TCM Series – Understanding Eczema from TCM’s Perspective

TCM Physician Lau Kiew Teck with Raffles Medical Group

Many parents have asked me “What about TCM?” while others have suggested that I explore TCM as an eczema treatment option for my child. I’ve looked into TCM briefly in this archive post, but felt I didn’t know enough to evaluate it. For this TCM Series, I’ve the privilege of interviewing TCM Physician Lau Kiew Teck of Raffles Medical GroupRaffles Chinese Medicine Clinic, whose special interests include respiratory conditions, dermatology, pediatrics, diabetes and digestive system disorders.

Refer to the first part of this interview here and the second part here.

Understanding Herbal Bath & Cream

MarcieMom: I read that herbal bath and creams are also prescribed by TCM physicians. What are the ingredients of the herbal bath & cream? Given that there is so much transparency being pushed for in labeling ingredients of skin care products, are ingredients in TCM products fully labeled?

Physician Lau: In my practice at Raffles Hospital, our products are fully labeled and certified by Singapore Health Science Authority.

MarcieMom: Moisturizers, bath oil, bleach bath and steroid topical creams are treatment prescribed by western medicine. Is herbal cream, herbal bath similar? (as in have properties to repair the skin barrier, kill staph bacteria and reduce inflammation)

Physician Lau: As the properties are different between the western medicine and the herbal cream, we are unable to compare. The herbal bath definitely helps in reducing the inflammation thus creating an environment for the skin to recover. Repairing of skin largely depends on the individual body’s nature.

MarcieMom: Acupuncture is also a treatment option used for eczema; how does acupuncture treat eczema and is it recommended for children?

Physician Lau: As mentioned previously, TCM focuses on the holistic approach where a combination of treatment of acupuncture and herbs are used. For instance, if you are suffering from eczema due to weak digestive health, TCM, be it herbs or acupuncture or both, is administered to treat the indigestion problems and subsequently, through the holistic approach, it will speed up the recovery of eczema. I will not recommend acupuncture for children.

MarcieMom: Also, where are TCM medicine produced in? How can a patient check the harvesting of the herbs (whether using insecticide), the manufacturing facility (use of chemicals) and the packing facility?

Physician Lau: Patients can check the manufacturer’s label to see where the medicine is produced in. It is impossible to check on the harvesting of the herbs with the looks of it. Such assessments have to undergo testing.

MarcieMom: I understand that in skincare products, there is a lot of emphasis of choosing a reliable company that conducts clinical trials and ensures no contamination in its manufacturing and not using ingredients that are common allergens such as preservatives, fragrance and parabens. Do TCM’s herbal cream have the same emphasis on these?

Physician Lau: Based on the guidelines of Singapore Health Science Authority, all TCM products dispensed in Raffles Hospital are certified.

MarcieMom: Thank you Physician Lau for helping us understand a little more on TCM in the treatment for eczema for the past three weeks.

TCM Series – Understanding Eczema from TCM’s Perspective

TCM Physician Lau Kiew Teck with Raffles Medical Group

Many parents have asked me “What about TCM?” while others have suggested that I explore TCM as an eczema treatment option for my child. I’ve looked into TCM briefly in this archive post, but felt I didn’t know enough to evaluate it. For this TCM Series, I’ve the privilege of interviewing TCM Physician Lau Kiew Teck of Raffles Medical GroupRaffles Chinese Medicine Clinic, whose special interests include respiratory conditions, dermatology, pediatrics, diabetes and digestive system disorders.

Refer to the first part of this interview here.

Herbal Medicine & its Compounds & Prescription

Herbs such as Flos Lonicerae (Jingyinhua), Herba menthae (Bohe), Cortex Moutan (danpi), Rhizoma Atractylodis (Cangzhu) and Cortex Phellodendri (hungbai) are herbs commonly prescribed by TCM physicians for eczema. They have anti-allergic, anti-inflammatory and reducing itchiness effects.

MarcieMom: Physician Lau, could you explain to us what compounds are made up in the herbs that you commonly prescribe to eczema children? (Compounds meaning containing which Vitamin or which carotenoid)

Physician Lau: These compounds are extensive and it is not possible to list them all down.

Marcie Mom: I searched for studies on TCM and effects on atopic dermatitis and it appear that studies which indicate positive results (meaning lower severity of eczema or less reliance on cortisteroids) have relatively small sample size (see here and here). In this review article, the authors from The Chinese University of Hong Kong, Pediatrics and Institute of Chinese Medicine departments, concluded that the “beneficial effects of Chinese medicine on children with atopic dermatitis have not been consistently demonstrated”. I would think this is due to limited studies, both in number of studies and the sample size of studies, which led to inconclusive results and the ambivalence of non-TCM practitioners to recommend their patients to explore TCM.

MarcieMom: Physician Lau, do you know of any conclusive large-scale study of TCM on eczema?

Physician Lau: Not that I know of.

MarcieMom: I also read that the TCM prescription is individualized and not standardized across eczema patients. Why is it not possible to be standardized? Would prescribing the common herbs for eczema and in a standard dosage makes it easier for studies to be conducted and also for greater transparency in TCM medicine?

Physician Lau: Each patient requires different attention and treatment and TCM does that. It customizes the treatment for the patient so patient can recover speedily.

MarcieMom: Related to the above, the individualized treatment characteristic of TCM makes it scarier for parents, what if their TCM physician prescribes the wrong potency or frequency? I’m thinking about western steroid creams, a mom would easily google the strength of the steroid and know if it ought not be used daily. Can you advise (1) what questions a parents should ask their TCM physician about the medicines given to their child and (2) what are the common dosage and length of taking these meds?

Physician Lau: Each consultation differs from patient to patient so there is no common dosage or length of taking these medications. The most frequently asked question is “are they safe?” Yes, they are safe and there are no known side effects.

MarcieMom: I read quite a few studies preparing for this interview and found that all of them measure the toxicity level in kidney and liver (and most conclude no toxicity effect). Why is this mentioned in the studies of TCM? Is there a risk of toxicity because the compounds in the herbal medicine are too potent?

Physician Lau: In fact, all medications including western medicine measures the toxicity level in the kidney and liver as these are important and immediate organs that has reactions to the medicine. All medication concoctions follow this benchmark.

MarcieMom: Thank you Physician Lau for the reply. Next week, we’d explore herbal bath and cream treatment options.

Traditional Chinese Medicine (TCM) Series – Understanding Eczema from TCM’s Perspective

TCM Physician Lau Kiew Teck with Raffles Medical Group

Many parents have asked me “What about TCM?” while others have suggested that I explore TCM as an eczema treatment option for my child. I’ve looked into TCM briefly in this archive post, but felt I didn’t know enough to evaluate it. For this TCM Series, I’ve the privilege of interviewing TCM Physician Lau Kiew Teck of Raffles Medical Group, Raffles Chinese Medicine Clinic, whose special interests include respiratory conditions, dermatology, pediatrics, diabetes and digestive system disorders.

More on Physician Lau: Physician Liu Qiao De graduated from Singapore College of Traditional Chinese Medicine in 1977 and has been practising TCM since. In the early 90’s, Physician Liu pioneered a Quit Smoking programme using auricular acupuncture. Physician Liu’s special interests include treating skin problems such as eczema and psoriasis. In pediatrics, he specializes in treating asthmatic conditions.

Eczema – A Multi-Factorial Condition

Eczema is a condition which is contributed by multiple factors like genetics, over-active immune system, damaged skin barrier, allergy, environment and persistence of staph bacteria residing on eczema skin. It is also a chronic condition, meaning treatment options are meant to manage the eczema instead of curing it.

From what I’ve read on the web, eczema is due to weaknesses or imbalances in body organs, in particular, the spleen, the lungs and the stomach, which leads to skin with eczema rash. Thus, various TCM options, such as herbal medicine and acupuncture, are ways to detoxify and strengthen these organs, specifically to (1) clear heat, (2) remove dampness and (3) remove wind.

Marcie Mom: Physician Lau, is this also TCM’s stand on eczema – that it is multi-factorial and chronic? Kindly help us understand the factors (from TCM’s perspective) that contribute to eczema and whether TCM is a treatment option to manage or to cure eczema. Can the factors/ causes of eczema be reconciled between TCM and western medicine?

Physician Lau: Eczema is both multi-factorial and chronic condition that is contributed by genes, immune system, damaged skin, allergy and environment. TCM focuses on the holistic approach where a combination of treatment of acupuncture and herbs are used. Patients can choose to use either TCM or western medicine or both to treat eczema; we don’t enforce any specific arrangement.

Foods to Avoid for an Eczema Patient

I read from the web that food and beverage such as alcohol, coffee, sugar, spicy food and deep-fried food are to be avoided. Also for fruits deemed “heaty” such as durian, mango, longan and lychee. Foods that are “cooling” such as green beans are encouraged.

MarcieMom: Physician Lau, can you help to explain “heaty” versus “cooling” food? Most of us in Asia are familiar with the use of “heaty” and “cooling” but it’s seldom heard of by our readers in US, UK and Canada.

Physician Lau: Food only becomes heaty or cooling when your body reacts to the food. In general, the food in its nature is heaty or cooling based on its properties.

MarcieMom: Above foods such as alcohol and spicy food are top triggers of eczema, while sugar and deep-fried food are inflammatory (further explained in this post). Green bean is an anti-inflammation food, featured in this post. Anti-inflammatory foods include those that contain anti-oxidants, Vitamin C, carotenoids, flavonoids, quercetin and kaemferol that can reduce oxidation, fight free radicals and inflammation.  Can I then understand the “heaty” food that TCM recommends to avoid as being inflammatory and those to have more as having anti-inflammatory compounds? 

Physician Lau: Fried and spicy food and alcohol in general.

MarcieMom: Thanks Physician Lau for replying to these questions – TCM still seem to be a complicated topic to understand and hope to learn more in next week’s interview.

Alternative treatment – TCM for child eczema

TCM uses herbs, acupuncture and cream for treatment

You may have been asked by your friend to explore TCM (“Traditional Chinese Medicine”) treatment for your child and wonder if it is viable. I wondered the same and read whatever I could online on it. The information is sparse and prescriptions seem to differ based on the TCM doctor’s interpretation of your child’s condition after examining his skin, tongue, pulse and asking questions about his urine, stools, behavioural and sleep patterns. There is therefore no standard prescription and as a result, there is much less research on the effect of the treatment. Below are whatever I understood based on reading online.

TCM Treatment

The treatment is based on that the skin is affected by the ‘inside’ of the body and thus, herbs or acupuncture may be used to treat your child’s kidney, spleen or liver. The treatment is usually to remove toxins, phlegm, dampness and ‘heat’ in blood. Acupuncture for kids may use the Japanese system sho-ni-shin which does not involve puncturing the skin. Herbs, of up to 15 types, may be prescribed for you to boil and give your child. Cold compress using herbs, oatmeal bath, moisturizing herbal lotion may be prescribed too.

Versus Western Approach

There appears to be many similarities such as moisturizing, soaking in bath oil and control of allergic food. Diet control seems to be prescribed without conducting a skin prick test, and generally food such as cow’s milk, sugar, addictive, food colors and preservatives are to be avoided. I came across an article that suggested not having the child vaccinated as vaccination has toxin (I think vaccination is important and unless supported by strong medical evidence, we should not be excluding vaccination for our child).

So is TCM Safe?

I always think it is safer to consume something when the side effects are known then to consume something with no known side effects (since no one tested it)! The herbs that TCM prescribe may be anti-inflammatory, antihistaminic or immunosuppressant. The improved results may not take place at all or from 2 weeks to 8 months from what I’ve read on other parents’ forum posts or blog or research. The biggest question obviously is we know oral steroid works very fast but we know it is not for long-term use (in fact, my baby Marcie’s doctor said strictly once for Marcie), is it possible then for a TCM medicine to work equally fast and yet so safe that no side effect is known? So far, there are people online that sent their TCM medicine for lab analysis and found to contain steroids (equally, you will find others saying TCM doesn’t contain steroid), people who stopped the TCM medicine and the rashes came back or others who continue with steroid application while undergoing TCM treatment.

As mentioned earlier, the research is too little on TCM and for children, I personally won’t risk it, unless I have access to a lab and can test everything the TCM doctor gives my baby.

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