by Alexandra Nicole Nuralam

TCM Face Mapping: What Your Acne is Trying to Tell You

Your skin is the biggest and most visible organ. But it differs from the other organs in a simple way: When there’s a problem, you’ll definitely know about it.

And this is where face mapping comes in. An ancient practice rooted in Chinese medicine that spans thousands of years, face mapping treats your face as a road map to pinpoint the underlying issues in other parts of the body. When there’s an issue in an organ or meridian—the networks that connect our bodily systems—it can become visible on our face in the form of breakouts, congested pores, or cystic acne. The location of blemishes on the face supposedly represent the organ that’s affected.

So can face mapping lead to clear skin? We consult Jun Negoro, a physician trained in Biomedical Science and Traditional Chinese Medicine, to get the full story on face mapping: how it works and how you can use it to diagnose the causes of acne.

What is the cause of acne according to TCM?

TCM physicians have identified this condition thousand of years ago, labelling it as fen ci (粉刺), which mean “white thorns”. The three most common causes of acne are Lung Heat, Stomach Damp-Heat and Blood Stagnation.

The most common pattern is caused by Lung Heat with toxins. This emerges as red and painful papules that form and disperse quite quickly.

When the heat becomes more pronounced, it congeals to form darker red acne with pus. It is often accompanied by symptoms in the digestive system such as constipation, bad breath or ulcers.

As time passes, chronic acne can lead to a deficiency or a stagnation of qi and blood. This form of acne is often dark and purplish with deep pustules or cysts, which take a longer time to heal.

What is face mapping and how does it work?

Face mapping traditionally stems from TCM and it reflects how different parts of the face are associated with different organ systems. TCM has an integrative view of the body and recognises that there is no intrinsic separation between mind, body and spirit. Hence it is believed that a person’s skin is a reflection of their inner workings of the body. 

Whenever the qi energy is at its optimal, the complexion would be clear and bright. However, any deficiency or pathogenic factors would reflect on the skin, causing its appearance, colour and shen (“inner glow”) to change. Using face mapping as a guide, physicians would be able to focus the treatment on the respective areas and re-establish the harmony and balance in the organ systems for better skin. 

What are the causes of acne in different parts of the face? What are the solutions?

Forehead

This area is linked to the small intestines. Ultimately, acne is an inflammatory disease so focusing on gut health is key. TCM focuses on eating at regular times, eating until you’re about 70% full and having a wide variety of whole unprocessed food. It is crucial to eat mostly warm food because warming the food is part of the digestive process and it will keep the digestive fire strong to maintain a healthy gut microbiome. Following a low inflammatory and low histamine food is also helpful in controlling acne.

Cheeks

The upper cheeks are related to the stomach. Acne in this area usually means that there is excess heat in the stomach. It is best to limit excessive amounts of spicy, oily food and raw cold food to maintain optimal function of the stomach. 

For the lower cheeks, the right cheek is associated with the lungs, whereas the left cheek has more to do with the liver. Consuming some “cooling” food such as watermelon, daikon and bitter gourd can clear the internal heat to control the inflammation. It is also important to disinfect your handphones regularly to minimise direct contact with germs on the cheeks.

Jawline and Chin

Acne around the lower third of the face is often present in women with hormonal issues. Common causes include post-birth control pills, Polycystic Ovarian Syndrome (PCOS) and menopausal women with blood stasis and heat. Herbs, acupuncture treatments and supplements to balance the hormones may be useful for some. It is also recommended to see a gynaecologist.

In clinical practice, acne is not just based on face mapping. Face mapping is a guide for physicians but it’s more important to consider the types of acne such as colour, degree of inflammation and lesions. Those with severe acne may often have low self-esteem, which may lead to stress and lower quality of life. Therefore, physicians need to take on an integrative approach by treating both the internal, external, as well as emotionally. 

Are there any TCM herbs that we can take to get rid of and prevent acne? 

Before taking any TCM herbs, it’s important to understand that each patient will have different patterns. Hence, it is crucial to take into consideration the accompanying symptoms, age, gender, lifestyle and constitution when taking a TCM herbal formula. 

We use TCM herbs such as Bai Hua She She Cao (白花蛇舌草), Huang Qin (黄芩) and Jin Yin Hua (金银花) to clear heat. In conditions where Stomach Heat is more prominent, herbs like Shan Zha (山楂), Yi Yi Ren (薏苡仁), Zhi Qiao (枳壳) are used accordingly. For chronic acne with Blood Stagnation, some examples of herbs to gently move qi and blood stasis are Tao Ren (桃仁), Hong Hua (红花) and Dang Gui Wei (当归尾).

At home, you can use Yi Yi Ren (otherwise known as pearl barley) and mung beans to remedy acne with heat toxins. Both have slightly cooling properties, so they can clear heat to reduce swelling, inflammation and help smoothen the skin. 

Peach gum and white fungus are traditional beauty foods that contain collagen, which help invigorate the skin’s elasticity and nourish the skin by tonifying the Yin. Pair them with red dates, goji berries or Chinese pear for a delicious dessert. For those who fancy savoury flavours, jellyfish and black wood ear mushrooms tossed in sesame oil is a great choice for boosting collagen and clearing excess heat naturally.

Can you share any other tips to help with acne?

True skin healing takes time, and that is the reality. The skin regenerates itself every 30 days and we are working with this natural turnover process. The goal here is to restore the function of the skin, as well as the underlying system that supplies nutrients to the skin.

It’s important to be patient as there are no quick fixes. Sometimes it can take months to notice an improvement in your skin health, so the decisions that you make every day (both positive and negative!) must be done carefully. Some tips to keep in mind:

1. Don’t touch your face!

2. Change your pillowcase at least once a week.

3. Change your towel and face mask (if you’re using a reusable one) regularly.

4. Wash your face with a gentle cleanser only twice a day, no more and no less.  Washing too often will strip the natural oils and your skin will produce more oil to compensate. You can also try cleansing with strong oolong tea or Jin Yin Hua herbs to clear toxic heat from the surface.

5. Paying attention to your period cycles and finding a way to regulate them is important to get rid of acne on the chin.

6. Avoid fried, greasy, excessively hot and spicy foods, dairy, and reduce simple carbohydrates. These create internal Dampness and Heat, which can manifest as acne.

7. Avoid fa foods such as shellfish, processed foods and heaty fruits such as durian, lychee and longan. These foods exacerbate inflammatory conditions, push the heat outwards towards the skin and may cause acne flare-ups.

8. Consider supplements to support gut health and keep your antioxidant levels up.

9. Facial acupuncture can be incredibly helpful in decreasing inflammation, smoothening skin texture and treating post-inflammatory scarring.

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