Acupuncture Today – December, 2002, Vol. 03, Issue 12

Constitutional Facial Acupuncture: Changing the Face of Aging, Part Three

Treating Rosacea: A Chronic Condition

By Alexis Bennett and Mary Elizabeth Wakefield, LAc, Dipl. Ac., MS, MM

In our last article, we explored the modality of herbal therapy, using poultices, creams, and essential oils. As we continue our journey, we examine a chronic skin condition, rosacea, and its treatment within the protocol of constitutional facial acupuncture renewal.


Rosacea is a chronic, highly visible skin condition, marked by acute swelling and inflammation. It may begin with a tendency to flush easily, then progress to persistent erythema (redness of skin) and telangiectasia (enlarged blood vessels) along with papules and pustules of the cheeks; nose; forehead; and chin. In more serious cases, the nose is red and bumpy, and the eyes become gritty and red, with a possible loss of vision.

Symptoms of Rosacea and Associated Target Groups

  • Rosacea: Roseaca usually affects women from the age of 30-50; often of Celtic origin with fair, sensitive skin, light eyes and hair.
  • Rhinophyma: Rhinophyma affects usually men; W.C. Fields, for example, had a red, bulbous nose and thickened, puffy cheeks, probably exacerbated by excessive alcohol consumption.
  • Ocular changes: 60% of rosacea patients develop gritty eyes; conjunctivitis; blepharitis (inflammation of the eyelids); iritis; keratitis (inflammation of the cornea); and eventually, loss of vision.
  • Acne: Acne usually affects a younger population with the skin eruptions usually confined to the back and chest. This is not toxic heat, as in normal acne. However, the patient will manifest redness of the skin and enlarged blood vessels.

Etiology (Specific Signs and Symptoms and Recommended Treatment)

According to Mazin Al-Khafaji, co-author of Peter Deadman's Manual of Acupuncture, rosacea falls into the following patterns:

  • Heat accumulation in the lung meridian: Because the taiyin channels contain more qi than blood, the lung's yang qi can become hot, rise and overflow into the face and nose area.
  • Heat accumulation in the stomach and spleen: Stagnant heat in the yangming channels rises to the face and nose, aggravated by the consumption of hot drinks, spicy food and alcohol, which all enter the mouth. This opens and damages the blood vessels in the face.

Recommended Treatments for Both of the Above Patterns

  • Signs and symptoms: easily flushes, erythema, red papules with an absence of, or a few, pustules
  • Persistent erythema: chuan xiong (radix ligustici chuanxiong); hong hua (flos carthami tinctorii); safflower is good for circulation, easing blood stasis, and especially for erythema
  • Papules: tao ren (semen persicae); peach kernel moistens the intestines and moves blood stasis; also hong hua
  • Blood stasis: heat stagnates and leads to the stasis of heat and blood; this is further exacerbated by extremes of heat and cold
  • Signs and symptoms: permanent red flush, telangiectasia, many papules and pustules
  • Persistent erythema: mu dan pi (cortex mouton radicis); peony tree root has a strong relationship to the skin and complexion, and is used quite often to treat stagnant heat in the face. Zhi zi (fructus gardeniae jasminoidis); gardenia moves stagnant blood, and is one of the herbs to mix with frothed egg white in a facial poultice for treating facial heat
  • Facial itching: jing jie (herba seu flos schizonepetae)
  • Menstrual aggravation: yi mu cao (herba leonuri heterophylli); Chinese motherwort is wonderful for invigorating blood and regulating the menses; it also eases abdominal pain. Xiang fu (rhizoma cyperi rotundi); cypress spreads and regulates liver qi, regulates menses and alleviates pain

Note: according to the Law of Attraction, you can use these formulas both internally and topically.

Possible Western Treatments

  • tetracycline;
  • minocycline, doxycycline and erythromycine;
  • oral and topical metronidazole;
  • isotretinoin (in severe cases);
  • surgery (laser and dermabrasion; for rhinophyma); and
  • steroids (can initially improve circulation, followed by distinctive worsening of the condition).


  • pathogens;
  • sunburn;
  • extremes of temperature;
  • physical/emotional stress;
  • birth control pills;
  • alcohol;
  • intense exercise;
  • hot, spicy drinks or food;
  • caffeine, tea, dairy, wheat;
  • citrus, eggplant, tomato, salty condiments;
  • harsh skin treatments (chemical peels, etc.);
  • cold, flu, allergies;
  • menses;
  • menopause;
  • dairy, wheat products; and
  • acne medications, topical cortisone, or any medication that causes the blood vessels to dilate.

Note: It is important to educate your patients about the triggers for rosacea. Be aware that a hereditary predisposition can be a major contributing factor of this chronic, progressive, vascular disorder. Early treatment is essential.


  • avoid hot or cold water;
  • be moderate;
  • use fragrance-free, color-free, noncomedogenic productions for skin hydration;
  • add drops of German chamomile, lavender or calendula essential oil to your products for calming redness and inflammation;
  • use a hydrosol with essential oils to prevent surface dryness, especially in dry, hot climates


  • use vitamins A, B, C, D, E and zinc, and silicon (found in horsetail capsules); evening primrose oil and borage oil; fruits, vegetables and fiber; drink plenty of water and healing herbal teas
  • especially for rosacea: eliminate wheat and dairy from the diet; take 200-400 I.U. of vitamin E and evening primrose daily

Rosacea Skin Tea (formulated by Shatoiya de la Tour). This tea is especially good for rosacea, either as a tea or cold compress. It is also good for acne, eczema, psoriasis and burns or sunburn.


  • 1-1/2 parts dried nettle
  • 1 part dried red clover flowers
  • 1 part dried calendula flowers
  • 1 part dried comfrey leaf
  • 1/2 part dried lavender buds

Boil one quart of water, remove from heat, add 4-5 teaspoons of tea mixture, and steep for 30 minutes. Sip tea all day, or apply a cold compress to irritated skin. It is a good idea to make an infusion the night before, and drink it during the day.

A promising new product for this condition may be alpha lipoic acid. In his book, The Wrinkle Cure, Dr. Nicholas Perricone cites "dramatic results" in rosacea clients using a solution of 1% alpha lipoic acid in a lecithin-based lotion. When applied to the face twice daily, this treatment was very effective, according to Dr. Perricone. In addition, a diet consisting of antioxidant-rich fruits and vegetables, such as Brussels sprouts, broccoli and cantaloupe is recommended.

A Treatment for Rosacea within the Constitutional Facial Herbal Protocol

Evaluate each case according to the individual patient's constitutional makeup; the signs and symptoms you've ascertained during your interview; and any filters you use in your treatment.

Be judicious about the employment of topical products in your treatment; become aware of the patient's history of allergic responses to skin creams, etc. When in doubt, use a conservative approach! Avoid warm or hot poultices, as well as any products containing alcohol or other potential irritants.

Educate your patients about stress management and their potential triggers for rosacea and related syndromes. Be aware that this chronic, progressive skin condition needs to be treated carefully and constitutionally, and that the inherent healing benefits of your treatments will become more apparent from week to week.

We invite you to continue with us on our voyage to empower beauty, renew spirit and enhance longevity.

Alexis Bennett is a licensed acupuncturist in New York, certified in Pennsylvania, and is board certified by the NCCAOM. She received her master's degree from Tri-State College of Acupuncture, a B.S. from the University of Nebraska, and studied nutrition at the graduate school of the University of Kentucky. Alexis has studied facial renewal since 1999, and completed her advanced constitutional facial acupuncture certification with Mary Elizabeth Wakefield. She also co-teaches constitutional facial acupuncture renewal with Mary Elizabeth in a variety of locations on the East Coast. Alexis has a private practice in Wayne, Pennsylvania.
Click here for previous articles by Mary Elizabeth Wakefield, LAc, Dipl. Ac., MS, MM.


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