TCM physician certified by the Traditional Chinese Medicine Practitioners Board (TCMPB).
Note: All words in Italics refer to the TCM organ-system and not the anatomical organ referenced in western medicine.
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 A to Z about Acne & Zits: The Complete Guide to Clear Skin. (Published by Straits Times Press)