Skin disease in Chinese medicine sits under Wài Kē (外科, "external medicine"). The skin is the outermost layer of the body, governed by the Lung and defended by wèi qì, moistened by the blood, and cooled or warmed through the interplay of yīn and yáng. Every rash, plaque or lesion is read as a pattern of wind, heat, damp, dryness, blood-heat, blood stasis or deficiency expressed at the surface.
Four lenses used together, not in isolation.
Lung governs skin and body hair; Spleen governs damp; Liver stores blood and moves qi; Kidney holds essence. Most chronic skin disease maps onto one or two of these.
Wind (sudden, migratory, itchy), Heat (red, hot, exudative), Damp (weeping, sticky, stubborn), Dryness (cracked, scaly), Cold (pale, better with warmth), Fire-Toxin (severe, systemic).
Acute urticaria sits at the wèi level; deep bright-red plaques at the yíng-xuè level. Depth guides how aggressively to cool blood versus release the exterior.
Where the lesion sits matters: forehead = yangming/Lung, jaw = Stomach/Chōng-Rèn, flanks = Liver-Gallbladder, lower legs = Spleen damp. Point selection follows the channel through the lesion.
Showing 27 of 27 conditions
Atopic dermatitis, contact dermatitis, dyshidrotic eczema
Damp-Heat in Spleen & Stomach (Pí Wèi Shī Rè)
Weeping, red, itchy vesicles; yellow crust; greasy tongue coat; slippery-rapid pulse.
Principle: Clear heat, drain damp, cool blood.
Blood Deficiency with Wind-Dryness (Xuè Xū Fēng Zào)
Chronic dry, thickened, lichenified plaques; intense night itch; pale tongue; thready pulse.
Principle: Nourish blood, moisten dryness, extinguish wind.
Wài Kē Zhèng Zōng (外科正宗, 1617) frames Shī Chuāng as damp lodging in the skin division.
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Plaque, guttate, inverse, pustular psoriasis
Blood-Heat (Xuè Rè)
Bright red plaques, rapid spread, silvery scale, thirst, red tongue, rapid pulse.
Principle: Cool blood, clear heat, resolve toxin.
Blood Stasis (Xuè Yū)
Dark, thick, well-demarcated plaques; long-standing; purple tongue; wiry pulse.
Principle: Invigorate blood, dispel stasis, soften lesions.
Blood Deficiency & Dryness (Xuè Xū Fēng Zào)
Faded pink plaques, fine dry scale, pale tongue, thready pulse.
Principle: Nourish blood, moisten skin, gently expel wind.
Zhū Bìng Yuán Hòu Lùn (诸病源候论, 610 CE) describes Bái Bǐ as wind and heat contending in the blood level.
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Comedonal, inflammatory, cystic acne; hormonal acne
Lung Heat (Fèi Rè)
Forehead and nose papules, red base, mild pustules; thin yellow coat; floating-rapid pulse.
Principle: Clear Lung heat, disperse wind-heat.
Stomach & Intestine Damp-Heat (Wèi Cháng Shī Rè)
Perioral and jaw pustules, greasy skin, constipation, foul breath; greasy yellow coat.
Principle: Clear heat, drain damp, harmonise middle jiao.
Phlegm-Stasis Nodules (Tán Yū)
Deep cysts, scarring, dark discolouration; purple tongue; wiry-slippery pulse.
Principle: Transform phlegm, invigorate blood, soften nodules.
Yī Zōng Jīn Jiàn (医宗金鉴, 1742) links Cuó Chuāng to Lung-Stomach heat rising to the face.
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Chronic spontaneous / inducible urticaria, angioedema
Wind-Heat in the Skin (Fēng Rè Xí Fū)
Bright red wheals, worse with heat, sudden onset; red tongue tip; floating-rapid pulse.
Principle: Disperse wind, clear heat, calm itch.
Wind-Cold on the Exterior (Fēng Hán Xí Biǎo)
Pale wheals worse in cold/wind, better with warmth; thin white coat; floating-tight pulse.
Principle: Warm and release the exterior, dispel wind-cold.
Blood Deficiency generating Wind (Xuè Xū Shēng Fēng)
Chronic recurrent hives, night itch, dry skin, pale tongue, thready pulse.
Principle: Nourish blood, extinguish wind.
Jīn Guì Yào Lüè (金匮要略) notes 'Yǐn Zhěn' arising when wei qi fails to secure the surface.
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Erythematotelangiectatic, papulopustular, phymatous, ocular rosacea
Lung–Stomach Heat rising (Fèi Wèi Rè Shèng)
Central facial flush, papules, warmth; red tongue; rapid pulse.
Principle: Clear Lung and Stomach heat, cool blood.
Blood Stasis in the Channels (Xuè Yū Zǔ Luò)
Persistent telangiectasia, phyma, dusky-red nose; purple tongue.
Principle: Move blood, dredge collaterals.
Wài Kē Dà Chéng (外科大成, 1665) describes Jiǔ Zhā Bí from wine-heat steaming the Lung and blood level.
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Acute zoster, post-herpetic neuralgia (PHN)
Liver Gallbladder Damp-Heat (Gān Dǎn Shī Rè)
Bright red band of vesicles on flank/trunk, burning pain, bitter mouth; wiry-rapid pulse.
Principle: Clear liver-gallbladder damp-heat, resolve toxin.
Qi Stagnation & Blood Stasis (PHN) (Qì Zhì Xuè Yū)
Lingering neuralgia after lesions heal; stabbing, fixed pain; purple tongue.
Principle: Move qi and blood, unblock collaterals, stop pain.
Yī Zōng Jīn Jiàn (医宗金鉴) records 'Shé Chuàn Chuāng' following the girdle vessel with wind-fire toxin.
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Non-segmental, segmental vitiligo
Qi & Blood Disharmony with Wind (Qì Xuè Shī Hé, Fēng Xié Zǔ Luò)
Well-demarcated depigmented patches, slow spread, no itch; pale tongue.
Principle: Harmonise qi and blood, dredge collaterals, expel wind.
Liver–Kidney deficiency (Gān Shèn Bù Zú)
Longstanding stable patches, greying hair, weak low back; thready pulse.
Principle: Tonify liver and kidney, nourish essence and blood.
Zhū Bìng Yuán Hòu Lùn attributes Bái Diàn Fēng to wind pathogen contending with weak wei qi in the skin.
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Alopecia areata, telogen effluvium, androgenetic alopecia
Liver–Kidney essence deficiency (Gān Shèn Jīng Kuī)
Gradual thinning, premature greying, tinnitus, weak low back; thready pulse.
Principle: Tonify liver-kidney, replenish essence and blood.
Blood Stasis obstructing scalp (Xuè Yū Zǔ Fā)
Sudden round patches, post-stress or post-illness; purple tongue.
Principle: Invigorate blood, dredge scalp collaterals.
Zhū Bìng Yuán Hòu Lùn: 'hair is the surplus of the blood; when blood is empty the hair falls.'
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Seborrhoeic dermatitis, dandruff, cradle cap
Wind-Heat with Blood Dryness (Fēng Rè Xuè Zào)
Dry flaky scalp/brows, itch, fine white scale; red tongue with thin coat.
Principle: Disperse wind, cool blood, moisten dryness.
Damp-Heat in Spleen & Stomach (Pí Wèi Shī Rè)
Greasy yellow scale, oily skin, itch worse with rich/fried food; yellow greasy coat.
Principle: Clear damp-heat from middle jiao, disperse wind.
Wài Kē Zhèng Zōng: 'greasy wind of the face arises from damp-heat steaming upward.'
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Tinea corporis, cruris, pedis, capitis
Damp-Heat with Wind toxin (Shī Rè Fēng Dú)
Annular scaly plaques, itch, moist maceration between toes/groin.
Principle: Clear damp-heat, kill parasites, disperse wind.
Blood Dryness with Wind (Xuè Zào Shēng Fēng)
Chronic dry scaly patches, thickened skin, mild itch.
Principle: Nourish blood, moisten dryness, disperse wind.
Wài Kē Dà Chéng: 'xuǎn arises from damp-heat lodged in the skin, engendering wind and worms.'
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Irritant and allergic contact dermatitis
Wind-Heat toxin invading skin (Fēng Rè Dú Xié)
Sudden red itchy patch matching contact area, vesicles, burning.
Principle: Disperse wind, clear heat, resolve toxin.
Damp-Heat with weeping (Shī Rè Yùn Fū)
Oozing vesicles, crusting, marked oedema.
Principle: Clear damp-heat, drain exudate.
Zhū Bìng Yuán Hòu Lùn: 'when wind-toxin lodges in the skin, red rash and itch arise.'
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Impetigo, folliculitis, furuncles
Damp-Heat Fire toxin (Shī Rè Huǒ Dú)
Yellow crusted pustules, honey-coloured exudate, surrounding erythema.
Principle: Clear heat, resolve toxin, drain damp.
Spleen Deficiency with recurrent boils (Pí Xū Fù Fā)
Chronic recurring boils, fatigue, pale tongue with teeth marks.
Principle: Tonify spleen, clear residual toxin.
Wài Kē Zhèng Zōng: 'sores of the skin arise from fire toxin lodged in the flesh.'
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Herpes simplex labialis and genitalis
Lung–Stomach Wind-Heat (Fèi Wèi Fēng Rè)
Perioral vesicles with tingling prodrome, low fever, sore throat.
Principle: Disperse wind-heat, clear Lung-Stomach.
Liver channel Damp-Heat (genital) (Gān Jīng Shī Rè)
Genital vesicles, burning, yellow discharge; wiry rapid pulse.
Principle: Drain liver damp-heat.
Jīn Guì Yào Lüè references rè chuāng as heat rising to the surface.
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Verruca vulgaris, plantar warts, molluscum
Wind-Damp lodged in skin (Fēng Shī Zǔ Fū)
Rough papules, slow growth, minimal inflammation.
Principle: Disperse wind-damp, invigorate blood locally.
Liver Blood deficiency (Gān Xuè Bù Zú)
Multiple recurrent warts, dry skin, brittle nails.
Principle: Nourish liver blood to strengthen skin defence.
Zhū Bìng Yuán Hòu Lùn: 'yóu arises when wind evils lodge in the interstices.'
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Melasma, chloasma, PIH
Liver Qi Stagnation with Blood Stasis (Gān Yù Xuè Yū)
Symmetrical facial pigmentation, PMS, irritability, dark tongue edges.
Principle: Soothe liver, invigorate blood.
Kidney Yin deficiency (Shèn Yīn Xū)
Grey-brown patches, low back ache, night sweats, red peeled tongue.
Principle: Nourish kidney yin, cool blood.
Wài Kē Zhèng Zōng attributes lí hēi bān to liver-kidney disharmony and blood not nourishing the face.
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Perioral dermatitis, granulomatous rosacea variant
Stomach Heat rising (Wèi Rè Shàng Yán)
Papulopustules around mouth sparing vermilion border, burning.
Principle: Clear stomach heat, disperse wind.
Spleen Damp with residual heat (Pí Shī Yú Rè)
Persistent low-grade papules, worse with heavy skincare or steroid rebound.
Principle: Drain damp, clear residual heat.
Wài Kē Xīn Fǎ: 'yangming heat rising to the mouth produces pustular sores of the lips.'
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Hidradenitis suppurativa (acne inversa)
Damp-Heat Toxin with Phlegm-Stasis (Shī Rè Dú Yū Tán)
Recurrent painful axillary/groin nodules, sinuses, scarring; greasy yellow tongue coat.
Principle: Clear damp-heat toxin, transform phlegm, invigorate blood.
Qi & Blood deficiency (chronic scarring stage) (Qì Xuè Liǎng Xū)
Long-standing sinus tracts, fatigue, poor healing.
Principle: Tonify qi and blood, promote tissue regeneration.
Wài Kē Zhèng Zōng discusses recurrent axillary yōng jū from damp-heat and phlegm-stasis.
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Cutaneous and oral lichen planus
Liver Qi Stagnation transforming to Fire (Gān Yù Huà Huǒ)
Violaceous flat-topped papules, intense itch, stress-triggered; wiry rapid pulse.
Principle: Soothe liver, clear fire, cool blood.
Yin deficiency with Blood Dryness (Yīn Xū Xuè Zào)
Chronic lesions, oral erosions, dry mouth, red peeled tongue.
Principle: Nourish yin, moisten and cool blood.
Zhū Bìng Yuán Hòu Lùn describes purple flat sores from stagnant heat obstructing collaterals.
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Keloid and hypertrophic scarring
Qi & Blood Stasis in the collaterals (Qì Zhì Xuè Yū)
Raised firm scar extending beyond wound margin, itch, tenderness.
Principle: Invigorate blood, break stasis, soften hardness.
Yī Zōng Jīn Jiàn: 'scars that rise and refuse to settle are stasis in the collaterals.'
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Pityriasis rosea (post-viral exanthem, HHV-6/7 linked)
Wind-Heat in Blood level (Xuè Rè Fēng Shèng)
Herald patch followed by scaly oval macules on trunk, mild itch, thin yellow tongue coat, floating-rapid pulse.
Principle: Cool blood, dispel wind, release exterior heat.
Damp-Heat with Blood Dryness (Shī Rè Xuè Zào)
Prolonged course, coarser scale, itch worse at night, red tongue with thin greasy coat.
Principle: Clear damp-heat, nourish and moisten blood.
Zhū Bìng Yuán Hòu Lùn describes wind-heat lodging in the ying-blood as scattered rose-coloured patches.
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Malassezia yeast overgrowth causing hypo- or hyperpigmented scaly patches
Damp-Heat with Wind in the skin (Shī Rè Jiā Fēng)
Fawn or pink scaly patches on chest, back and shoulders; worse in humid weather; slippery pulse.
Principle: Clear damp-heat, dispel wind, kill parasites topically.
Qi & Blood disharmony (hypopigmented residual) (Qì Xuè Shī Hé)
Pale patches remaining after clearance; pale-red tongue; thin pulse.
Principle: Regulate qi and blood, restore skin colour.
Wài Kē Dà Chéng lists Zǐ Bái Diàn Fēng under wind-damp disorders of the surface layer.
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Sarcoptes scabiei mite infestation
Wind-Damp with insect toxin (Fēng Shī Chóng Dú)
Intense night itch, burrows in finger webs, wrists, waistband; papules and excoriations; household contacts affected.
Principle: Kill parasites, dispel wind-damp, clear toxic heat.
Zhū Bìng Yuán Hòu Lùn attributes Jiè Chuāng to 'small insects burrowing between the skin division'.
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Chronic pruritic nodular disease (Hyde's prurigo)
Damp-Heat with Blood Stasis (Shī Rè Xuè Yū)
Firm hyperpigmented nodules on extensor limbs, dug-out excoriations, dusky base, wiry-slippery pulse.
Principle: Clear damp-heat, move blood, soften nodules.
Blood Deficiency with Wind (Xuè Xū Shēng Fēng)
Dry skin, pale nail beds, poor sleep, itch worse at night, thready pulse.
Principle: Nourish blood, moisten skin, extinguish wind.
Yī Zōng Jīn Jiàn describes Wán Shī Jù Jié as damp gathering into stubborn knots that itch relentlessly.
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Cold-induced inflammatory acral lesions
Cold congealing the channels with Blood Stasis (Hán Níng Xuè Yū)
Dusky-purple painful swellings on fingers, toes, ears after cold exposure; itch on rewarming; pale-purple tongue.
Principle: Warm channels, disperse cold, invigorate blood.
Yang Deficiency with Qi Stagnation (Yáng Xū Qì Zhì)
Cold hands and feet year-round, fatigue, pale tongue with white coat, deep-slow pulse.
Principle: Tonify yang, warm the middle, move qi to the extremities.
Wài Kē Dà Chéng: 'cold seizes the collaterals, blood congeals and swells into Dòng Chuāng.'
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Primary focal or generalised excessive sweating
Lung–Wei Qi Deficiency (spontaneous sweat) (Fèi Wèi Bù Gù)
Daytime sweating with slight exertion, easy colds, pale face, weak pulse.
Principle: Tonify Lung qi, consolidate the exterior.
Yin Deficiency with Empty Heat (night sweat) (Yīn Xū Nèi Rè)
Night sweats, five-centre heat, red tongue with little coat, thready-rapid pulse.
Principle: Nourish yin, clear deficient heat, secure the fluids.
Damp-Heat in the Liver channel (palmar/plantar/axillary) (Gān Jīng Shī Rè)
Sticky sweat on palms, soles, axillae; irritability; yellow greasy coat; wiry-slippery pulse.
Principle: Clear liver damp-heat, harmonise the channels.
Jǐng Yuè Quán Shū distinguishes zì hàn (spontaneous, qi-xu) from dào hàn (night, yin-xu).
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Immune-mediated targetoid eruption (HSV, mycoplasma, drugs)
Wind-Heat Toxin in Blood level (Fēng Rè Dú Shèng)
Sudden targetoid lesions on hands and forearms, fever, sore throat, red tongue with yellow coat, floating-rapid pulse.
Principle: Clear heat, resolve toxin, cool blood.
Cold-Damp with Blood Stasis (winter recurrences) (Hán Shī Xuè Yū)
Recurrent dusky targets on distal limbs in cold weather, purple tongue, deep-wiry pulse.
Principle: Warm channels, invigorate blood, resolve damp.
Wài Kē Zhèng Zōng documents Duō Xíng Hóng Bān as heat toxin surfacing in the blood division after wind attack.
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Chronic cutaneous lupus with scarring plaques
Yin Deficiency with Internal Heat (Yīn Xū Nèi Rè)
Photosensitive scaly plaques on face and scalp, five-centre heat, night sweats, red tongue with peeled coat.
Principle: Nourish yin, clear deficient heat, cool blood.
Blood-Heat with Toxin (Xuè Rè Dú Shèng)
Fresh red inflamed plaques, telangiectasia, wiry-rapid pulse.
Principle: Cool blood, resolve toxin, protect fluids.
Qi & Blood Stasis (scarring stage) (Qì Xuè Yū Zhì)
Atrophic scars, dyspigmentation, hair loss on scarred scalp; dusky-purple tongue.
Principle: Move blood, dissolve stasis, tonify substrate.
Traditional 'Hóng Hú Dié Chuāng' (red butterfly sore) is described in Ming–Qing dermatology as yin-deficient fire surfacing on the face.
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Refer immediately for: rapidly spreading rash with fever, mucosal involvement, suspected SJS/TEN, cellulitis, pustular psoriasis flare, ophthalmic zoster, anaphylaxis or angioedema with airway signs, or any pigmented lesion suspicious for melanoma (ABCDE criteria).
Avoid needling directly through active pustules, weeping lesions or infected skin. Bleeding techniques and cupping require intact clotting — screen anticoagulant use. Herbal prescribing must follow local scope (AHPRA / TGA in Australia) and avoid restricted substances such as Ephedra and Aconite.