Korean Medicine Constitutional Treatment for Acne — Cheongsangbangpung-tang and Hwangryeonhaedok-tang

How acne develops

Acne vulgaris arises from the combined action of excess sebum secretion, follicular keratinization, bacterial (C. acnes) proliferation, and inflammation. While increased androgens during puberty are a major trigger, adult acne is more often driven by stress, sleep deprivation, dietary habits, and hormonal imbalance. Adult acne along the jawline and lower cheeks particularly suggests hormonal and digestive issues.

Lung-stomach damp-heat (肺胃濕熱) and blood heat (血熱)

In Korean medicine, acne is viewed as internal heat erupting through the skin.

• Lung-stomach damp-heat (肺胃濕熱): Greasy foods, late-night meals, and alcohol cause damp-heat to accumulate in the stomach (胃), and since the lung (肺) governs the skin, this heat rises to the facial skin. Pustular acne concentrates on the forehead and nose (T-zone).
• Blood heat (血熱): Stress and emotional suppression cause heat to gather in the blood level (血分). It is characterized by red, warm papular acne on the cheeks and chin and worsens before menstruation.

Cheongsangbangpung-tang (淸上防風湯) and Hwangryeonhaedok-tang (黃連解毒湯)

Cheongsangbangpung-tang is a formula that clears wind-heat in the upper body (face and head). With Bangpung, Hyenggae, Yeongyo, Bakha, Chija, Hwanggeum, and Hwangnyeon, it cools heat in the head and face and suppresses inflammation. It is effective for early red papules and pustular acne.

Hwangryeonhaedok-tang, composed of Hwangnyeon, Hwanggeum, Hwangbaek, and Chija, is a powerful heat-clearing and detoxifying formula. It is used for severe acne with intense systemic heat and recurring pustules.

• When indigestion accompanies: Combine with Pyeongwi-san to clear damp-heat in the spleen and stomach
• Premenstrual flare type: Modify Soshiho-tang to regulate liver heat (肝熱)
• When scarring occurs: Add Doin and Jeokjakyak to invigorate blood, dissolve stasis, and promote dermal regeneration

Skincare rules for acne-prone skin

Wash your face twice a day with a mildly acidic cleanser. Excessive cleansing destroys the sebum barrier and actually increases sebum production. Limit dairy and refined carbohydrates (bread, snacks) since they trigger sebum secretion through insulin spikes. Squeezing acne with your hands causes scarring and secondary infection.