CLINICAL APPLICATIONS

* Any skin conditions that appear red and dry, and may be flaky or scaly with underlying damage and atrophy of the skin

* Skin conditions considered as dry, such as dermatitis, eczema, urticaria, hives, rash, and allergic rash caused by skin irritants such as detergents or other chemicals

 

WESTERN THERAPEUTIC ACTIONS

* Antiallergic effect to relieve allergy

* Antipruritic function to relieve itching

* Anti-inflammatory activities to reduce skin swelling and inflammation

* Antibiotic effect to treat skin infection

* Antitoxin and antidote effects to neutralize and antagonize chemicals, allergens, and toxins

 

CHINESE THERAPEUTIC ACTIONS

* Clears heat, moistens dryness, eliminates toxins

* Dispels wind, relieves itching

* Strengthens the Spleen, dispels dampness

 

DOSAGE

Take 3 to 4 capsules three times daily. Dosage can be increased up to 6 to 8 capsules three times daily in acute cases. This formula should not be taken for more than two months continuously.

 

INGREDIENTS

Bai Shao (Radix Paeoniae Alba)

Cang Zhu (Rhizoma Atractylodis)

Chai Hu (Radix Bupleuri)

Chan Tui (Periostracum Cicadae)

Che Qian Zi (Semen Plantaginis)

Chi Shao (Radix Paeoniae Rubra)

Chuan Mu Tong (Caulis Clematidis Armandii)

Chuan Xiong (Rhizoma Chuanxiong)

Dang Gui (Radix Angelicae Sinensis)

Di Huang (Radix Rehmanniae)

Fang Feng (Radix Saposhnikoviae)

Fu Ling (Poria)

Gan Cao (Radix et Rhizoma Glycyrrhizae)

Geng Mi (Semen Oryzae)

Hei Zhi Ma (Semen Sesami Nigrum)

Huang Bo (Cortex Phellodendri Chinensis)

Huang Lian (Rhizoma Coptidis)

Huang Qin (Radix Scutellariae)

Jing Jie (Herba Schizonepetae)

Ku Shen (Radix Sophorae Flavescentis)

Lian Qiao (Fructus Forsythiae)

Long Dan (Radix et Rhizoma Gentianae)

Mu Dan Pi (Cortex Moutan)

Niu Bang Zi (Fructus Arctii)

Shan Yao (Rhizoma Dioscoreae)

Shan Zhu Yu (Fructus Corni)

Shi Gao (Gypsum Fibrosum)

Shu Di Huang (Radix Rehmanniae Praeparata)

Tian Hua Fen (Radix Trichosanthis)

Yi Yi Ren (Semen Coicis)

Ze Xie (Rhizoma Alismatis)

Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle)

Zhi Mu (Rhizoma Anemarrhenae)

Zhi Zi (Fructus Gardeniae)

 

BACKGROUND

The skin is the largest organ in the body, and it functions as a protective barrier that keeps undesirable substances from entering. Because the skin is the physical barrier that separates the exterior from the interior, skin health can be affected by factors from both the outside and the inside. External factors that affect the skin include infection (bacteria, virus, and parasites), external exposure to allergens (poison ivy, poison oak, chemicals used in cosmetics or cleaning agents, and drugs used in skin creams), insect bites (spiders and ticks), or trauma. Internal factors that affect the skin include inhalation of allergens (dust, pollen, and dander), ingestion of allergens (peanuts, nuts, fish, wheat, eggs, and milk), intake of certain drugs (penicillin, sulfa drugs, aspirin, and opioids), autoimmune diseases (systemic lupus erythematosus, Sjögren¡¦s syndrome, and psoriasis), and emotional or physical imbalance (stress and anxiety).

        Although there are multiple and complicated causes of skin disorders, the clinical manifestations are relatively simple and straight forward: most skin disorders have either wet or dry characteristics. Optimal treatment requires the use of medicinal substances to treat both the cause and the symptoms.

        Skin disorders with damp/wet characteristics may have open lesions with infection, inflammation, ulceration, pus and abscesses; and they often affect areas with excessive moisture, such as toes, buttocks, armpits, groin, and under the breast. Examples of skin disorders with damp/wet characteristics include skin infection, skin ulcers, exudative skin lesions, sores, abscesses, carbuncles, furuncles, cellulitis, seborrheic dermatitis, and acne vulgaris.

        Skin disorders with dry characteristics often appear to be dry, red, flaky, and scaly with underlying damages to and atrophy of the skin. Examples of skin disorders with dry characteristics include psoriasis, atopic dermatitis, urticaria, rosacea, warts, tinea versicolor, erysipelas, and eczema.

 

FORMULA EXPLANATION

In most cases, acute dermatological disorders are generally due to wind and/or heat invasion, which is generally associated with physical contact or oral ingestion of allergen(s). On the other hand, chronic dermatological conditions involve the accumulation of dampness in the body as well as dryness resulting from fire and toxin drying out the yin in the body for a prolonged period of time. Dermatrol (Dry) is formulated with four groups of herbs to address both acute and chronic cases of skin disorders with dry lesions.

        The first group of herbs aims to relieve itching by releasing exterior wind: Chai Hu (Radix Bupleuri), Chan Tui (Periostracum Cicadae), Fang Feng (Radix Saposhnikoviae), Jing Jie (Herba Schizonepetae) and Chuan Xiong (Rhizoma Chuanxiong). These herbs have antihistamine effect to treat allergy, and antipruritic effect to relieve itching.

        The second group of herbs clears heat and eliminates toxins to address localized inflammation and infection: Chi Shao (Radix Paeoniae Rubra), Chuan Mu Tong (Caulis Clematidis Armandii), Huang Bo (Cortex Phellodendri Chinensis), Huang Lian (Rhizoma Coptidis), Huang Qin (Radix Scutellariae), Ku Shen (Radix Sophorae Flavescentis), Lian Qiao (Fructus Forsythiae), Long Dan (Radix et Rhizoma Gentianae), Mu Dan Pi (Cortex Moutan), Niu Bang Zi (Fructus Arctii), Shi Gao (Gypsum Fibrosum), Tian Hua Fen (Radix Trichosanthis), Zhi Mu (Rhizoma Anemarrhenae), and Zhi Zi (Fructus Gardeniae). These herbs clear heat and eliminate toxins throughout the entire body, including upper, middle, and lower jiaos. Furthermore, Zhi Mu (Rhizoma Anemarrhenae) and Tian Hua Fen (Radix Trichosanthis) both effectively moisten and purge fire to address the dry nature of the lesions. These herbs have antibiotic function to treat skin infection, and an anti-inflammatory function to reduce skin swelling and inflammation.

        Furthermore, despite the dry appearance of the rash, almost all patients suffering from dermatological disorders have some form of dampness inside. Therefore, the third group of herbs is used to strengthen the Spleen and drain dampness: Cang Zhu (Rhizoma Atractylodis), Fu Ling (Poria), Yi Yi Ren (Semen Coicis), Che Qian Zi (Semen Plantaginis), and Ze Xie (Rhizoma Alismatis). These herbs have diuretic and anti-inflammatory activities to reduce skin swelling and water retention.

        Finally, the fourth group of herbs aims to tonify blood and nourish yin, which addresses the underlying causes of chronic, non-healing rashes, sores, and dermatological problems. Blood deficiency leads to malnourishment of the skin, characterized by dryness, coarseness, lack of moisture, and lack of skin tone. With the dry nature of the skin condition, blood must be tonified. Also with abundant blood, wind cannot rise to cause further itching. This group of herbs tonifies yin and nourishes blood to prevent heat from flaring up causing the symptoms to become worse. Herbs in this group include Bai Shao (Radix Paeoniae Alba), Dang Gui (Radix Angelicae Sinensis), Di Huang (Radix Rehmanniae), Geng Mi (Semen Oryzae), Hei Zhi Ma (Semen Sesami Nigrum), Shan Yao (Rhizoma Dioscoreae), Shan Zhu Yu (Fructus Corni) and Shu Di Huang (Radix Rehmanniae Praeparata). Gan Cao (Radix et Rhizoma Glycyrrhizae) and Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle) harmonize the formula. As these herbs strengthen the underlying body constitution, they also regulate and balance the endocrine system, and in turn, facilitate the release of endogenous corticosteroids to reduce swelling and inflammation.

        In summary, Dermatrol (Dry) is an excellent formula to treat dry skin disorders by using herbs that moisten dryness, clear heat and eliminate toxins, and dispel wind and relieve itching.

 

CAUTIONS & CONTRAINDICATIONS

* This formula is contraindicated in patients with cold or deficiency cold signs.

* This formula is contraindicated during pregnancy and nursing.

* In addition to external factors (dry skin, atopic dermatitis, contact dermatitis, infections) or internal factors (allergic reactions through ingestion or inhalation), skin disorders may be caused by conditions such as cholestasis, chronic renal failure, hyper- or hypothyroidism, diabetes, iron deficiency, and polycythemia vera. Optimal treatment requires these conditions to be ruled out, or confirmed and treated.

* This formula is contraindicated for long-term use. Identification and elimination of the cause is the best long-term solution. When symptoms clear up, re-evaluate the condition and prescribe some other formulas to address the underlying cause of the skin condition. Many times the patient may have another attack and it is usually due to poor dietary habit, so it is essential to ask the patient to be extremely careful with what they eat in order to prevent future break outs.

* This herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.

 

CLINICAL NOTES

* Yin Care, a topical herbal solution, may be applied topically to help relieve itching. Also, toothpaste may also be applied topically to relieve temporary itching.

* This formula is designed by Dr. Jimmy Wei-Yen Chang and has worked effectively for over 90% of his patients who suffer from various dermatological conditions with dry, red lesions. However, it is not to be used for long term as the heat clearing effect may damage the Spleen and Stomach. After the symptoms/signs improve or are alleviated, one must find the underlying cause and treat it so the lesions do not return. Taking the herbs at a large dosage or for a prolonged period of time may not be necessary as the triggering factors are either due to exposure to allergen or improper diet and lifestyle. Please refer to Nutrition and Lifestyle Instructions sections to help maintain a healthy constitution and clear skin.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Dry skin lesions due to dryness and heat in the Lung and Large Intestine: floating and forceful pulse on the right cun.

 

SUPPLEMENTARY FORMULAS

* For severe itching, add Silerex.

* With additional signs of fire manifesting in red eyes, red tongue, anger and/or constipation, addGardenia Complex and Gentle Lax (Excess).

* In chronic dermatological conditions where the surrounding skin of the lesions appears purple and the tongue is purple, add Circulation (SJ).

* To enhance the overall antibacterial function, add Herbal ABX.

* To enhance the overall antiviral function, add Herbal AVR.

* For severe inflammation, add Astringent Complex.

* With more yin and fluid deficiencies, add Nourish or Nourish (Fluids).

* Due to exposure to chemicals such as paint, nail polish, glue, drugs, pain killers, bleach, aerosol, new house syndrome, etc., add Herbal DTX.

* For low immune system, wei (defensive) qi deficiency, or chronic overall deficient patients with inability to heal lesions/wounds, add a high dose of Immune +.

* For skin condition associated with stress, add Calm.

 

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Quchi (LI 11), Xuehai (SP 10), Hegu (LI 4), Sanyinjiao (SP 6), Fengchi (GB 20), Dazhui (GV 14), Fengmen (BL 12), Fengshi (GB 31), Jianyu (LI 15), Zusanli (ST 36)

 

Classic Master Tung's Points:

* Eczema: Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Linggu (T 22.05), Minghuang (T 88.12), Tianhuang (T 88.13), Qihuang (T 88.14), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Jinqianshang (T 88.24), Jinqianxia (T 88.23)

* Atopic dermatitis: Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Linggu (T 22.05), Zhisima (T 11.07)

* Herpes zoster: Linggu (T 22.05), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Shuitong (T 1010.19), Shuijin (T 1010.20)

* Tinea versicolor: Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Simashang (T 88.18), Simaxia (T 88.19), Simazhong (T 88.17), Shuijin (T 1010.20), Shuitong (T 1010.19). Bleed the LR area T5 ¡V T9 and KI area T9 ¡V T12 on the back with cupping. Bleed before needling for best result.

* Hives: Simashang (T 88.18), Simaxia (T 88.19), Simazhong (T 88.17), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Zhisima (T 11.07)

 

Master Tung¡¦s Points by Dr. Chuan-Min Wang:

* Dry, flaky lesions: Simazhong (T 88.17), Simashang (T 88.18), Simaxia (T 88.19)

 

Balance Method by Dr. Richard Tan:

* Right side: Sanjian (LI 3), Quchi (LI 11), Houxi (SI 3), Xiaohai (SI 8), Taibai (SP 3), Yinlingquan (SP 9), Taichong (LR 3), Ququan (LR 8)

* Left side: Chize (LU 5), Taiyuan (LU 9), Zusanli (ST 36), Xiangu (ST 43)

* Alternate sides from treatment to treatment.

 

Ear Acupuncture:

* Ah shi points, Endocrine, Subcortex, Lung, Shenmen, Sympathetic

 

Auricular Medicine by Dr. Li-Chun Huang:

* Rash and itching: Allergy Area, Shenmen, Sympathetic, Occiput, Nervous Subcortex, Lung, Diaphragm, Spleen, Liver. Bleed Ear Apex.

* Contact dermatitis: Allergic Area, Sympathetic, Adrenal Gland, Liver, Spleen, Lung, Endocrine, corresponding points (to the area affected). Bleed Ear Apex.

¡± For dermatitis with severe pain, add Shenmen and Occiput.

* Eczema: Allergic Area, Lung, Sympathetic, Spleen, Shenmen, Endocrine, Occiput, Diaphragm, corresponding points (to the area affected). Bleed Ear Apex.

* Cutaneous pruritis: Shenmen, Occiput, Liver, Spleen, Lung, Endocrine, Diaphragm, Allergic Area. Bleed Ear Apex.

* Urticaria: Liver, Lung, Spleen, Diaphragm, Shenmen, Occiput, Allergic Area, Sympathetic, Endocrine, Adrenal Gland. Bleed Ear Apex.

* Severe itching: Prick five times on the ear apex, five times each on the helix near the Great Auricular Nerve and Lesser Occipital Nerve.

 

Taoist Ear Points by Jun-Qing Luo:

* Bleed the back of the ear for any visible veins. This is very effective for relieving itching and treatment of any dermatological disorders.

 

NUTRITION

* According to the five elements theory, the Spleen (earth element) generates the Lung (metal element). In order to be free of any skin condition, which is governed by the Lung (metal element), the Spleen (earth element) must be free from damaging foods. Consumption of damaging foods, such as ones listed below, will worsen the patient¡¦s condition and possibly make herbal treatment less or ineffective.

¡± Seafood: especially shellfish, like crabs, oyster, scallops, clams, lobster, and shrimp (they enter the yangming Stomach channel).

¡± Fermented foods: cheese or fermented tofu.

¡± Dairy: milk, cream, yogurt, cheese, and ice cream.

¡± Sugar: any and all foods containing sugar, such as cake and dessert.

¡± Meat: lamb, beef, goose, and duck.

¡± Deep-fried or greasy food.

¡± Certain fruits: mango and durian.

¡± Stimulants: coffee, alcohol, and energy drinks.

¡± Carbohydrates: white rice or bread as they may damage the Spleen and in turn produce more dampness.

¡± Spicy, pungent, aromatic vegetables: pepper, garlic, onions, basil, rosemary, cumin, fennel, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili pepper, and wasabi.

* If the patient is allergic to any food or feels uncomfortable after eating certain foods, then it is best to avoid eating it.

 

The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Increase consumption of Chinese prunes, guava skins, pearl barley, vinegar, garlic, walnuts, cucumber, beet tops, dandelion greens, squash, and mung beans.

* Take fifteen peeled and sliced water chestnuts and one cup of vinegar, slowly simmer in a non-metal pot for 20 minutes until the water chestnuts absorb most of the vinegar. Then mash into a paste and seal in a jar. Spread evenly on a gauze pad and apply to affected area, changing daily if not too serious, three times daily if serious. Mild cases should show improvement within five days.

* Apply mashed garlic to affected area, changing twice daily for one week.

 

LIFESTYLE INSTRUCTIONS

* To properly restore the immune function, the patient is advised to sleep by 10:00 p.m. so they may enter deep sleep by 1:00 a.m. (Liver time according to the Chinese Anatomical Clock) to fully rest the Liver to restore its detoxification functions.

* Avoid being overly tired from working or stress whenever possible.

* Do not scratch or irritate lesions as it might lead to scar formation and further infection.

* Proper skin care is important for treatment of skin conditions. Use cool or lukewarm water when bathing, mild or moisturizing soap, limited bathing duration and frequency, and avoid tight or irritating clothing.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Skin disorders with dry characteristics, such as psoriasis, atopic dermatitis and urticaria, often appear to be dry, red, flaky, and scaly. Skin disorders with dry characteristics are usually characterized by underlying damages to and atrophy of the skin, caused by external (infection, direct contact, trauma) or internal (ingestion or inhalation of allergens, autoimmune diseases, emotional or physical imbalance) factors. Optimal treatment requires the use of medicinal substances to treat both the cause and the symptoms. Dermatrol (Dry) contains herbs with multiple pharmacological effects, including but not limited to antiallergic, antipruritic, anti-inflammatory, antibiotic, antitoxin and antidotal.

        Dermatrol (Dry) contains many herbs with direct and general effects to treat skin disorders. Jing Jie (Herba Schizonepetae) has a general effect on the skin, and has been used successfully to treat dermatological disorders, such as measles, pruritic rash and itching.[1] Chan Tui (Periostracum Cicadae) has been used effectively to treat chronic urticaria.[2] Dang Gui (Radix Angelicae Sinensis) has an antipimple and an antieczema effect exerted through the regulation of nuclear factor kappa B, maleic dialdehyde (MDA), polymorphonuclear cells, interleukin-1£], inducible nitric oxide synthase, and tumor necrosis factor-£\.[3] Di Huang (Radix Rehmanniae) has been used with good success to treat rashes, urticaria and contact dermatitis.[4] Lastly, Ku Shen (Radix Sophorae Flavescentis) has been used with a 79% effective rate in 148 patients to treat dermatological disorders, such as rashes, itching, and eczema.[5]

        Dermatrol (Dry) utilizes many herbs with antiallergic and antipruritic effects to treat various skin disorders. Ku Shen (Radix Sophorae Flavescentis) has both antipruritic and antiallergic effects, and is one of the best herbs to treat skin disorders. According to a study in subjects with artificially-induced dermatitis, the extract from Ku Shen (Radix Sophorae Flavescentis) shows an antipruritic effect to inhibit scratching in a dose-dependent manner.[6] The antipruritic effect is attributed in part to its effect to reduce several eicosanoid-related skin inflammation, such as atopic dermatitis.[7] Furthermore, topical application of Ku Shen (Radix Sophorae Flavescentis) has been shown to treat artificially-induced contact dermatitis through inhibition against recruitment and degranulation of mast cells.[8] Huang Qin (Radix Scutellariae) has a remarkable effect as an antiallergic agent. It inhibits histamine and leukotriene release from mast cells with greater potency than Intal (cromolyn), a drug that prevents the release of inflammatory chemicals such as histamine from mast cells.[9] Furthermore, Huang Qin (Radix Scutellariae) also inhibits the passive cutaneous anaphylaxis reaction through its downregulation of the expression of various inflammatory mediators.[10] Shu Di Huang (Radix Rehmanniae Praeparata) has been shown to inhibit systemic allergic reactions in a dose-dependent manner through the inhibition of histamine release from the peritoneal mast cells and significant suppression of tumor necrosis factor-alpha (TNF-£\) production.[11] Topical application of an extract from Di Huang (Radix Rehmanniae) and Shu Di Huang (Radix Rehmanniae Praeparata) shows marked anti-inflammatory and antiallergic activities to treat atopic dermatitis by suppressing the expression of cytokines, chemokines, and adhesion molecules.[12] Niu Bang Zi (Fructus Arctii) has a significant antiallergic effect to reduce the release of inflammatory mediators through inhibition of degranulation and cys-leukotriene release.[13] It effectively treats allergic diseases, including atopic dermatitis, by inhibiting the expression of IL-4 and IL-5.[14] Furthermore, Zhi Mu (Rhizoma Anemarrhenae) has a strong antiallergic effect, and can be used to inhibit the passive cutaneous anaphylaxis reaction induced by the antigen-immunoglobulin E (IgE) complex.[15] Lastly, Jing Jie (Herba Schizonepetae) and Lian Qiao (Fructus Forsythiae) have an antipruritic effect to inhibit itch-scratch response induced by substance P.[16]

        Dermatrol (Dry) incorporates many herbs with anti-inflammatory effects to treat inflammatory skin disorders. Huang Qin (Radix Scutellariae), Huang Lian (Rhizoma Coptidis), and Huang Bo (Cortex Phellodendri Chinensis) all have anti-inflammatory activities, and may be used to treat different skin disorders.[17] Fu Ling (Poria) and Lian Qiao (Fructus Forsythiae) are two herbs with beneficial effects to treat skin diseases involving chronic inflammation. These two herbs have inhibitory effects on lipoxygenase, cyclo-oxygenase, and elastase activities, which are therapeutic targets in dermatological disorders.[18] Chai Hu (Radix Bupleuri) reduces inflammation by decreasing capillary permeability caused by histamine and 5-hydroxy-tryptamine.[19] Glycyrrhizin and glycyrrhetinic acid, two compounds from Gan Cao (Radix et Rhizoma Glycyrrhizae), have demonstrated marked anti-inflammatory effects by enhancing the overall duration of effect of cortisone. There are two proposed mechanisms of actions: they may enhance cortisone¡¦s effect by decreasing liver metabolism, or they may increase plasma concentration by affecting protein binding.[20] The anti-inflammatory influence of glycyrrhizin and glycyrrhetinic acid is approximately 1/10^th that of cortisone.[21] Lastly, other herbs with anti-inflammatory effects include Dang Gui (Radix Angelicae Sinensis), [22] Di Huang (Radix Rehmanniae),[23] Jing Jie (Herba Schizonepetae),[24] Fang Feng (Radix Saposhnikoviae),[25] Mu Dan Pi (Cortex Moutan),[26] Niu Bang Zi (Fructus Arctii),[27] Shan Yao (Rhizoma Dioscoreae),[28] Shan Zhu Yu (Fructus Corni),[29] Zhi Mu (Rhizoma Anemarrhenae),[30] and Zhi Zi (Fructus Gardeniae).[31]

        Dermatrol (Dry) utilizes many herbs with antibiotic effects to treat skin infections. Herbs with antibacterial effect include Huang Bo (Cortex Phellodendri Chinensis),[32]^,[33] Huang Lian (Rhizoma Coptidis),[34] Huang Qin (Radix Scutellariae),[35]^,[36] Ku Shen (Radix Sophorae Flavescentis),[37]^,[38] Tian Hua Fen (Radix Trichosanthis),[39]^,[40] Jing Jie (Herba Schizonepetae),[41] Lian Qiao (Fructus Forsythiae),[42] Long Dan (Radix et Rhizoma Gentianae),[43] Mu Dan Pi (Cortex Moutan),[44] Zhi Zi (Fructus Gardeniae),[45] and Zhi Mu (Rhizoma Anemarrhenae).[46]^,[47] Herbs with antiviral effect include Huang Lian (Rhizoma Coptidis),[48]^,[49]^,[50] Huang Bo (Cortex Phellodendri Chinensis),[51] Huang Qin (Radix Scutellariae), [52] Ku Shen (Radix Sophorae Flavescentis),[53]^,[54] Chai Hu (Radix Bupleuri),[55] Che Qian Zi (Semen Plantaginis),[56] Fang Feng (Radix Saposhnikoviae),[57] Lian Qiao (Fructus Forsythiae),[58] Long Dan (Radix et Rhizoma Gentianae),[59] Tian Hua Fen (Radix Trichosanthis),[60]^,[61] and Zhi Mu (Rhizoma Anemarrhenae).[62] Herbs with antifungal effect include Huang Lian (Rhizoma Coptidis),[63] Huang Qin (Radix Scutellariae),[64] Niu Bang Zi (Fructus Arctii),[65] Zhi Zi (Fructus Gardeniae),[66] and Zhi Mu (Rhizoma Anemarrhenae).[67] Lastly, Ku Shen (Radix Sophorae Flavescentis) also has antiparasitic,[68] antiprotozoal,[69] and antimalarial effects.[70]

        Lastly, in today¡¦s industrialized world, many cases of skin disorders are directly associated with exposure to certain allergens, chemicals, and toxins. Therefore, Gan Cao (Radix et Rhizoma Glycyrrhizae) and Fang Feng (Radix Saposhnikoviae) are used as they have antitoxin and antidotal effects to treat skin disorders caused by exposure to certain toxins and chemicals. Glycyrrhizin, generally considered to be one of the main constituents of Gan Cao (Radix et Rhizoma Glycyrrhizae), has a marked detoxifying effect to treat poisoning, including but not limited to drug poisoning (chloral hydrate, urethane, cocaine, picrotoxin, caffeine, pilocarpine, nicotine, barbiturates, mercury, and lead), food poisoning (tetrodotoxin, snake and mushrooms), and others (enterotoxin, herbicides and pesticides).[71] Furthermore, the use of Gan Cao (Radix et Rhizoma Glycyrrhizae), Fang Feng (Radix Saposhnikoviae), and Lu Dou (Semen Phaseoli Radiati) has been shown to be an effective antidote for arsenic poisoning.[72]

        In summary, Dermatrol (Dry) is a great formula to treat various skin disorders with dry appearance. It contains herbs with antiallergic and antipruritic effects to treat symptoms of itching and irritation. It utilizes herbs with anti-inflammatory effects to reduce swelling and inflammation. It incorporates herbs with antibiotic effects to treat skin infections. Finally, it incorporates herbs with antitoxin and antidotal activities to treat skin disorders caused by exposure to certain toxins and chemicals.

 

COMPARATIVE ANALYSIS

Though there are many skin disorders with different causes and clinical manifestations, most skin disorders are treated with antibiotics, antihistamines, and anti-inflammatory drugs. Antibiotic substances (antibacterial, antiviral, and antifungal) are effective treatment options for skin infection caused by bacteria, virus, and/or fungus. Antibiotics can be ingested orally or applied topically. Since skin disorders are often accompanied by itching, antihistamines are often used to block allergic reactions and to relieve itching through their sedative effects. For more severe cases of skin inflammatory disorders, topical or oral corticosteroids are used to reduce swelling and inflammation. In addition to these three main categories of drugs, moisturizing agents or drying agents are prescribed to treat dry and wet skin conditions, respectively. Moisturizing agents, such as creams or lotions with oil, put a thin film of oil on the skin and help the skin hold on to its natural moisture. Drying agents, such as talcum powder or aluminum salts, help to dry up excessive moisture and minimize infections in areas such as toes, buttocks, armpits and/or groins.

        In TCM, successful treatment of skin disorders requires the use of herbs to treat wind-heat at the exterior and toxic heat in the interior. Herbs that dispel wind-heat from the exterior generally have antihistamine and antipruritic effects, and are great to treat symptoms of itching and irritation. Herbs that clear toxic heat from the interior generally have an antibiotic effect to treat the infection and an anti-inflammatory function to reduce swelling and inflammation. Overall, herbs are a safe and effective option to treat skin disorders, without the harsh side effects and adverse reactions of drugs.

        Drugs and herbs are both effective to treat skin disorders, and each has its inherent advantages and disadvantages. For skin disorders characterized by acute, severe or isolated incidence, such as exposure to poison oak, insect bite, and severe allergic or anaphylactic reactions, drugs are more effective as they are more potent and have a faster onset of action. Furthermore, such conditions are often treated aggressively but only for a short period of time, and therefore, side effects and adverse reactions of drugs can be managed and are not likely to create long-term problems. In contrast, skin disorders characterized by chronic and persistent nature, such as chronic idiopathic dermatitis or urticaria, will respond favorably to herbs. Finally, though drugs and herbs are both effective to symptomatically treat skin disorders characterized by allergic reactions, the only cure is to identify the allergen(s) and avoid any exposure to it if at all possible.