Traditional Chinese medicine practitioner Yun Niu brings a different perspective to the problem of adult acne.

Adult acne in traditional Chinese medicine (TCM) is the external manifestation of excessive fire and toxins present in the body. Mechanisms behind this include:

Fire in the lung In TCM, the lung looks after the skin, and if the lung is overheated by the fire, this shows up on the skin as acne. This is why many people find their acne worsens in summer. If the fire is associated with wind, then the acne can be itchy.
Heat in the spleen and stomach This can relate to too much spicy or fatty food, or foods we term “direct from fire”: barbecued, deep-fried, or roasted foods, which hold too much heat and when eaten, the heat remains in the stomach and eventually affects skin. This type of acne can be red and sore, and the eruptions often have pus or a white centre.
Unbalanced or deficiency of yin and yang energy
Smoking, as it heats the lung, intensifying the fire.
Alcohol, as it creates fire, especially in the liver and digestive system.
Stagnation of energy (qi) or food Qi stagnation usually relates to uprising liver qi. This typically occurs in women during menstruation as it causes PMS, and is why many younger women experience more acne during or before menstruation. Stress is a major cause of qi stagnation, with acne often relapsing when the person is under mental or emotional pressure. Stagnation can also be caused by spicy or fatty food, and foods that are hard to digest. Overeating accumulates the stomach stagnation and consequently increases toxins – the root of acne.
Too much sugar Sugar slows metabolism, which compromises digestion and builds internal heat.
Fire and stagnation Acne can also be caused by a combination of fire and stagnation. Stagnation leads to an accumulation of toxins. This type of acne is usually large, looks red and is sore. Acne caused by lack of yin energy is termed deficiency fire in TCM. This means the primary cause is not overly heated organs but weakened yin energy. Chronic acne can be linked to depleted spleen energy as well as intensified fire. This can arise from undergoing unsupervised cleanses or detoxes, which result in the withdrawal of too much healthy energy. When the spleen is affected, the digestive system is weakened, toxins are formed, and acne appears.
Blood deficiency is another factor. The acne may not be sore but keeps returning. Some people feel thirstier during this period, but drinking does not satisfy the thirst.

What you can do

*Give up smoking and avoid alcohol, or drink it only in moderation.
*Eat more fresh, green, easily digested foods while minimising sugar intake.
*Eating more medicinal foods, e.g. white radish, green tea, goji berry, and black sesame seed.
*Drink enough water, but not excessively.
*Go to bed early and have sufficient sleep. We usually recommend before 11 p.m. as late sleepers and too little sleep cause deficiency of yin energy, which affects liver function and digestion.
*Exercise regularly to improve circulation.
If acne is inflamed or associated with PMS, irritable bowel syndrome, liver concerns or food allergies, consult a TCM practitioner. Treatment can involve both herbal medicine and acupuncture. For a particularly worrisome appearance on the face, I recommend facial acupuncture as it helps eliminate fresh pimples, and reduces the colour stagnation on the skin from previous outbreaks.

Yun Niu PhD is a member of the Australian Traditional Medicine Society.