Author
Bowtie Team
Updated on
2025-08-11
Disclaimer: This article is translated with the assistance of AI.
Struggling with eczema? Traditional Chinese Medicine expert Dr. Choi Ka Lai from Bowtie & JP Health Center dives into its types, causes, treatments, and shares essential diet advice plus foods to avoid for better skin health.
Types of Eczema
Atopic Dermatitis
This often affects people with allergic tendencies, such as infants and children. Red, itchy rashes commonly appear on the face, hands, feet, and folds of the knees and elbows. The intense itching can lead to thickened, reddened skin, and scratching may cause infections.
Contact Dermatitis
This can be divided into irritant contact dermatitis and allergic contact dermatitis. The former occurs when skin contacts irritating substances, while the latter happens with allergens like cosmetics, paint, or dust mites.
Dyshidrotic Eczema
Commonly seen on fingers and toes, it comes with severe itching and blisters. After a few weeks, dryness and peeling occur, potentially leading to deep cracks. It often develops into chronic eczema with accompanying pain.
Nummular Eczema
Affected areas show coin-shaped round red patches, often on limbs or torso. The cause is unknown, more common in men, and can be triggered by cold, dry air or chemicals like formaldehyde.
Neurodermatitis
This involves habitual, localized itching, often on the scalp, sides of the neck, ears, wrists, back, ankles, or genitals. Before lesions form, unconscious scratching can thicken the skin, deepen fine lines, and lead to other infections.
Seborrheic Dermatitis
Often presents as increased dandruff. In infants, it can cover the entire scalp; in adults, it’s common around the eyebrows and sides of the nose. The area shows abundant flaky scales. It’s caused by overgrowth of Malassezia yeast, leading to rapid shedding of skin cells and inflammation.
Stasis Dermatitis
Common in patients with varicose veins, it causes local skin oozing, crusting in itchy areas, thickened skin, and eventual pigmented plaques over time.
Causes of Eczema
Eczema’s mechanism often stems from emotional distress, restlessness, or internal heat from the heart, leading to blood heat. It can also arise from exposure to wind, dampness, or heat pathogens that block the skin, or from poor diet causing spleen dysfunction, generating internal dampness that turns to heat and affects the skin. Parental history of eczema, consuming hot or spicy foods during pregnancy, or early childhood exposure to blood heat and wind can trigger it in infants and young children.
Internal Factors
- Allergic constitution, with parents having a history of eczema
- Dietary biases, gastrointestinal digestive disorders, allowing foreign proteins as allergens to enter the body
- High stress, excessive fatigue, or mental overstimulation
- Endocrine and metabolic disorders, such as progesterone autoimmune eczema or eczema-like rashes in diabetics
- Blood circulation issues, like varicose veins in the lower limbs easily triggering leg eczema
External Factors Causing Eczema
- Frequent contact with irritants, such as water, chemical cleaners, or dust
- Clothing with poor sweat-wicking or non-breathable materials irritating the skin
- Seasonal triggers, like hot, humid summers where sweat irritates skin, or dry winters causing excessive skin dryness
- Over-cleansing or grooming of skin, leading to facial eczema, while areas with less sebum like legs or arms show no red, itchy rashes
Eczema Locations and Health Insights
Wind Above, Dampness Below
Wind tends to rise upward and is changeable, often wandering unpredictably. If affected by wind pathogens, intense itching rashes commonly appear on the head, face, and upper limbs. Dampness is heavy and turbid, tending downward, with skin lesions often showing oozing fluids, non-red skin color, and frequently occurring on the lower limbs.
Four Bends Wind
Eczema occurring on the inner elbows and behind the knees is mainly due to constitutional intolerance, internal damp-heat accumulation, and wind-damp-heat pathogens invading the skin, blocking the meridians.
Hands
Housewife’s hand is a common form of contact dermatitis, caused by frequent hand washing, exposure to soap, detergent, soapy water, disinfectants, and chemicals, which damage the skin’s protective barrier, leading to moisture loss, dryness, and reduced resistance to external irritants, resulting in rashes.
Around the Eyes
Often caused by wind-dampness or spleen-stomach damp-heat, or from using eye care products and makeup that trigger allergies.
Trunk
Commonly seen with damp-heat, food or drug allergies.
Eczema’s clinical manifestations and locations vary, and in ancient times, it had different names based on these.
| Affected Areas | Ancient Disease Names |
| Back of the hand | Goosefoot sore |
| Lower leg | Damp shank sore |
| Head and face | Facial oily wind |
| Limb joint folds | Four bends wind |
| Ears | Whirling ear wind |
| Whole body | Soaking sore |
| Scrotum | Embroidered ball wind |
| Navel | Navel sore |
Traditional Chinese Medicine Treatments for Eczema
Taking Chinese Herbal Medicine
Through the four diagnostic methods and syndrome differentiation, treatments are tailored based on different etiologies, pathogenesis, and syndrome types. Various herbal formulas can be used to treat eczema. During flare-ups, the principle is to clear heat, cool the blood, dispel wind, promote diuresis, and relieve itching. In remission periods, the focus is on strengthening the spleen to dispel dampness, benefiting the lungs to consolidate the exterior, nourishing the blood, and dispelling wind. This helps reduce the severity of eczema itching, frequency of outbreaks, scope of affected areas, and chances of recurrence. It’s recommended to consult a registered Chinese medicine practitioner for further diagnosis and to clarify the etiology and pathogenesis. Below are common syndrome types for reference:
External Wind-Heat Invasion
Onset is rapid, mainly presenting as red papules spreading over the body, with unbearable itching. Scratching may cause bleeding, but exudation is minimal. Commonly seen in acute papular eczema and some subacute eczema. Treatment involves dispersing wind, cooling the blood, clearing heat, and removing dampness, using modified Xiao Feng San.
Damp-Heat
Sudden onset with bright red, itchy rashes and significant exudation, possibly forming scabs, yellow crusts, or erosions. Stools are dry and hard, urine is yellow or red. Often seen in acute eczema or acute flare-ups of chronic eczema. Treatment focuses on clearing heat, promoting diuresis, dispelling wind, and relieving itching, using modified Si Miao San.
Spleen Deficiency Generating Dampness
Skin lesions are dull and not red, with minimal and clear exudation; may include yellow scales or mainly plaques with oozing. Complexion is pale, appetite is poor, stools are loose, or there may be abdominal distension. Corresponds to some subacute eczema. Treatment involves strengthening the spleen, transforming dampness, dispelling wind, and relieving itching, using modified Shen Ling Bai Zhu San.
Blood Deficiency with Wind-Dryness: Long-standing condition with infiltrated, thickened, and chronic skin lesions, accompanied by pigmentation. It waxes and wanes, with dry scaling and minimal dry exudation. May include dry mouth and throat, irritability, dizziness, insomnia, and dry stools. Treatment focuses on nourishing blood and yin, relieving itching, and dispelling wind, using modified Dang Gui Yin Zi.
Chinese Herbal Ointments
Zi Yun Gao
Basic ingredients include lithospermum, angelica, and sesame oil. Shikonin and its derivatives in lithospermum have antimicrobial effects, providing bactericidal and bacteriostatic benefits for skin wounds, promoting granulation tissue formation. Sesame oil is now often replaced with shea butter to moisturize the skin.
Indications: Minor burns, frostbite, hemorrhoids, small wounds, eczema, mild bacterial infections, mild fungal infections. Use with caution in G6PD patients.
San Huang Gao
San Huang refers to scutellaria, coptis, and phellodendron, used to clear heat, detoxify, and reduce swelling.
Indications: Eczema, heat sores with swelling and pain, small wounds. Use with caution in G6PD patients.
Herbal Baths
Use 30g each of dictamni cortex, kochia fruit, sophora root, and schizonepeta. Wash the herbs, wrap in gauze or a fishnet bag, boil for 1 hour, add to bath water. When the water temperature reaches 40°C, soak for 20 minutes.
External Herbal Application
Grind equal parts of adzuki beans and schizonepeta spikes into powder, mix with egg white, and apply externally to the affected area. (From Ben Cao Gang Mu)
TCM Dietary Therapy and Suggestions
Foods to Avoid
Avoid seafood triggers like shrimp, crab, scallops, razor clams, clams, and raw oysters. Also, minimize or avoid hot and warming foods such as beef, lamb, and other red meats. Fruits with damp-heat properties like durian, mango, and pineapple should be eaten sparingly. High-histamine foods including alcohol, smoked meats, bacon, ham, sausages, peanuts, nuts, pickled vegetables, cheese, and refined sugars should also be avoided.
Dietary Recommendations
Opt for foods that strengthen the spleen and stomach, clear heat, dispel dampness, and detoxify as part of dietary therapy.
Mung Beans
Sweet in taste, cold in nature, non-toxic, enters the heart and stomach meridians. Can clear heat, relieve summer-heat, promote diuresis, reduce swelling, improve vision, and lower blood pressure. Effective against various sores caused by heat toxins.
Adzuki Beans
Sweet and sour in taste, neutral, enters the heart and small intestine meridians. Promotes diuresis to reduce swelling, detoxifies, and drains pus. Commonly used for edema, beriberi swelling, jaundice with red urine, rheumatic heat arthralgia, carbuncles, sores, and intestinal abscesses with abdominal pain.
Coix Seeds
Sweet and bland in taste, slightly cold, enters the spleen, stomach, and lung meridians. Promotes diuresis and percolation of dampness, strengthens the spleen to relieve arthralgia, clears heat, and drains pus. Modern pharmacology shows coix seeds promote water metabolism in the body, with anti-inflammatory and analgesic effects. Rich in vitamin B complex and vitamin E, they have antioxidant properties, delay aging, and make the skin glossy and smooth.
Soup Recommendations
Spleen-Strengthening Dampness-Dispelling Soup
Ingredients: 30g imperata rhizome, 10g poria, 10g tangerine peel, 20g white hyacinth beans, 20g fresh dioscorea, 30g smilax, 250g lean pork
Preparation: Peel and cut fresh dioscorea into segments, soak tangerine peel to soften and remove pith, blanch lean pork. Place all ingredients in a pot, add 800ml water to make soup. Bring to a boil, then simmer on low heat for 1 hour. Season with salt to taste and consume at a comfortable temperature.
Eczema Care Tips
Keep Skin Moisturized
Areas affected by eczema should be kept well-hydrated. Common options include petroleum jelly. Recent medical research shows that skincare creams containing ceramides can help alleviate dryness in eczema patients.
Choose the Right Shower Gel
Opt for simple ingredients, avoiding excessive fragrances or perfumes. Low-allergen soaps are ideal, such as comfrey soap, baby bath soap, or honey soap.
Five Steps to Relieve Eczema Itch
- Avoid scratching; if itchy, gently pat the area or distract yourself.
- Clean the itchy spot with saline solution (keep it refrigerated for convenience).
- Pat dry.
- Apply moisturizer.
- If there are cracks, use petroleum jelly to aid healing.
Can Eczema Be Cured? TCM Insights
Eczema is an autoimmune issue and generally doesn’t disappear completely. The skin barrier dysfunction makes one more sensitive to external irritants. However, through Western and Chinese medicine treatments, exercise, dietary attention, and identifying allergens, along with herbal medicine, acupuncture, and topical creams, you can effectively reduce the scope, frequency, and itchiness of outbreaks, minimizing the overall impact.
What to Do If Eczema Causes Oozing or Blisters?
First, disinfect the area with saline solution. Do not pop blisters yourself, and apply a moisturizing gel. Check if stress or poor diet is a factor; opt for light meals to restore immune balance. Consult a Western or Chinese medicine doctor for further treatment.
Special Care for Baby Eczema?
Babies have delicate, thin skin with underdeveloped protective layers, making them prone to moisture loss. Eczema often appears on cheeks, around ears, forehead, elbows, knees, and other dry or friction-prone areas. Common types include seborrheic dermatitis and diaper rash.
- For diaper rash, keep the baby’s bottom dry; clean with tissues and apply a thin layer of moisturizer.
- Prioritize moisturizing with appropriate creams and products. Textures like lotions, creams, or gels suit different seasons, areas, or severity. For eyelid eczema, avoid heavy petroleum jelly; opt for creams. In winter, gels may not hydrate enough—choose creams, lotions, or oil-based products.
- Hot water worsens itching, so use lukewarm water for baths.
- For severe atopic eczema, use bath oils; the residual oil moisturizes. Do this 2-3 times a week.
Does Petroleum Jelly or Ointment Help Eczema?
They provide moisturizing benefits and reduce itching. Depending on the condition: In acute phases with wetness, oily ointments may be less effective—clean with saline instead. Chronic eczema with lichen-like patches responds well to oily ointments. For cracks, petroleum jelly aids healing.
Can Essential Oils Ease Eczema Symptoms?
Essential oils are aromatic molecules extracted from plants. High exposure can cause allergies like redness, swelling, or blisters. Do a patch test first to avoid worsening itchiness. Consult professionals for dilution. Children, pregnant women, those with high blood pressure, kidney issues, cancer, or epilepsy should use caution. Avoid applying to broken skin.
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