Eczema, Rashes, and Skin Complaints

Eczema, Hives, Rosacea, and Skin Conditions

Chronic skin conditions are rarely just a matter of what is happening on the surface. Eczema, hives, acne, rosacea, and other inflammatory skin problems can be influenced by a complicated mix of immune activity, environmental exposures, hormonal changes, stress, sleep, diet, and the health of the skin barrier itself. Treatment therefore begins with understanding the larger pattern rather than simply trying to suppress the visible eruption.

Our approach usually combines acupuncture with individualized dietary and lifestyle changes, appropriate topical care, and Chinese herbal medicine when it is needed. Which of these takes priority depends on the person and the condition.

Diet can be particularly important in some chronic inflammatory skin conditions, especially eczema and chronic hives. When a patient is able to make the changes, we may use a more structured therapeutic diet while symptoms are active and then gradually broaden it as the patient improves. If making substantial dietary changes feels overwhelming at first, we can begin treatment with acupuncture and other measures and introduce the dietary work when the patient has the resources to take it on.

Importantly, food tolerance can change over time. Foods that clearly aggravate symptoms early in treatment may become much better tolerated as the underlying condition settles and overall health improves. This process can continue over a period of months or even years. Our goal is therefore not to leave patients permanently avoiding an ever-growing list of foods, but to use diet therapeutically when it is useful and expand it whenever the patient’s changing tolerance allows.

Acupuncture is also an important part of treatment. In addition to treating the skin presentation itself, we look at associated patterns — itching, inflammation, disrupted sleep, digestive symptoms, hormonal changes, stress, and the tendency toward recurrent flares.

Chinese herbal medicine may be added when the presentation calls for it. Herbal formulas are individualized according to the characteristics of the skin and the patient’s overall pattern, and they can be adjusted as the condition changes.

What we treat

• Eczema and atopic dermatitis in adults and children
• Hives and chronic urticaria, including cases in which no clear trigger has been identified
• Contact and irritant dermatitis
• Rosacea and facial flushing
• Adult and hormonal acne, particularly jawline acne and breakouts that track the menstrual cycle
• Dry, itchy skin and persistent itching
• Skin changes associated with hormonal transitions, including stopping hormonal contraception and perimenopause
• Flares associated with stress, seasonal changes, or the menstrual cycle

What treatment involves

Treatment is individualized, but we commonly begin with a combination of acupuncture and dietary therapy. The emphasis varies considerably depending on the condition.

For eczema and chronic hives, dietary therapy is usually an important part of our approach when the patient is able to undertake it. Dietary recommendations may include a more structured therapeutic diet, along with probiotics, supplements, skin-care products, and topical preparations when relevant. As the patient improves, dietary restrictions can often be relaxed and foods gradually reintroduced according to tolerance.

Acupuncture is used both for the skin condition itself and for the larger patterns that may be accompanying it — including inflammation and itching, digestive symptoms, disrupted sleep, stress, and hormonal changes. Treatment is individualized according to what appears to be contributing to the condition in that particular patient.

Rosacea is somewhat different. In our clinical experience, facial redness and flushing can respond remarkably well to acupuncture, sometimes without the need for dietary changes, herbs, or other treatment modalities. For patients with rosacea, acupuncture may therefore be the primary treatment rather than one part of a larger protocol.

Chinese herbal medicine is added when appropriate rather than automatically. When herbs are used, the formula is individualized and may change as the skin changes. Very red, hot, inflamed skin, for example, requires a different approach from skin that is chronically dry, fragile, or poorly nourished.

Chronic hives are another condition we see frequently, including cases in which an extensive evaluation has failed to identify a clear cause. An identifiable trigger is helpful when there is one, but it is not necessary for us to begin treatment. We look at the pattern of the hives, possible aggravating factors, diet, digestion, stress, hormonal changes, and the patient’s broader health, and develop treatment accordingly.

Chronic skin conditions usually require some patience. Improvement may occur gradually over a period of weeks to months, depending on the severity and duration of the condition. Itching, sleep, and the intensity or frequency of flares may begin improving before the skin has completely cleared.

Working alongside dermatological care

A clear diagnosis matters with skin conditions. New, changing, unusual, infected, or non-healing skin lesions should be appropriately evaluated.

You do not need to stop prescribed treatment in order to work with us. If you are using prescription topical medications, biologics, immunosuppressive medications, or other systemic treatments, let us know so that these can be taken into account when developing your treatment plan.

We are particularly cautious about abrupt changes to medications used to control severe inflammatory skin disease. If the skin improves sufficiently that you want to reduce a prescription medication, that change should be made in coordination with the prescriber rather than simply stopping it.

Common questions

Do I have to change my diet?

For eczema and chronic hives, dietary therapy is usually an important part of our treatment approach. When a patient is able to make the changes, we generally recommend starting there alongside acupuncture and other treatment.

That said, changing your diet can feel like a lot, particularly when you are already dealing with a difficult or exhausting skin condition. If it feels overwhelming at first, we can begin treatment without asking you to change everything at once and introduce dietary changes when you have the resources to take them on.

The diet is also not necessarily permanent. As the skin settles and overall health improves, foods that initially aggravated symptoms may become better tolerated. Over time, often over a period of months or years, we work toward broadening the diet as much as possible rather than leaving patients with an unnecessarily restricted way of eating.

Is treatment mainly acupuncture or herbs?

Usually acupuncture and dietary therapy form the foundation, with Chinese herbal medicine added when we think it will be useful. The balance is different for every patient.

How long before I see a change?

It depends on the condition, its severity, and how long it has been present. Some symptoms can begin changing relatively quickly, while longstanding inflammatory skin conditions may require treatment over several months.

Can children be treated?

Yes. Acupuncture can be adapted for children, using very few needles or non-insertive techniques when appropriate. Dietary recommendations and herbal doses, when herbs are needed, are also adjusted for age.

Do I have to stop my steroid cream?

No. There is no reason to abruptly stop prescribed topical treatment when beginning acupuncture or Chinese medicine. If your skin improves and you want to reduce your use, that should be done thoughtfully and with appropriate guidance.

I have chronic hives and nobody knows why. Can you still treat me?

Yes. We frequently treat chronic urticaria even when no identifiable trigger has been found. We look closely at the pattern of the hives, possible aggravating factors, diet, digestion, stress, hormonal changes, and the patient’s broader health rather than requiring a single identifiable cause before beginning treatment.

Does stress really affect skin conditions?

It certainly can. Stress and disrupted sleep can aggravate inflammatory skin conditions, and sometimes the relationship is striking. We address those patterns as part of treatment rather than viewing them as separate from the skin.

Can you help my adult acne?

Yes. We treat adult acne, particularly when there is a hormonal pattern — along the jawline, around the menstrual cycle, after stopping hormonal contraception, or during perimenopause. Acupuncture, dietary therapy, and Chinese herbal medicine can all be helpful, although results are generally more gradual and sometimes more modest than those achieved with prescription medications.

For severe or scarring acne, dermatological treatment is important, and medications such as isotretinoin can be extremely effective. For women with hormonal acne, spironolactone can also produce results that Chinese medicine may not match. We are happy to work alongside dermatological treatment, or to offer a non-pharmaceutical approach for patients whose acne is appropriate for it and who prefer that option.