Complementary therapies for eczema: Chinese herbal medicine

Chinese herbal medicine is just ‘medicine’ in large parts of the world. It is commonly used alongside conventional, Western medicine in China and East Asia. We look at how it works and the evidence supporting its use in the treatment of eczema. We also investigate at how to find a trustworthy practitioner.

How does Chinese herbal medicine work?

Chinese herbal medicine is part of traditional Chinese medicine, which also includes acupuncture, massage, dietary advice and exercise. The underlying principles of Chinese medicine are very different from the Western approach to healthcare. Rather than treating individual symptoms, Chinese medicine aims to normalise imbalanced energy, or Qi (pronounced ‘chee’), that runs through invisible meridians in the body. 

The traditional Chinese medicine philosophy proposes that everything, including organs of the body, is composed of the five elements: fire, earth, metal, water and wood. Herbs associated with the five tastes – sweet, salty, bitter, pungent and sour – are thought to correspond to these five elements. For example, since the skin is a metal element Yang organ, it would be treated with a pungent herb.

Chinese herbal medicines are mainly plant based, but some preparations include minerals or animal products. Prescriptions can take the form of teas, tablets, soaks or topical creams. These can either be a traditional formula or a personalised blend of a number of remedies based on the pattern of symptoms for a particular patient.

One traditional formula commonly used in the treatment of eczema is Xiao Feng San (also known as clear wind powder). Many of the herbs in the formula are known to have anti-inflammatory and antibacterial effects. For example, ku shen (sophora root) is widely known for reducing inflammation, itch, and growth of the bacteria Staphylococcus aureus¹ which is commonly associated with eczema.

Can Chinese herbal medicines treat eczema effectively?

While there have been some scientific studies of herbal medicine, it doesn’t easily fit into randomised control trials which are seen as the ‘gold standard’ of scientific research. These trials focus on testing one chemical’s impact on one mechanism within the body. They do this by giving hundreds of people with similar symptoms the same chemical (or an inactive placebo) and measuring changes in symptoms. 

In Chinese medicine, prescriptions are typically individualised for each patient and there are thousands of chemicals in each herbal formula. This does not sit comfortably with the concept of testing one chemical’s effect on one mechanism. Indeed, the skill of the practitioner in prescribing could potentially have just as big an effect as the herbs themselves.  

That said, there have been a number of studies carried out into the effectiveness of Chinese herbal medicine in the treatment of eczema. While many of studies show statistically significant positive outcomes for the Chinese herbal medicine treatment groups, the low strength of evidence and high risk of bias means that these results cannot be regarded as scientifically reliable^{2 3}.

Other studies have looked at the effectiveness of Chinese herbal medicine when used alongside conventional, Western medicine for the treatment of eczema. The combined treatment seems to be more effective without any increase in the risk of adverse events. For example, one study in Taiwan looking at children with eczema showed an 44% reduction in the use of steroid creams in the group using Chinese herbal medicines alongside conventional treatments⁴. However, once again, the current available evidence remains too weak to make a conclusive decision⁵.

Overall, the scientific evidence supporting the use of traditional Chinese herbal medicine is encouraging but by no means definitive. There is also plenty of anecdotal evidence of eczema being helped by this approach. However, Chinese herbal medicine is not without risks.

Using Chinese herbal medicine safely

There are concerns that Chinese herbal products contain drugs not listed on their labels. For example, some Chinese herbal creams that are used to treat eczema have been shown to contain steroid medications and herbal preparations for oral use containing conventional painkillers have been found. There are also concerns over impurities. There have been instances of Chinese herbs containing heavy metals, such as lead, cadmium, and mercury as well as other, potentially toxic, herbs. These impurities can lead to permanent kidney and liver damage. 

In the UK and EU, oral and topical herbal medicines used for minor ailments should be registered with the herbal medicine registration scheme and include the registration number on the packaging. This scheme aims to ensure that medicines comply with quality standards relating to safety information and manufacturing. It also aim to ensure that information about how and when to use them is readily available. It does not guarantee effectiveness. However, there are still a large number of unregistered herbal medicines not covered by the scheme. 

In the USA, herbal medicines themselves are classified as food supplements. While they can be banned if shown to be dangerous, there is no requirement to demonstrate their efficacy. The regulations only cover safety and labelling requirements.

Finding a practitioner

With all this in mind, finding a practitioner who can treat your child and supply good quality herbal prescriptions is key. You will also need to find a practitioner with experience of treating babies and children as many of the herbal preparations have a bitter taste that young children are likely to spit out. An practitioner with experience of children will be able to prescribe more palatable herbs.

There is no government approved register of practitioners in the UK. However the Register of Chinese Herbal Medicine ensures that their members are qualified to degree level in Chinese herbal medicine. Members are expected to only use herbs from approved suppliers.

In the USA, regulation varies by state with most states requiring practitioners to hold at least degree level qualifications. The following organisations will have lists of suitably qualified practitioners in your area: the American Association of Acupuncture and Oriental Medicine, the National Certification Commission for Acupuncture and Oriental Medicine, and the Institute of Traditional Medicine. 

Our sources

1. https://pubmed.ncbi.nlm.nih.gov/31514082/
2. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008642.pub2/full
3. https://pubmed.ncbi.nlm.nih.gov/32724323/
4. https://www.ncbi.nlm.nih.gov/pubmed/25449448
5. https://pubmed.ncbi.nlm.nih.gov/34629103/

In summary

While the evidence supporting the effectiveness of traditional Chinese medicine is not irrefutable, it is encouraging. However, it is not regulated and there are very real risks associated with taking substandard herbal medicine. There is also the risk that your child will find the prescribed herbs unpalatable. The key is finding a reputable practitioner with experience of treating children.

As well as sharing our experience of bringing up an eczema child (and favourite allergy-friendly recipes), we also manufacture and sell our unique stay-on scratch mitts and PJs for itchy babies, toddlers and children. We now stock sizes from 0-adult years in a range of colours and designs. Visit our webshop for more information.