Eczema in Traditional Chinese Medicine: Which Type Are You? (Chart, Herbs and Care)
TCM skin knowledge
Part of our Eczema guide
Traditional Chinese Medicine explains eczema as a pattern rather than a single disease. Itch is linked to Wind, weeping or oozing skin to Dampness, redness and warmth to Heat, and long-standing dry, thickened skin to Blood Dryness. Herbs are chosen to match the pattern, and clinical trials of Chinese herbal medicine have reported improvements in eczema severity, itch and sleep.
- TCM describes eczema through Wind, Dampness, Heat and Blood Dryness, often in combinations such as Damp-Heat or Wind-Heat.
- A meta-analysis of eight high-quality placebo-controlled trials (662 patients) found Chinese herbal medicine improved eczema severity and sleep.
- A review of 20 trials of topical Chinese herbs identified Ku Shen, She Chuang Zi and Bai Xian Pi among the core herbs.
- These are traditional concepts that sit alongside modern dermatology, which explains eczema through a weakened skin barrier and immune activity.
Which eczema type are you?
Use this chart to match what your skin looks like with the TCM pattern, the modern description and the care that suits it. Many people move between types: a red, weeping flare can settle into dry, thickened patches over weeks.
| What you see | TCM pattern | Modern description | Daily care | External herbs used |
|---|---|---|---|---|
| Sudden red, very itchy rash that spreads or moves | Wind-Heat | Acute flare | Cool compresses, gentle moisturiser, avoid heat and scratching; see how to stop itching fast | Bing Pian (borneol), menthol, Bai Xian Pi |
| Red, weeping, oozing or blistering patches, often in folds | Damp-Heat | Acute or subacute (weeping) eczema | See a doctor if it oozes, crusts or spreads (possible infection); creams only on intact skin | Ku Shen, She Chuang Zi, Huang Bai (often as cool compresses) |
| Recurring, mildly weeping or puffy patches, with tiredness or poor digestion | Spleen Deficiency with Dampness | Chronic relapsing eczema | Steady daily moisturising, trigger diary, regular meals; see eczema triggers | She Chuang Zi, Ku Shen |
| Dry, rough, thickened or cracked skin with stubborn itch, worse at night or in winter | Blood Dryness with Wind | Chronic, lichenified eczema | Thick creams or ointments twice a day, soak and seal; see eczema in winter | Rich moisturising bases, cooling herbs for itch |
Where QICAOGANGMU fits: its Ku Shen and She Chuang Zi pair is the classic external combination for itchy Damp-Heat and Wind-type eczema, and its petrolatum base suits dry, itchy patches. Use it on intact skin only, not on weeping or broken areas. See the research behind each ingredient or shop the 5-tube pack.
How does TCM diagnose eczema?
A TCM practitioner looks at how the rash behaves: whether it is dry or weeping, red or pale, sudden or long-standing, and where it appears. Together with the tongue, pulse and general health, these signs point to a pattern that guides treatment. Two people with the same modern diagnosis of atopic dermatitis can therefore receive different TCM patterns and different herbs.
What do Wind, Dampness and Heat mean in eczema?
| TCM concept | What the skin looks like | Typical features | Treatment principle |
|---|---|---|---|
| Wind | Changeable, sudden, widespread | Intense itch that moves or comes and goes | Dispel Wind, stop itch |
| Dampness | Moist, swollen, lingering | Oozing, weeping, blisters, crusts | Resolve Dampness |
| Heat | Red, warm, inflamed | Bright redness, burning, flares with heat | Clear Heat |
| Blood Dryness | Dry, rough, thickened | Scaling, cracking, lichenified patches, chronic itch | Nourish Blood, moisten Dryness |
Wind
Wind is the classic TCM explanation for itch, because its qualities are movement and change. It is emphasised when itch is intense and the rash shifts or flares quickly.
Dampness
Dampness describes wet, oozing, swollen or stubborn rashes, as seen in acute or weeping eczema. Oozing skin should still be checked for infection, which needs separate treatment.
Heat
Heat describes redness, warmth and a burning feeling. It often appears with Wind or Dampness during flares.
Blood Dryness
Blood Dryness describes chronic, dry, rough or thickened eczema with persistent itch. Here "Blood" is a TCM concept, not a blood test result.
What are the common TCM eczema patterns?
Wind-Heat
Sudden, red, very itchy rashes, often widespread. The principle is to dispel Wind and clear Heat.
Damp-Heat
Red, weeping, oozing or blistering eczema, typical of acute flares and skin-fold rashes. The principle is to clear Heat and resolve Dampness.
Spleen Deficiency with Dampness
Recurring, less red but persistent or mildly weeping eczema, often with poor digestion or tiredness. In TCM, the "Spleen" is a functional system for digestion and fluid metabolism, not the anatomical organ.
Blood Dryness with Wind
Long-standing, dry, thickened and scaly eczema with stubborn itch. The principle is to nourish Blood, moisten Dryness and dispel Wind.
Which herbs and formulas are used for each eczema pattern?
| Pattern | Classic oral formula | Key external herbs |
|---|---|---|
| Wind-Heat | Xiao Feng San | Bing Pian, Bai Xian Pi, menthol (Bo He) |
| Damp-Heat | Long Dan Xie Gan Tang (modern, safety-checked versions) | Ku Shen, She Chuang Zi, Huang Bai, Di Fu Zi |
| Spleen Deficiency with Dampness | Chu Shi Wei Ling Tang | She Chuang Zi, Ku Shen |
| Blood Dryness with Wind | Dang Gui Yin Zi | Rich moisturising bases, Zi Cao oil |
Ku Shen and She Chuang Zi are the most widely used external pair for itchy, damp eczema. Ku Shen is traditionally used to clear Heat, dry Dampness and stop itching, and laboratory research shows its compounds reduce inflammatory and itch signals in skin cells (Jo et al., 2022). Osthole from She Chuang Zi reduced scratching by blocking the TRPV3 itch channel in mice (Sun et al., 2018). See also the best herbs for itchy skin.
What does clinical research show about Chinese herbal medicine for eczema?
Oral Chinese herbal medicine. A meta-analysis of eight high-quality, placebo-controlled trials (662 patients) found Chinese herbal medicine improved eczema severity scores (including EASI-90 response), itch and sleep compared with placebo. Quality of life scores did not differ significantly, and mild side effects were slightly more frequent (Cai et al., 2022).
Xiao Feng San. In a randomised, double-blind trial of 71 people with severe, hard-to-treat eczema, total lesion scores fell by about 80% after 8 weeks of Xiao Feng San compared with about 14% on placebo, with better itch and sleep scores (Cheng et al., 2011).
Topical Chinese herbal medicine. A meta-analysis of 20 randomised trials found topical Chinese herbs improved eczema symptom scores and response rates, especially in mild and moderate eczema. The core herbs identified across these formulas included Huang Bai (Phellodendron), Ku Shen (Sophora flavescens), She Chuang Zi (Cnidium monnieri) and Bai Xian Pi (Dictamnus dasycarpus) (Wang et al., 2023).
For a wider look at the evidence, see how herbal creams compare with other steroid-free options.
How does the TCM view compare with modern dermatology?
Modern dermatology explains eczema (atopic dermatitis) through a weakened skin barrier, immune activity and itch signalling. Treatment is built on daily moisturisers, with prescription topicals and newer systemic medicines for more severe disease (American Academy of Dermatology).
The two systems describe the same skin in different languages. Heat and inflammation both involve redness and warmth, and Dampness overlaps with weeping eczema, but they are not identical concepts. Many people use both: modern care to control the disease and TCM principles and herbs to support skin comfort.
The Damp-Heat herb pair in one cream. QICAOGANGMU combines Ku Shen and She Chuang Zi with cooling borneol and menthol, tested steroid-free by TÜV SÜD PSB. Rated 4.6 to 4.7 out of 5 on Amazon. See the formula
What does TCM say about diet and lifestyle for eczema?
TCM dietary advice depends on the pattern. People with Heat patterns are often advised to limit spicy, fried and alcoholic foods, and people with Damp patterns to limit greasy, very sweet and heavy foods. These are traditional recommendations. Strict elimination diets are not recommended for everyone with eczema, and suspected food allergies should be assessed by a doctor.
Is Chinese herbal medicine safe for eczema?
- Use a qualified practitioner for oral herbs. Oral formulas are tailored to the pattern and need monitoring, especially for children and people on other medicines.
- Choose reputable, tested products. Some older Damp-Heat formulas were historically linked to substitution with toxic aristolochia species, so quality control matters.
- Check creams for hidden steroids. Some products sold as herbal creams have been found to contain undeclared corticosteroids. Read how to check a Chinese eczema cream.
- Patch test topical products on a small area first.
- See a doctor for infected, rapidly spreading or severe eczema, and for babies.
Eczema guides by type and situation
This guide is the starting point of our eczema library. For specific types and situations:
| Topic | Read |
|---|---|
| All types of eczema and their triggers | Types of eczema |
| Hands: dry, cracked or blistering | Hand eczema · Pompholyx |
| Coin-shaped patches | Nummular eczema |
| One thick patch you keep scratching | Neurodermatitis |
| Rash from a product, metal or plant | Contact dermatitis |
| Winter flares | Eczema in winter |
| Babies and children | Baby eczema |
| Is it eczema or psoriasis? | Eczema vs psoriasis |
| Coming off steroid creams | Switching safely · Hydrocortisone alternatives · Steroid withdrawal |
| Itch relief | Stop itching fast · Itchy at night · Herbs for itch |
Where QICAOGANGMU fits
QICAOGANGMU Steroid-Free Herbal Cream
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QICAOGANGMU is a steroid-free cream built on the classic Damp-Heat external herb pair, She Chuang Zi 3% and Ku Shen 1.5%, two of the core herbs identified in topical Chinese herbal eczema trials. Cooling Bing Pian (borneol) 2% and menthol 0.5% address Wind-type itch, Bai Bu 0.5% adds a traditional external herb, and a glycerin and petrolatum base supports dry skin.
- Steroid-free: TÜV SÜD PSB found none of 8 corticosteroids (lab reports)
- Fully declared formula: every active ingredient and its percentage on the label
- 100-day money-back guarantee
- US shipping in 2 to 6 business days, free over US$15
Just trying it? Buy 1 tube for US$9.50. Free US shipping over US$15.
Patch test on a small area first, use a thin layer on intact skin and avoid the eyes, lips and genitals. Ingredient review · Product details
Free guide: The 7-Day Itch Relief Plan
One simple step a day to calm itchy skin and sleep better, from our herbal science researcher. Get the 10-page PDF:
- Daily checklists and an itch diary
- Dermatology and TCM tips side by side
- A bedtime routine for night-time itch
Thank you! Download the 7-Day Itch Relief Plan (PDF). Look out for our welcome email too.
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Frequently asked questions
How does TCM explain eczema?
TCM explains eczema as a pattern of Wind (itch), Dampness (weeping or oozing), Heat (redness and warmth) and Blood Dryness (chronic dry, thickened skin), often in combinations such as Damp-Heat. Herbs are chosen to match the pattern.
What is Damp-Heat eczema?
Damp-Heat eczema is red, weeping, oozing or blistering eczema, typical of acute flares. TCM treats it by clearing Heat and resolving Dampness, with external herbs such as Ku Shen and She Chuang Zi.
Does Chinese herbal medicine work for eczema?
A meta-analysis of eight high-quality placebo-controlled trials found Chinese herbal medicine improved eczema severity and sleep, and a review of 20 trials found topical Chinese herbs improved symptom scores, especially in mild to moderate eczema.
Is Dampness the same as infection?
No. Dampness is a traditional pattern for weeping skin. Oozing eczema can also be infected, which needs medical assessment.
What foods should I avoid for eczema in TCM?
TCM advice depends on your pattern. Heat patterns often limit spicy, fried and alcoholic foods, and Damp patterns limit greasy and very sweet foods. Suspected food allergies should be checked by a doctor before cutting out foods.
What type of eczema do I have in TCM?
Sudden, red, itchy rashes suggest Wind-Heat; red, weeping patches suggest Damp-Heat; recurring patches with tiredness or poor digestion suggest Spleen Deficiency with Dampness; and dry, thickened, itchy skin suggests Blood Dryness with Wind. A qualified practitioner confirms the pattern.
Related articles
References
- Cai X, Sun X, Liu L, et al. Efficacy and safety of Chinese herbal medicine for atopic dermatitis: evidence from eight high-quality randomized placebo-controlled trials. Front Pharmacol. 2022;13:927304. PMID 36238577
- Wang MC, Chou YT, Kao MC, et al. Topical Chinese herbal medicine in treating atopic dermatitis (eczema): a systematic review and meta-analysis with core herbs exploration. J Ethnopharmacol. 2023;317:116790. PMID 37328084
- Cheng HM, Chiang LC, Jan YM, et al. The efficacy and safety of a Chinese herbal product (Xiao-Feng-San) for the treatment of refractory atopic dermatitis: a randomized, double-blind, placebo-controlled trial. Int Arch Allergy Immunol. 2011;155(2):141-148. PMID 21196758
- Jo S, Gong EY, Yoo W, et al. Anti-itching and anti-inflammatory effects of kushenol F via the inhibition of TSLP production. Pharmaceuticals (Basel). 2022;15(11):1347. PMID 36355519
- Sun XY, Sun LL, Qi H, et al. Antipruritic effect of natural coumarin osthole through selective inhibition of thermosensitive TRPV3 channel in the skin. Mol Pharmacol. 2018;94(4):1164-1173. PMID 30108138
- American Academy of Dermatology. Atopic dermatitis clinical guideline.
Educational information only. TCM patterns are traditional concepts, not medical diagnoses. This article does not replace an individual assessment by a doctor or qualified TCM practitioner.
