Q. I am a 61-year-old man. In the past few months, I have been troubled by sudden daily eruptions of rashes. I usually feel the itch in the evening.
If I scratch at the area, rashes, which look like boils, will appear. Sometimes, the rashes disappear by midnight. I have tried using calamine lotion and balms, but to no effect. I am told that these rashes could be due to age-related hormonal imbalance. Is there any truth in this? How can I get rid of them?
A. It sounds like you have chronic idiopathic urticaria, commonly known as hives. This skin condition is characterised by wheals (reddish swellings) or itching that occurs almost daily for more than six weeks.
It comes and goes on various parts of the body and can be triggered by an allergic reaction to food, drugs, infections or stress. Severe hives can lead to chronic skin diseases, interrupted sleep and depression.
In traditional Chinese medicine (TCM), this condition can arise when the lungs, intestines, stomach, liver and kidneys are deficient. A lack of qi (vital energy), blood and yin (the element that cools organs), poor blood circulation or blood stasis, and pathogenic factors, such as wind, heat, cold, dryness and dampness, can also contribute to the problem.
Skin reflects lung health
In TCM, the skin is a reflection of the lungs. If your lungs are not working well, your skin becomes unhealthy, itchy and dry. One factor that can cause the lungs to malfunction is ageing, which may apply in your case. Others are smoking and respiratory illnesses.
Besides the lungs, your problem can also be traced to external pathogens, of which wind could be the main culprit. A combination of wind and cold, for instance, may cause "cold hives" - pink or porcelain-white wheals which are aggravated whenever the wind blows on the skin or when you are in a cold environment.
Wind and heat, on the other hand, may trigger angry and red "heat hives"; map-like patches that have a burning sensation.
If your problem stems from the stomach and intestines, it could be due to an imbalanced diet. In addition, intestinal parasites, such as hookworms, can create internal heat and dampness in the stomach and intestines. This would trigger bright red wheals with abdominal pain, nausea, diarrhoea or vomiting.
Elderly people with general weakness and chronic diseases may also be unable to produce sufficient qi and blood to nourish the skin. This produces internal wind and dryness which, in turn, can trigger pink or flesh-coloured wheals. These would often recur for several months or even years, with the lesions worse when one is tired.
Meanwhile, the liver stores blood and controls the circulation of qi. A lack of blood or negative emotions, such as fear and depression, will weaken the liver and create internal wind, heat and fire. This may manifest in the form of pink hives around the liver meridian such as the lower abdomen, lower back and thighs.
Internal dryness and heat can also arise in the kidneys, as a result of factors such as ageing, chronic diseases and keeping late nights. The kidneys control water and other fluids in the body. When they malfunction, dark red wheals may result. The lesions would be worse at noon and at night, and the person would also feel restless, have night sweats and a dry mouth.
Another effect of internal heat and dryness is poor blood circulation, as the flow of qi and blood would be hampered. In these instances, the person may also see dark red or purple wheals on areas where there is pressure on the skin, such as the areas underneath a watch or belt.
To ease your problem, you may consider Chinese herbal medicine (both taken orally and applied on the skin), acupuncture, moxibustion and cupping therapy.
Herbs that are commonly prescribed to counter the effects of wind and heat to reduce "heat hives" are honeysuckle flower, lophathrum herb and heartleaf houttuynia herb.
To eliminate "cold hives", try cassia twig, ephedra, white peony root, Chinese date and perilla leaf.
If your hives are triggered by eating certain foods, try the virgate wormwood herb, hawthorn fruit and glabrous greenbrier rhizome. These dispel heat and dampness in the stomach and intestines. Meanwhile, the rangooncreeper fruit, smoked plum and areca seed are used to kill intestinal parasites.
To boost your qi and blood, take codonopsis root, Indian bread and baical skullcap root.
If you are looking to strengthen the liver and kidneys, go for the common curculigo rhizome, dodder seed and yerbadetajo herb. Lastly, blood circulation can be improved with the help of peach seed, safflower, Chinese angelica and combined spicebush root.
Besides taking herbal remedies, avoid temperature changes, wind, heat and cold. For example, try not to have a fan or air-conditioner blow directly at you. Avoid hot showers too, as the heat may invade the body.
Reduce stress levels and improve blood circulation by doing light exercises such as brisk walking, yoga, taiji and qigong. Diet-wise, abstain from alcohol, spicy ingredients, cold or raw food and red meat such as beef. This is to reduce internal heat and dampness.
Sleep early and have enough rest so that your body can produce more qi and blood to nourish your skin.
You should also identify and avoid any allergens, such as skincare products, hair dyes and seafood, that may have triggered your hives. Going for a patch test can help to ascertain if you indeed have such an allergy.
MS LIM LAY BENG
Traditional Chinese medicine practitioner at YS Healthcare TCM Clinic at The Adelphi