Literature Review of Traditional Chinese Medicine Dermatology in the Treatment of Eczema/Atopic Dermatitis

Introduction

According to Guo (2014), Traditional Chinese Medicine (TCM) plays a critical part in the treatment of a range of skin disorders by reducing the dryness and itchiness effect experienced by people suffering from eczema.Eczema refers to a set of medical conditions that impair the skin leaving it irritated or inflamed(Qin et al., 2014). Atopic eczema, also called atopic dermatitis, is medically recognized as the most common form of eczema affecting a large group of individuals all over the world. This type of eczema includes a combination of different diseases and conditions with common inheritance tendencies of developing allergic conditions such as hay fever and asthma (Ng, 2016).

Epidemiologically, the prevalence of eczema in the United States ranges from 10% to 20 % among infants and approximately 3% of children and adults (Qin et al., 2014). Most of the children suffering from eczema begin experiencing this condition at the age of 10, and its adverse effects may remain permanent for the rest of one's life if it goes undetected. Comparative study findings indicate that toddlers experiencing elm, cat or egg allergies have increased risks of developing eczema conditions at the age of four(Kidson, 2008; Schachner & Hansen, 2011). Eczema has some genetic correlation in a manner that children with parents experiencing this condition have a risk of developing the same. The most common symptoms associated with atopic eczema include skin itchiness and dryness (Guo, 2014). The affected areas usually assume a red color and cause an itching effect if no treatment is administered.

Atopic eczema affects all parts of the body, but it can be easily spotted in the hands, backs of the knees, inside regions of the elbows as well as the scalp and face in children. The effects of atopic eczema in people appear in two different periods, when symptoms are less visible and when they become more severe (Ho & Ong, 2015). The critical periods are referred to as flare-ups. In most cases, people with a fair skin usually experience a reddish skin before turning brown while eczema may affect pigmentation in darker-skinned people worsening the color of the area to appear darker or lighter (Qin et al., 2014).

The psychosocial effects of atopic dermatitis and all the forms of eczema affect every member of the society ranging from children to older adults (Guo, 2014). Pre-school children suffering from atopic eczema are at a higher risk of experiencing hyperactivity and have a greater reliance on their parents when compared to their colleagues who are unaffected. Children with eczema condition are often prone to be teased and bullied in social places such as school, which can result in poor school performance, social isolation with greater feelings of social stigmatization. Atopic eczema patients also record a variety of lifestyle restrictions including the type of clothes to be put on, owning pets, and leisure/physical activities such as swimming and other outdoor sporting activities (Qin et al., 2014). Children and adults suffering from atopic eczema may also suffer from psychosocial effects such as poor self-image, decreased social skills and low self-esteem.

However, eczema can be controlled with proper treatment. TCM is one of the most efficient medically-accepted strategies used in the effective management and treatment of skin diseases. Yeung and Chung (2017) define TCM as an outstanding collection of medicine that has been in use for over 3,000 years. They emphasize that TCM helps in relieving a variety of pain before the realization of modern medication TCM entails an alternative therapy administered orally, topically, or as an injection and emphasizes the use of herbs in combined formulations for particular patients. TCM has proved useful in dermatology in China and beyond (Qin et al., 2014).

Traditional treatment and healing entail effective application of skills, practice, and knowledge in line with theoretical experiences and a range of beliefs native to diverse cultural groupings. As such, TCM is used in the maintenance of well-being in addition to the improvement of mental and physical diseases (Qin et al., 2014). TCM uses a variety of terms that help in the proper understanding of the entire treatment strategy and the philosophy involved. TCM healing mechanism is holistic and dependent on the interplay experienced between two critical terms referred as Qi and Chi; these two terminologies to refer to the essential energy that provides people with warmth, animation as well as the ability for someone to express himself mentally.

Acupuncture and TCM, in general, understand atopic eczema as a form of imbalance in body energy which paves the way for the external pathogenic attributes to attack the body causing a variety of effects on the human skin including inflammation, itchiness, dryness, and redness (Yeung & Chung, 2017). In acupuncture, manipulation of Qi occurs through the acupuncture points and must remain in constant motion and in a direction that is deemed correct for proper health. Blood follows where Qi goes hence, the process of manipulating Qi enhances blood circulation in ones body.

Western Management techniques recommend that there should be a proper combination of western medication and TCM through the application of treatment procedures such as acupuncture and alternative herbal drugs. Acupuncture, however, has been significantly used not only in China but the entire world due to the numerous numbers of benefits associated. A critical and detailed observation of the affected region alongside the signs and symptoms displayed by a given patient is used as the most common differentiation patterns and treatment.

According to Guo (2014), TCM comprises of numerous practices in medicine sharing common concepts of treatment that have been in use for over 2,000 years and include a variety of herbal medicine, massage, acupuncture, exercise as well as dietary therapies. A plethora of conditions related to eczema are primarily diagnosed through symptoms and treated through the use of traditionally recognized herbs and drugs comprising of dried roots, flowers, leaves or barks of trees (Qin et al., 2014). In most cases, these medicinal parts of the tree are obtained from traditionally prescribed trees which are consequently boiled to create a concentrated solution that is then consumed on a daily basis as recommended by the traditional practitioner.

However, inflammation associated with eczema is not exclusively treated by taking a single herbal pill (Ren et al., 2015). The toxicity of the inflammation is always too tenacious that it calls for consumption of stronger and highly concentrated dosages of raw herbs. In areas where the condition persists, this treatment may last for more than six months for the desired levels of healing to be attained. A considerable experience is also required when diagnosing a given type of eczema basing on the degree of skin dryness, hotness, and dampness (Yeung& Chung, 2017). In such conditions, an experienced TCM practitioner is highly required basing on his or her broad background in herbal dermatology.

This paper provides a detailed review of the literature regarding the use of TCM in the effective cure of eczema. A critical examination of the adverse effects of using Chinese herbs and acupuncture in the management of eczema is provided alongside a succinct conclusion that discusses the strength and limitations of Western Medicine and TCM in the treatment of eczema. The study also suggests a variety of clinical research directions that can be used in the efficient management of this fatal skin condition.

Effects of Using Chinese Herbs in the Management of Eczema

A variety of adverse reactions has been reported through findings gathered from different analytical studies to explain the impact of using Chinese herbal medicine in the treatment and management of eczema and its associated health conditions (Ren et al., 2015). A study investigating the effect of traditional Chinese herbs recorded 11 different cases of liver damage as a result of using Chinese herbal medicine in treating and managing skin conditions. Another study established that two individuals developed reoccurrence of hepatitis after an extended period of observation (Kong & Tan, 2015). Another study investigating patients use of Chinese traditional medication in the effective healing of eczema had developed severe conditions of cardiomyopathy in two weeks (Yeung & Chung, 2017).Besides, Chinese medicine practitioners believe that the decision to standardize herbal mixtures will have an adverse impact by contradicting the existing Chinese medicine and treatment theories.

The following table provides a summary of different herbs and the equal disease treatment.

Disease Name of the herb

Hepatotoxicity TurczDictamnusdasycarpusRadix polygonimultiflori

Radix Puerariae

Cortex Ulmusdavidiana

FructusPsoraleae

Cortex Cudraniae

Aloe Vera

Radix Smilacischinae

Corydalis speciosa Max

Ceramiumkondoi

Pseudoaldosteronism Radix Glycyrrhizae

Interstitial pneumonia Radix Scutellariae

Radix Bupleuri

Use of Acupuncture in the Treatment of Eczema

Chen et al. (2015) identify acupuncture is the most common traditional Chinese medical technique used in providing successful prophylaxis, treatment and proper management of all medical conditions associated with skin diseases including atopic eczema. However, the continuous use of this technique calls for proper analysis and understanding of its safety and the associated medical conditions. Guo (2014) defines acupuncture as a holistic medical approach which originates from Traditional Chinese medical practices in which traditionally trained and skilled practitioners stimulate specific and predetermined points on the body by inserting thin needles into their skin. This typical form of treatment is believed to be practically painless despite the worries expressed by a large number of patients with the pain that may result from the use of these needles (Li, Yang, Li, Zhang, Yang, Chang & Liu, 2013).

Guo (2014) ascertains that the use of Chinese herbal medicine alongside TCM techniques such as acupuncture can reduce skin feelings such as itchiness on a large extent. Eczema is globally recognized as the wind of four different crooks under the concept of Chinese medicine (Chen et al., 2015). The word crooks refers to the most critical location points of eczema-caused rashes on the knees and elbows. According to Kong and Tan (2015), acupuncture treats eczema and related health conditions by correlating the imbalances responsible for these circumstances as opposed to the effect of suppressing the immune response of a patient. The effect of removing or correcting the associated imbalances in the body energy can reduce skin inflammation and allow the body to heal on its own over time (Kidson, 2008).

Adverse Effects Associated With the Use Of Acupuncture

Qin et al. (2014) argue that the establishment of evidence base should rely on safety, availability, validity, and reliability because the use of acupuncture and other herbal techniques in treating eczema is becoming widespread and globally recognized. Also, it is globally known that the use of acupuncture can lead to far reaching adverse health effects (Gaeddert, 2013; Requena, 2016). For instance, the 1980s hepatitis outbreak in the United States provides a prime example of this assertion. Public health officers who carried out the thorough investigation of this incident established that most of the cases of hepatitis disorder reported were as a result of the cross-infection due to the use o...