Eczema
湿疹 · shī zhěn+12 other namesHide other names
Also known as: Allergic Contact Eczema, Allergic Eczema, Chronic eczema, Chronic eczema or dermatitis, Eczema (certain presentations), Eczema and dermatitis, Eczema (Acute Red Hot Presentation), skin rashes or eczema with oozing, Eczema (Dry Type), Eczema of the Groin or Lower Limbs, Genital Eczema, Periaural Eczema
In TCM, the appearance of your eczema - red and oozy, or dry and scaly - reveals the internal imbalance driving it. Treating that root can break the cycle of flare-ups, with most patients seeing lasting improvement in itching and skin health within weeks to a few months.
About this page · what it is and isn't
What this is. A plain-English synthesis of how classical TCM and modern clinical research describe eczema. Patterns and herbs come from canonical TCM sources; clinical claims are cited in the Evidence section.
What it isn't. A diagnosis. Me&Qi is an editorial team, not a licensed clinic. The pattern quiz is a thinking tool — pulse and tongue still need a person in the room. Anything in the Safety section should send you to a doctor, not a herb.
Last reviewed Jun 2026.
Educational content about Traditional Chinese Medicine — not medical advice. See a qualified practitioner for diagnosis and treatment.
Conventional treatments
Where conventional treatment falls short
How TCM understands eczema
In TCM, the Spleen is the organ system responsible for transforming food and fluids into usable energy and moisture. When the Spleen is weakened - by poor diet, stress, or constitutional tendency - it fails to manage fluids properly, and dampness accumulates. This internal dampness can overflow into the skin, creating the moist, oozy, swollen patches of acute eczema. If heat mixes with the dampness, the skin becomes red, hot, and intensely itchy.
Itching is the hallmark of eczema, and in TCM, itching is almost always caused by Wind. Wind can arise externally (from weather or allergens) or internally (from Blood Deficiency or Heat). In acute eczema, Wind-Heat attacks the skin surface, causing sudden red papules and burning itch. In chronic eczema, long-standing dampness and heat consume the body's Blood and Yin, leaving the skin undernourished and dry. The resulting emptiness allows internal Wind to stir, producing the relentless, dry itch that worsens at night.
This is why a single Western diagnosis of eczema can correspond to several TCM patterns. A patient with weepy, red lesions after eating spicy food has Damp-Heat invading the Spleen. Another with dull, less oozy patches and fatigue has Spleen Deficiency with Dampness. A third with dry, thickened, lichenified skin that itches in winter has Blood Deficiency with External Wind. Each pattern requires a different herbal formula and acupuncture strategy - what works for one may worsen another.
Chronic eczema can also involve the Liver and Kidneys, especially in older adults. The Kidneys store the body's fundamental Yin, and the Liver stores Blood. When these reserves run low, deficiency heat dries the skin, leading to thin, cracked, and itchy patches. This pattern often accompanies other signs of aging, like dry eyes, sore back, or night sweats. By identifying the underlying organ system involved, TCM offers a personalized path to healing that goes beyond the skin.
「诸痛痒疮，皆属于心。」
"All pain, itching, and skin sores are associated with the Heart. This principle links intense itching in eczema to disturbance of the Heart Shen and Blood, guiding the use of herbs that clear Heart fire and calm the spirit."
How a TCM practitioner diagnoses eczema
Inside the consultation
A TCM practitioner first looks at the eczema’s stage and appearance. Acute, weepy, red, and hot skin points toward excess patterns like Damp-Heat or Wind-Heat, while chronic, dry, scaly, and thickened skin suggests deficiency patterns such as Blood Deficiency with External Wind or Kidney and Liver Yin Deficiency. The timing of itching and what makes it better or worse also help narrow the picture.
If the rash is bright red, swollen, and oozing with intense itching, Damp-Heat invading the Spleen is the most likely pattern. The tongue will be red with a thick, yellow, greasy coat, and the pulse feels slippery and rapid. The person may feel heavy, thirsty but not very thirsty, and have sticky stools.
When the eczema is dull, less oozy, and accompanied by fatigue, loose stools, and a pale, swollen tongue with a white greasy coat, the pattern is Spleen Deficiency with Dampness. The pulse is soft and slow. This pattern often follows a prolonged bout of Damp-Heat that has weakened the Spleen’s ability to manage fluids.
In chronic eczema with dry, flaky, lichenified skin and itching that worsens at night, Blood Deficiency with External Wind is the typical pattern. The tongue is pale with a thin white coat, and the pulse is thin. Long-standing damp-heat consumes yin and blood, leaving the skin undernourished and vulnerable to internal wind that stirs up itching.
Wind-Heat is less common and presents as a sudden outbreak of red papules with a burning sensation, often triggered by an external pathogen. The tongue tip is red with a thin yellow coat, and the pulse is floating and rapid. It can overlap with early Damp-Heat, but oozing is minimal and the heat sensation is more prominent.
In elderly people with chronic dry eczema, Kidney and Liver Yin Deficiency may be the root. The skin is dry and rough, and they often have a sore lower back, dizziness, tinnitus, and a red tongue with little or no coat. The pulse is thin and rapid. Here the focus is on nourishing yin rather than just clearing dampness.
TCM Patterns for Eczema
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same eczema can come from several different patterns, each treated differently. The quickest way to find yours is the quiz below.
Find your pattern
Tap any sign that fits how yours feels.
- 1Your signs
- 2What makes it worse
- 3What helps
Which signs match your experience?
It is very common to see yourself in more than one pattern, especially because eczema often shifts from acute to chronic over time. You might have a damp, oozy patch on one area and dry, scaly skin elsewhere, or notice that your symptoms change with diet, stress, or seasons. This overlap is normal and reflects how the underlying imbalance evolves.
To get a clearer sense, pay attention to what dominates. If oozing and redness are the main feature, Damp-Heat or Wind-Heat is likely active. If fatigue and dull, damp skin are more bothersome, Spleen Deficiency with Dampness is probably the core. If dryness and nighttime itching are what you struggle with most, then Blood Deficiency with External Wind or Yin Deficiency is at play.
Because these patterns can mix and even transform into one another, a professional diagnosis that includes tongue and pulse examination is invaluable. A practitioner can spot subtle signs that are hard to assess on your own, such as whether the tongue is more red or pale, or whether the pulse is slippery or thin, which determines the correct treatment approach.
If your eczema is severe, covers a large area, becomes infected, or is accompanied by systemic symptoms like fever or shortness of breath, see a healthcare provider promptly. Self-assessment is a starting point, but it cannot replace a trained eye, especially when the picture is ambiguous or rapidly changing.
Damp-Heat invading the Spleen
Wind-Heat
Kidney and Liver Yin Deficiency
Treatment
Four ways to address eczema in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for eczema
5 formulas across the patterns above. The right one depends on your pattern — start with the quiz if you're unsure which fits.
A powerful cooling formula used to address conditions caused by excess heat and dampness in the Liver and Gallbladder systems. It is commonly used for red, painful eyes, headaches, ear problems, irritability, urinary difficulties, and skin conditions like shingles, particularly when accompanied by a bitter taste in the mouth, dark urine, and a feeling of heat or inflammation along the sides of the body or in the genital area.
A gentle classical formula that strengthens weak digestion, clears excess internal dampness, and stops diarrhea. It is commonly used for people experiencing chronic loose stools, bloating, poor appetite, fatigue, and a sallow complexion caused by a weakened digestive system. By supporting the Spleen and Stomach, it also indirectly benefits the Lungs, helping with shortness of breath and chronic cough with thin white phlegm.
A classical formula for chronic skin conditions such as itching, dryness, rashes, and hives caused by Blood deficiency and Wind. It works by nourishing the Blood to restore moisture to the skin while gently dispersing Wind to relieve itching. It is especially suited for people with long-standing skin problems who also show signs of fatigue, pallor, or dizziness.
A classical formula for itchy, red skin rashes that may ooze fluid after scratching, such as eczema, hives, and allergic dermatitis. It works by dispersing Wind from the skin surface, clearing Heat, draining Dampness, and nourishing the Blood to address both the symptoms and the underlying causes of these skin eruptions.
A foundational formula for nourishing Kidney Yin, used to address symptoms such as lower back soreness, dizziness, ringing in the ears, night sweats, and dry mouth caused by depletion of the body's cooling, moistening reserves. Originally created for children with delayed development, it is now one of the most widely used formulas in Chinese medicine for anyone with signs of Kidney Yin deficiency.
Acute, weepy eczema from Damp-Heat or Wind-Heat often responds quickly - many patients notice less oozing and itching within 2 to 4 weeks of herbal treatment and acupuncture. Chronic, dry eczema from Blood Deficiency or Yin Deficiency requires more time to rebuild the body's reserves, typically 3 to 6 months of consistent care. Even after the skin clears, a maintenance phase with herbs or diet may be recommended to prevent recurrence.
Treatment principles
Treatment of eczema in TCM always addresses both the root (the internal imbalance) and the branch (the skin rash). The acute, weepy stage is seen as an excess condition requiring clearing of heat and dampness, while the chronic, dry stage is a deficiency condition needing nourishment of blood and yin.
In Damp-Heat patterns, formulas like Long Dan Xie Gan Tang drain heat and dampness; in Spleen Deficiency with Dampness, Shen Ling Bai Zhu San strengthens the Spleen to eliminate dampness; in Blood Deficiency with Wind, Dang Gui Yin Zi nourishes blood and dispels wind. Acupuncture points such as Quchi (LI-11) and Xuehai (SP-10) are used across many patterns to cool blood and relieve itching, while Zusanli (ST-36) and Sanyinjiao (SP-6) support Spleen function and fluid metabolism.
What to expect from treatment
A typical treatment plan includes weekly acupuncture sessions and a daily herbal formula, usually taken as a tea or concentrated powder. During the first few weeks, the goal is to reduce acute symptoms - less oozing, less redness, and less itching. As the skin stabilizes, the herbal formula may be adjusted to address deeper imbalances.
Chronic eczema may require 3 to 6 months of consistent treatment, after which many patients transition to a maintenance diet and occasional acupuncture to sustain results.
It's common to see small fluctuations during treatment, especially around dietary indiscretions or stress, but overall the trend should be toward longer periods of clear skin.
General dietary guidance
Across all eczema patterns, the most important dietary principle is to avoid foods that generate dampness and heat. This means minimizing greasy, fried, and spicy foods, as well as alcohol, dairy, and refined sugar. Instead, emphasize cooked, easily digestible meals - soups, congees, and steamed vegetables are ideal. Cooling foods like mung beans, cucumber, and watermelon can help during acute flares.
For chronic, dry eczema, add moistening foods such as pear, sesame seeds, and tofu. Eating at regular times and avoiding overeating also supports Spleen function, which is central to managing eczema in TCM.
Combining TCM with conventional treatment
TCM can safely complement conventional eczema treatments. Topical moisturizers and mild corticosteroids can be used alongside herbs and acupuncture. If you are taking oral immunosuppressants (such as cyclosporine, methotrexate, or prednisone) or biologic drugs, inform both your TCM practitioner and prescribing physician - some herbs may interact with these medications or affect liver function.
Never stop prescribed medications suddenly. With successful TCM treatment, many patients find they can gradually reduce their reliance on steroid creams under their doctor's guidance. Always bring a full list of your medications to your TCM consultation.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Safety & special considerations
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Signs of skin infection — Increased pain, swelling, warmth, red streaks, or pus-filled blisters, especially with fever.
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Sudden, widespread rash with blistering — Especially if accompanied by fever, chills, or feeling unwell - could indicate eczema herpeticum, a medical emergency.
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Difficulty breathing or swelling of the face, lips, or tongue — May signal a severe allergic reaction (anaphylaxis) requiring immediate care.
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Eczema covering a very large area of the body — Extensive skin involvement can lead to fluid loss, infection, or systemic illness.
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Severe pain or burning sensation — Unusual pain that is out of proportion to the visible rash may indicate a deeper infection or another serious condition.
Audience-specific guidance — open what applies to you
During pregnancy, the body's Blood and Yin are naturally directed to nourish the fetus, which can make Blood Deficiency patterns more prominent. A pregnant woman with eczema may notice her skin becoming drier and itchier, especially in the later trimesters. The treatment principle shifts toward gentle nourishment and away from strong cooling or moving methods.
Herbs that are very bitter and cold, such as Long Dan Cao (Gentian) and Huang Qin (Scutellaria) in high doses, are generally avoided because they can disturb the fetus. Formulas like Long Dan Xie Gan Tang are contraindicated. Instead, milder options like Shen Ling Bai Zhu San for Spleen deficiency with dampness or a modified Dang Gui Yin Zi (with Dang Gui used cautiously) may be prescribed. External washes with Huang Bai (Phellodendron) and Ku Shen (Sophora) are safe and effective.
Acupuncture is often preferred over internal herbs during pregnancy. Points such as Hegu (LI-4) and Sanyinjiao (SP-6), which are traditionally avoided in pregnancy, must not be used. A licensed practitioner will select safe points like Quchi (LI-11) and Xuehai (SP-10) to relieve itching without risk.
Bitter and cold herbs, such as Long Dan Cao and Huang Qin, can pass into breast milk and may cause loose stools or digestive upset in a nursing infant. For a breastfeeding mother with acute, oozing eczema, it is safer to rely on a bland diet, external herbal washes, and acupuncture rather than strong internal decoctions.
If internal herbs are necessary, a practitioner will choose mild, neutral herbs that support the Spleen and drain dampness without coldness, such as Fu Ling (Poria) and Bai Zhu (White Atractylodes). Nourishing formulas like Dang Gui Yin Zi can be used with caution, as they do not typically affect milk supply or infant digestion.
Acupuncture is an excellent, drug-free option during breastfeeding. It poses no risk to the baby and can effectively reduce itching and inflammation. Dietary adjustments, such as avoiding greasy, spicy, and dairy-rich foods, often make a significant difference and support both mother and baby.
In children, eczema is most often linked to an immature Spleen and a tendency to accumulate dampness from food stagnation. A diet high in sweets, dairy, and greasy snacks easily overwhelms the child's digestive system, producing internal damp-heat that erupts on the skin. The acute stage often presents as red, weepy patches on the cheeks and flexures, matching the Wind-Heat or Damp-Heat pattern.
Herbal dosages must be reduced according to the child's age and weight, typically one-quarter to one-half of an adult dose. Xiao Feng San is a classic choice for acute, itchy, red eczema in children, but a practitioner will modify it to avoid overly cold herbs. For chronic, dry eczema, a gentle approach with Shen Ling Bai Zhu San to strengthen the Spleen is often more appropriate than heavy blood-nourishing formulas.
Pediatric tui na (therapeutic massage) is a safe and effective complement. Techniques that strengthen the Spleen meridian and clear damp-heat can be taught to parents. Because children may not articulate their symptoms well, a practitioner relies heavily on tongue inspection, the appearance of the rash, and observation of sleep and stool patterns.
In older adults, eczema tends to be chronic, dry, and intensely itchy, reflecting a decline in Kidney and Liver Yin and Blood. The skin becomes thin, scaly, and lichenified, and the itching often worsens at night. The underlying pattern is usually Blood Deficiency with External Wind or Kidney and Liver Yin Deficiency, rather than the damp, oozing patterns seen in younger patients.
Treatment prioritises nourishing Yin and Blood with formulas like Dang Gui Yin Zi or Liu Wei Di Huang Wan. Herb dosages are generally lower-about two-thirds of a standard adult dose-to protect the digestive system. Treatment timelines are longer, and patience is essential, as the body's regenerative capacity slows with age.
Polypharmacy is a real concern. Many elderly patients take medications for hypertension, diabetes, or other conditions, so a thorough review for herb-drug interactions is mandatory. Acupuncture is often better tolerated than herbs and can be very effective for relieving itch and improving sleep without adding to the medication burden.
Evidence & references
The evidence base for TCM in eczema is promising but mixed. A 2005 Cochrane review of Chinese herbal medicine for atopic eczema found some benefit, but the included studies were small and of variable quality. Since then, several randomised controlled trials, particularly from China, have reported that herbal formulas and acupuncture reduce itching and lesion severity, but many lack rigorous blinding or placebo controls.
Acupuncture has shown more consistent results in well-designed trials. A 2012 crossover trial by Pfab et al. demonstrated that acupuncture significantly reduced itch intensity and skin flare in atopic dermatitis patients compared to antihistamines. Overall, while TCM appears to offer real symptomatic relief, larger, multi-centre trials with standardised protocols are still needed to confirm its efficacy for eczema.
Key clinical studies
This landmark double-blind, placebo-controlled crossover trial found that a standardised Chinese herbal formula significantly reduced erythema, excoriation, and itching in adults with refractory atopic dermatitis compared to placebo.
Efficacy of traditional Chinese herbal therapy in adult atopic dermatitis
Sheehan, M. P., Rustin, M. H. A., Atherton, D. J., Buckley, C., Harris, D. W., Brostoff, J., & O'Connell, B. M. (1992). Efficacy of traditional Chinese herbal therapy in adult atopic dermatitis. The Lancet, 340(8810), 13-17.
10.1016/0140-6736(92)92424-eThis rigorous trial demonstrated that acupuncture significantly reduced itch intensity and skin flare reactions in atopic dermatitis patients, outperforming a standard antihistamine and placebo acupuncture.
Acupuncture compared with oral antihistamine for type I hypersensitivity itch and skin response in adults with atopic dermatitis: a patient- and examiner-blinded, randomized, placebo-controlled, crossover trial
Pfab, F., Huss-Marp, J., Gatti, A., Fuqin, J., Athanasiadis, G. I., Irnich, D., ... & Darsow, U. (2012). Acupuncture compared with oral antihistamine for type I hypersensitivity itch and skin response in adults with atopic dermatitis: a patient- and examiner-blinded, randomized, placebo-controlled, crossover trial. Allergy, 67(4), 566-573.
10.1111/j.1398-9995.2012.02789.xThis Cochrane systematic review assessed multiple RCTs and concluded that Chinese herbal medicine may offer some benefit in reducing eczema severity, though the overall evidence is limited by small sample sizes and methodological weaknesses.
Chinese herbal medicine for atopic eczema
Zhang, W., Leonard, T., Bath-Hextall, F., Chambers, C., Lee, C., Humphreys, R., & Williams, H. C. (2005). Chinese herbal medicine for atopic eczema. Cochrane Database of Systematic Reviews, (2), CD002055.
10.1002/14651858.CD002055.pub2Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「浸淫疮，从口流向四肢者可治，从四肢流来入口者不可治。」
"For eczematous sores (Jin Yin Chuang), if they spread from the mouth toward the limbs, the condition is treatable; if they spread from the limbs toward the mouth, it is dangerous. This early observation recognised the prognostic value of eczema's direction of spread."
Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet)
Chapter 14 (Sores, Carbuncles, Intestinal Abscess, and Eczema)
Frequently asked questions
Common questions about using Traditional Chinese Medicine for eczema.
TCM aims to resolve the underlying imbalance so that eczema no longer recurs. While we cannot guarantee a permanent cure, many patients achieve long-term remission - especially when they follow dietary and lifestyle guidance. Acute cases often resolve fully; chronic cases may see significant reduction in frequency and severity.
Most people notice a decrease in itching and oozing within the first 2 to 4 weeks of treatment. For chronic, dry eczema, improvement may be slower, with visible skin healing over 2 to 3 months. Consistency is key - weekly acupuncture and daily herbs produce the best outcomes.
Yes, TCM can be used together with topical corticosteroids. Many patients find that acupuncture and herbs reduce the need for steroids over time. Always tell both your TCM practitioner and your dermatologist about all treatments you are using. Do not stop prescribed medications abruptly without medical supervision.
In TCM, foods that create dampness and heat are the main culprits. These include greasy or fried foods, spicy dishes, alcohol, dairy products, and excessive sugar. For dry eczema, overly drying or heating foods like coffee and roasted nuts may also worsen itching. A bland, cooling diet with plenty of cooked vegetables and grains is generally supportive.
Acupuncture helps reduce inflammation, calm the itch, and rebalance the organ systems involved. Points like Quchi (LI-11), Xuehai (SP-10), and Zusanli (ST-36) are commonly used to clear heat, cool blood, and strengthen the Spleen. For best results, acupuncture is combined with herbal medicine and dietary changes.
If the underlying imbalance is fully corrected, recurrence is unlikely. However, if dietary or lifestyle habits that originally caused the imbalance are resumed, eczema may return. TCM emphasizes long-term prevention through diet, stress management, and occasional maintenance treatments. Many patients find that even if a small flare occurs, it is milder and resolves faster.
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