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KAMWO MERIDIAN HERBS esents Dermatology M Practitioner’s Guide

Version 1.0 2019 CONTENT

ACNE 2

ALLERGIC RHINITIS/ SINUSITIS 2

ALOPECIA AREATA 3

BACTERIAL INFECTIONS 3

ECZEMA (DERMATITIS) 4

SUB-FORMS OF ECZEMA 7

FUNGAL & YEAST INFECTIONS 11

LICHEN PLANUS 14

LICHEN SCLEROSIS 15

LICHEN SIMPLEX 15

MELASMA / CHLOASMA 15

PERI-ORAL DERMATITIS 16

PSORIASIS 16

ROSACEA 19

SCARING 20

URTICARIA 20

VIRAL INFECTIONS 21

VITILIGO 22 ACNE

DAY TIME

FEI ZI SHUI (Break Out Day Gel) Apply several times a day to affected skin

JIN YIN HUA FACE WASH (Honeysuckle Break Out Wash) Use to wash affected areas on the skin, rinse off, avoid using soap.

XIAO CUO MIAN MO (Break Out Mask) Use this Face Mask 2-3 times a week, leave on for 15 minutes before washing off

NIGHT TIME These products leave a yellow mark on the skin that can be washed off in the morning.

FOR DRY SKIN TYPES DIAN DAO SHUI GAO (Break Out Night Cream For Combination Skin) Apply to affected area and leave on over night

FOR GREASY SKIN TYPES FEI ZI DIAN DAO SHUI (Break Out Night Gel For Oily Skin) Apply to affected area and leave on over night. Currently not available.

ALLERGIC RHINITIS/ SINUSITIS

RHINITIS BI YAN (Nasal Spray) 1-2 sprays in each nostril 2-3 times a day

SINUSITIS CANG ER ZI (Nasal drops) 1-2 drops in each nostril 2-3 times a day 2 ALOPECIA AREATA

CE BAI YE DING (Enriching Hair Tincture) Apply to the affected bald area twice a day.

BACTERIAL INFECTIONS

IMPETIGO

SAN HUANG SHUI GAO (Three Yellow Cream) Crusted forms of Impetigo

CHUAN XIN LIAN SHUI GAO (Skin Calming Cream) Dryer forms of impetigo

HUANG LIAN SHUI (Exce Gel 1) Wider spread forms of Impetigo. Currently not available.

Initially use powder until dryer and then use creams as above.

QING SAN (Powder) Eroded or Weepy forms of Impetigo with discharge Sprinkle the powder on area until the area is less weepy

QING DAI SAN (Powder) Eroded or Weepy forms of Impetigo with discharge Sprinkle the powder on area until the area is less weepy

Alternatively (once crusting forms) mix the powder with a little sesame oil and apply to the area.

SHI ZHEN GAO (Ointment) Impetigo with Mild Eczema

3 4 ECZEMA

ECZEMA (Dermatitis) Patients with eczema tend to vary in their response to different topical products, and are very sensitive. If a patient is not getting the desired result from o particular topical product, they should try another one from the list.

There are several different types of Eczema (Atopic, Nummular, Hand Eczema, Stasis, Seborrhoeaic etc) However, within these types, when it comes to topical applications, Eczema can be divided into Three main morphological subtypes.

For most types of Eczema you can follow the differentiation below, however, there are a few exceptions where different topicals for different forms of eczema (see heading below under SUB-FORMS OF ECZEMA) are more suitable, notably in Ear canal Eczema, Hand Eczema. Lip Eczema, Seborrhoeic Eczema, Scalp Eczema.

THREE MAIN MORPHOLOGICAL SUBTYPES

HOT BLOOD Red, ill-defined lesion, scaly and itchy

DAMP HEAT Red, swollen, itchy, eroded, weepy or crusted lesions

DRY BLOOD Pale, little inflammation, mostly dry or fissured

4 HOT BLOOD ECZEMA

SMALLER AFFECTED AREAS

SHI ZHEN SHUI GAO (Cream)

HUANG LIAN GAO (Ointment)

ZI CAO SHUI GAO (Cream) To keep skin moisturised

WIDESPREAD LESIONS HU ZHANG SHUI (Gel)

HUANG LIAN GAO (Gel)

ZI CAO SHUI GAO (Cream) To keep skin moisturized HOT BLOOD ECZEMA

HOT BLOOD ECZEMA WITH INFECTION CHUAN XIN LIAN SHUI GAO (Cream)

5 4 DAMP HEAT ECZEMA

SMALLER AFFECTED AREAS SHI ZHEN GAO (Ointment Paste)

ZI CAO SHUI GAO (Cream) DAMP HEAT ECZEMA

WIDESPREAD LESIONS

HUANG LIAN SHUI (Gel) More suitable as gel spreads easily. Currently unavailable.

ZI CAO SHUI GAO (Cream) To keep skin moisturised

EROSION OF THE TOP LAYER OF SKIN QING FENG SAN (Powder)

QING DAI SAN (Powder) Sprinkle powder on area until the area is less weepy

SHI ZHEN GAO (Ointment) To keep skin moisturised

DAMP HEAT ECZEMA WITH INFECTION SAN HUANG SHUI GAO (Cream)

6 DRY BLOOD ECZEMA

A LITTLE REDNESS, MOSTLY DRY AND SCALY, OR CRACKED SKIN (often seen once most of the eczema resolves)

ZI CAO SHUI GAO (Cream)

GAN CAO SHUI GAO (Cream) DRY BLOOD DRY

SUB-FORMS OF ECZEMA

ATOPIC ECZEMA Differentiate according to Three main morphological subtypes (See under main title of Eczema).

EAR CANAL ECZEMA

HUANG LIAN DI (Drops) 2-3 drops 2-3 times a day. Currently unavailable. EAR CANAL

7 4 HAND ECZEMA (DERMATITIS)

POMPHOLYX ECZEMA Blistering Dermatitis of the palms, sides of fingers, and sometimes soles of feet. This dermatitis typically has two phases: First the blistering phase, then after a week or so the dry phase manifests.

BLISTERING PHASE SAN BAI SAN (Powder) HAND ECZEMA

Empty the contents of a packet of powder into a bowl of just boiled water and stir. Steam the affected area over the bowl, this will help reduce the itching. When the liquid is cool enough, soak the affected area for 15–20 minutes.

DRY PHASE ZI CAO SHUI GAO (Cream)

GAN CAO SHUI GAO (Cream)

RUN ZU SHUI GAO (Cream)

FOR HOT INFLAMED AREAS SHI ZHEN SHUI GAO (Cream)

8 9 LIP ECZEMA HAND ECZEMA FINGER TIPECZEMA(DERMATITIS) NIGHT TIME DAY TIME Currentlyunavailable.

DA HUANG GAO (Cream) BAIJIGAO (Cream) RUNZUSHUIGAO (Cream) ZICAO SHUIGAO (Cream) ZICAO RUNCHUNGAO (MoisturisingLipBalm) LIP ECZEMA(DRY CHAPPEDLIPS) HAND ECZEMA(DERMATITIS)

Apply &occludeApply glovesormittens) (coverfingerswithvinyl Currently unavailable. For fissuredskinandhypertrophic(thick)skin. For fissuredskinandhypertrophic(thick)

NUMMULAR/DISCOID ECZEMA

This is a nummular (well defined) round or oval dermatitis typically seen on the SCALP ECZEMA limbs and body. Most types are Damp Heat (blistering) though Dry Hot types also occur. Once the condition is in resolving stage, it becomes Dry Blood.

SCALP ECZEMA

SHAMPOO S (Shampoo) Use this shampoo 3-4 times a week to wash your hair. Currently not available.

RUN FA YOU (Oil) Apply to scalp at night (2-3 times a week) and cover with protective shower cap. In morning wash off the oil.

SEBORRHOEIC DERMATITIS SCALP ECZEMA

Most types are Hot & Dry and will present with dry, red and scaly skin. Occasionally Damp Heat types are seen, presenting with weepy, crusty and eroded skin, often intertriginous areas are affected (armpits, groins, below the breasts in women).

FOR ALL TYPES OF SEBORRHOEIC

WU SHI GAO (Ointment) Once absorbed apply Zi Cao Shui Gao Cream

ZI CAO SHUI GAO (Cream)

10 FUNGAL & YEAST INFECTIONS

FOOT (ATHLETES FOOT) & HAND TINEA

BLISTERING TYPE SAN BAI SAN (Powder) Mix boiling water onto the contents of one sachet of San Bai San. Then first steam affected area (this will help to reduce itching). When liquid is cool enough, soak for 20-30 minutes. Do this twice a day.

CU PAO FANG (Vinegar Soak) Soak for 15-20 minutes a day Can re-use soak within 2 weeks or so, but must pour it back into the bottle and seal firmly

TI XUAN GAO (T-Ointment) FOOT & HAND DRY TYPE CU PAO FANG (Vinegar Soak) Soak for 15-20 minutes a day Can re-use soak within 2 weeks or so, but must pour it back into the bottle and seal firmly

TI XUAN GAO (T-Ointment)

11 BODY, SCALP OR GROIN TINEA BOD Y, Y, SCAL P

TI XUAN DING (T-Tincture) Apply tincture to affected area, when dried apply

TI XUAN GAO (T-Ointment) , GROIN

ECZEMA WITH FUNGAL INFECTION ECZEMA FUNGAL

SHI ZHEN GAO (Ointment)

12 NAIL FUNGAL INFECTIONS

CU PAO FANG (Vinegar Soak) Soak nails for 15 minutes

FENG HUA GAO (Ointment) Currently not available.

NAILS YA DAN ZI YOU (Oil) After application of either of the above, wrap the nail with cling-film or saran wrap for 24 - 48 hrs. Then clean the nail and cut off all the fungal nail and affected tissue without injuring the nail. Repeat the procedure until the nail is clear

PITYRIASIS VERSICOLOR

A yeast infection typically affecting the upper back and chest. It may be brown or white in colour with fine scaling, accompanied by mild or no itching.

SAN HUANG DING (Tincture) Apply 2-3 times a day PITYRIASIS VERSICOLOR

13 LICHEN PLANUS

LICHEN PLANUS OF THE SKIN HUA JIAO DING (Tincture)

HUANG LIAN GAO (Ointment)

HU ZHANG SHUI (Gel)

SCALP LESION CE BAI YE DING (Tincture)

DRY SKIN

ZI CAO SHUI GAO (Cream) Use this shampoo 3-4 times a week to wash your hair.

HYPERTROPHIC FORMS (TYPICALLY THICK LESIONS ON SHINS)

HEI BU YAO GAO (Thick Ointment) First, place jar in hot water to partially melt the ointment. Apply product to affected area and allow to form a skin (it will form a black film). Wash off and reapply every 24 hours. Currently not available. 14

14 LICHEN SCLEROSIS

HUANG LIAN GAO (Ointment)

CANG ZHU SHUI (Gel) Currently not available.

ZI CAO SHUI GAO (Cream)

LICHEN SIMPLEX

SHE CHUANG ZI DING (Tincture) Apply to affected area whenever there is an itch (can be used several times a day). Do not expose treated area to direct sunlight.

MELASMA / CHLOASMA

This common condition mostly affects women. It is typically characterized by dark patches of skin on the cheeks, forehead and chin When it occurs in pregnancy it is called “mask of pregnancy”

QU BAN DING (Tincture) Apply to affected areas. allow to dry naturally and then apply. Currently not available.

QU BAN SHUI GAO (Cream) Currently not available.

QU BAN SHUI GAO (Mask) Can be used 2-3 times a week. Leave on for 15 minutes before washing off. Currently not available.

15 PERI-ORAL DERMATITIS

WU SHI GAO (Cream)

REJUVENATING FACE CREAM (Cream)

ZI CAO SHUI GAO (Cream)

PSORIASIS

Most cases of psoriasis can be divided primarily into two main catagory; Active type (Hot blood), and Resolving Type (Dry Blood). 95% of cases of Psoriasis are hot type.

Two other types that are less commonly seen in practice are Hyperkeratotic (Thick skin) type of the hands & feet and Pustular (pustular lesions on a red background) type of the palms and soles.

16 ACTIVE HOT PSORIASIS

The topical for psoriasis are strongly pigmented and leave some blue-black discoloring of the skin, this washes off easily and the results makes the minor inconvenience worth it. For lesions of the face where the blue-black colour is not deemed acceptable during the day, use Bai Bi Ding (Tincture) or Bai Bi Er Hao Shui Gao (Cream), but in the evening use Bai Bi Gao or Bai Bi Shui Gao.

DAY TIME BAI BI SHUI GAO (Cream)

NIGHT TIME BAI BI GAO (Ointment) After application of the ointment, wrap the area with ACTIVE-HOT saran wrap to increase the absorption. Very rarely wrapping the skin in this way will lead to red, itchy, sore skin - If so, apply the ointment without saran wrap.

RESOLVING PSORIASIS

Resolving Psoriasis starts off as hot type, but as it clears it becomes pale and dry. In the rare case of Erythrodermic Psoriasis (Red, very widespread lesions, covering 90% of body, actively growing red lesions) do not use Bai Bi Gao or Bai Bi Shui Gao in such instances, but rather treat topically as Resolving Psoriasis.

ZI CAO SHUI GAO (Cream)

GAN CAO SHUI GAO (Cream) RESOLVING

BAI BI ER HAO SHUI GAO (Cream)

17 HYPERKERATOTIC LESIONS OF PALMS & SOLES PALM S

DAY TIME

RUN ZU SHUI GAO (Cream) &

SOLES NIGHT TIME BAI BI GAO (Ointment) Wrap overnight with cling film or saran wrap

LESIONS OF SCALP OR FACE SCALP OR FACE

DAY TIME BAI BI ER HAO SHUI GAO (Cream)

BAI BI DING (Tincture)

NIGHT TIME BAI BI GAO (Ointment)

BAI BI SHUI GAO (Cream) Use at night only if discoloration of skin is an issue

SCALP PSORIASIS

BAI BI ER HAO SHUI GAO (Cream)

18 19 ACTIVE-HOT NIGHT TIME DAY TIME

DAY TIME JIUZHASHUIGAO JIUZHADING

areplentiful BAIBISHUIGAO (Cream) FEIZIDIANDAO SHUI DIANDAO SHUIGAO (Cream) Apply to affected area and leave onovernight. toaffectedareaandleave Apply Currentlynotavailable. ( SCALP PSORIASIS Tincture) ( Cream) ROSACEA ( Break OutNightGelFor OilySkin

Apply first, naturally,Apply todry allowing thenapply

Apply twiceadaytoaffected area Apply Use at nightinactivephaseifpustules Use at ) 20 SIMPLE SCARS KELOID SCARS HU ZHANG SHUI First, place jar in hot water to partially First, SCARING Apply 2-3 times a day. Currently not available.Apply 2-3 times a day. URTICARIA Apply to affected area to ease itching HU ZHANG SHUI HEI BU YAO GAO (Thick Ointment) GAO HEI BU YAO (Scar Oil) QU BA YOU

melt the ointment. Apply and allow product to keloid scar to form a skin (it will form a melt the ointment. Currently not available. off and reapply everyWash 24 hours. black film).

21 HERPES MOLLUSCUM COMMON WARTS / SIMPLEX CONTAGIOSUM VERRUCA Herpes SimplexandZoster. These conditionsincludeCommonWarts, Verruca, Molluscum Contagiosum,

beendippedintothe Ya DanZi You (Oil). (usually2-4weeks). looseskin, scruboffany oil. thenreapply thisprocessdailyuntilthewartsclear Repeat isideal). (Ducttape strongtape after24hoursandwashoffremainingoil, Removetape whetherblistering, erodedordry.

YA DAN ZIYOU (Oil) YA DAN ZIYOU (Oil) YUXINGGAO (Ointment) VIRAL INFECTIONS Pick the largest papule with a wooden toothpick that has withawoodentoothpickthat Pickthelargestpapule adroportwotocommonwartsthenoccludeApply with Use 2-3 times a day on all stages ofHerpes,Use 2-3timesadayonallstages HERPES ZOSTER neuralgia(Pain cleared). ofthe skinoncethelesionshave HerpesZoster, fromblistering, stage. erodedtodry Canalsobehelpfulinpost-herpetic

ofpigment. REDAI CHUANG GAO (Ointment) WUMEIDING (Plum Tincture) VITILIGO Use 2-3 times a day on all stages of Use2-3timesadayonallstages Apply toallareaswhere thereisloss Apply 22