Treating Eczema with Traditional Chinese Medicine (TCM) - Understanding the Mechanism and Treatment of Stress-Induced Eczema from a TCM Perspective

A lady came to consult the practitioner, Viola Tsang, at the clinic. Recently, she had developed several red rashes on her neck. The affected skin was dry, painful, and itchy — a clear sign that her eczema had relapsed. She had applied some herbal moisturizing lotion, which seemed to help temporarily, but the condition was not completely resolved. As she preferred to avoid using topical steroids, she decided to seek TCM treatment.

During the consultation, Viola noted that the patient had not recently eaten any common eczema-triggering foods such as shrimp or crab. Her daily routine had not changed significantly — except that work had been rather stressful lately.

The Triggering Mechanism of Stress-Induced Eczema

Stress is one of the most important yet easily overlooked factors contributing to eczema flare-ups. In our Central clinic, stress-related eczema is frequently seen. When patients experience increased work pressure, the resulting hormonal imbalance, immune dysregulation, and nervous system overactivity can collectively trigger inflammation, leading to eczema outbreaks and recurrent flare-ups.

From a TCM Perspective:

• Emotional stress impairs the Spleen and Stomach's digestive function, leading to internal dampness retention. Damp-heat accumulates and manifests on the skin.

• Stagnation of Liver Qi due to stress transforms into damp-heat, which surfaces as redness, swelling, itching, and oozing typical of eczema.

• Emotional constraint disrupts Qi and Blood circulation. Qi stagnation and Blood stasis impair nourishment of the skin, worsening itchiness.

• Stress weakens the body's defensive Qi, allowing pathogenic factors to invade. This imbalance between healthy Qi and pathogenic Qi leads to acute inflammatory exacerbations of eczema.

From a Western Medical Perspective:

• Stress triggers the release of cortisol and adrenaline, causing immune overactivation.

• Prolonged or intense stress dysregulates immune function, weakening the skin barrier.

• Sympathetic nervous system activation increases itch sensation, leading to frequent scratching and further skin barrier damage.

• Discomfort and cosmetic concerns from eczema aggravate anxiety, which in turn elevates stress hormones, perpetuating a vicious cycle of inflammation.

• Stress-related insomnia impairs skin repair and regeneration, delaying recovery.

How TCM Treats Stress-Induced Eczema Flares:

• Regulate qi flow to regulate emotions, resolve qi stagnation to allow qi and blood to circulate freely, and eliminate heat

• Restore normal digestive function to reduce dampness and eliminate the root cause of eczema—the "dampness" factor

• Eliminate external and internal sources of heat causing inflammation to reduce itchiness

• Let the heart calm down to enable patients to sleep soundly, allowing the skin time for self-repair

After five days of internal and topical herbal treatment, the patient's eczema was well controlled. Itching and pain were greatly reduced, the affected area significantly diminished, and her sleep quality improved. By her follow-up visit, the eczema had nearly resolved. Throughout the treatment, she followed Viola's dietary and lifestyle advice closely — avoiding triggering foods and ensuring adequate rest — which enhanced the therapeutic results and sped up recovery.

Lifestyle Habits and Their Impact on Eczema Recovery

In addition to medical treatment, lifestyle modification plays a crucial role in managing eczema and preventing recurrence.

Both TCM and Western medicine agree that dietary control is essential to reduce skin inflammation. Patients are generally advised to avoid eggs and related products, seafood, dairy products, red meat, spicy and heat-producing foods, and alcoholic beverages. However, dietary restriction should be individualized — patients should identify and avoid foods that personally trigger their eczema, rather than imposing overly broad restrictions that may lead to malnutrition.

Psychologically, maintaining emotional well-being is vital. Engaging in enjoyable activities can effectively relieve stress — many office ladies find "retail therapy" surprisingly helpful. Techniques such as meditation, deep breathing, mindfulness, or cognitive behavioral therapy (CBT) can also help stabilize emotions and reduce the negative impact of stress hormones on the immune system.

From the TCM standpoint, regulating emotions and ensuring smooth Liver Qi flow are key to dispelling internal damp-heat and restoring Qi and Blood balance disrupted by stress. Patients should maintain regular routines, get sufficient sleep, avoid overwork, and engage in moderate exercise to strengthen the body and promote healthy Qi and Blood circulation.

If necessary, seeking psychological counseling or psychiatric support is also recommended to prevent anxiety and depression from creating a vicious emotional cycle that worsens eczema.