TCM for Eczema, Acne and Psoriasis: Evidence

Basics from conventional care

• Eczema (atopic eczema) cannot be cured, but treatment can help manage symptoms; emollients are a core part of care. [3] The NHS lists signs that eczema is infected or has become eczema herpeticum, and says these may need antibiotics, so see a doctor. [3]
• Acne has many treatment options; a pharmacist can recommend products such as salicylic acid or benzoyl peroxide. [4]
• Psoriasis cannot be cured, but treatments help manage symptoms, and a GP can prescribe treatments or refer you to a dermatologist. [5]

See also eczema, acne and psoriasis.

How TCM describes skin conditions

TCM describes skin problems through ideas such as "heat", "dampness" and "blood" patterns, which are traditional frameworks, not diagnoses. Treatments include herbs taken by mouth, herbal washes and baths, creams, and sometimes acupuncture or cupping. The research below only tested those interventions.

Eczema

A Cochrane review of 28 trials (2,306 people) of Chinese herbal medicine (CHM) for atopic eczema judged most studies at high risk of bias with considerable inconsistency. [6] Pooled data from 2 placebo-controlled studies showed a higher "effectiveness rate" (relative risk 2.09) and lower itch scores with CHM, but the authors found no conclusive evidence that CHM by mouth or on the skin reduces eczema severity. [6] A 2023 meta-analysis of 20 trials of topical CHM found it appeared more effective than placebo or active controls, mainly in mild to moderate eczema, but heterogeneity was substantial. [7]

Label: insufficient evidence (Cochrane), promising but limited for topical use in mild to moderate disease. An earlier Cochrane review found small trials of a single mixture, Zemaphyte, that is no longer manufactured. [8]

Acne

A Cochrane review of complementary therapies for acne (35 studies, 3,227 people) concluded there was a lack of evidence to support herbal medicine, acupuncture or wet cupping for acne; low-quality evidence from single trials suggested a low-glycemic-load diet, tea tree oil and bee venom may reduce lesions. [9] It also noted a potential for adverse effects from herbal medicines. [9] Label: insufficient evidence. I found no more recent high-quality systematic review of Chinese herbs for acne that I could read.

Psoriasis

Added-on herbal baths are hard to blind and are usually compared with conventional treatment alone, so expectation effects cannot be excluded. Chinese herbal baths are described on Chinese herbal liniments, plasters, baths and soaks. No trial in these reviews supports stopping prescribed psoriasis treatment.