Board-certified allergist Dr. Michael Pistiner shares what he wishes more of his patients knew about the association of eczema and allergies.
Published On: Nov 18, 2019
Last Updated On: Mar 8, 2021
Olivia Hsu Friedman grew up battling eczema, asthma and a multitude of allergies. Although she tried all kinds of ointments and medications to manage her condition, she still suffered severe allergic reactions that regularly landed her in the hospital.
Eventually, Friedman began looking into alternative treatment options and decided to see a Traditional Chinese Medicine (TCM) practitioner. Within six months, she experienced “a pretty profound transformation” as her skin cleared up, her asthma improved and most of her allergies alleviated.
Friedman’s own experience inspired her to study – and ultimately become a practitioner of – TCM in order to bring the natural solutions to other patients.
“There are a lot of medications out there that are pretty good at managing symptoms, but not necessarily at alleviating the actual condition,” said Friedman, who earned a doctorate in acupuncture and Chinese medicine, as well as a diploma in TCM Dermatology.
“A lot of people get to the point where they’re looking for a deeper solution, and they eventually come to TCM.”
Now, Friedman operates Amethyst Holistic Skin Solutions in Chicago, where she uses Chinese herbal medicine to treat dermatology patients. She sat down with NEA recently to explain how TCM can help treat eczema.
TCM is an ancient approach to promoting health by bringing the body’s systems into balance. Where Western medicine focuses on treating specific symptoms, TCM looks at overall wellness.
“What’s different with Chinese medicine is that we’re looking at the root cause of the condition and trying to rebuild those systems so they can function normally,” Friedman said.
TCM employs several modalities, including acupuncture, which refers to the insertion of fine needles into strategic points on the body. Although Friedman is a licensed acupuncturist and serves on the board of the American Society of Acupuncturists, her practice is entirely focused on herbal medicine.
Chinese herbs can take the form of liquid extracts, capsules, powders or topicals. “In dermatology, the ideal way is to take them in liquid form,” Friedman said, because the extraction method maximizes the strength and efficacy of the herbs.
However, she often recommends topical herbs along with liquids, “to treat the skin from the inside and the outside as well.”
One of the greatest advantages that Friedman sees in Chinese herbal medicine is how the formulas can be customized for each patient.
“You can customize the ingredients and dosage of each formula based on that particular person’s condition, as well as other contributing factors that are making their eczema worse,” she said. “It’s a very individualized medicine.”
Friedman said TCM’s herbal arsenal includes more than 10,000 herbs, which are mainly found in the leaves, stems and roots of certain plants. Each formula may include anywhere from 10 to 30 different herbs — some of which have antibiotic, antibacterial or anti-inflammatory properties — which can be adjusted as each patient’s eczema evolves.
“In TCM, we recognize that as the condition progresses, eczema touches a lot of other systems,” Friedman said, “so we can really customize the formula to treat you based on where you’re at.”
While there have been some scientific studies of herbal medicine, Friedman said the research falls short because TCM doesn’t easily fit into randomized control trials (RCTs).
“RCTs are set up to focus on one chemical and how it reacts on one mechanism, and then we study it on hundreds of people and give them the exact same thing over time,” she said.
“But the problem with Chinese medicine in terms of research is that there are thousands of bioconstituents in each herbal formula. It’s very difficult to say that they’re only reacting on one mechanism, and because the medicine is so individualized, there is no one way to look at this medicine that fits the RCT.”
A few small studies suggest the therapeutic potential of TCM for eczema. In the early 1990s, trials in the U.K. found promising results: About half of the children and 70% of adults in one study saw 90% improvement in their eczema after 12 months of herbal treatment.
A more recent 2008 study combined Chinese herbal medicine with acupuncture to treat patients with atopic dermatitis (AD) for 12 weeks, and 100% of them reported reduced severity of their eczema.
Although medical professionals call for larger scale studies to confirm the efficacy of alternative therapies, there’s no shortage of anecdotal evidence from patients who have found relief through TCM.
“Chinese medicine has existed for thousands of years; there must be something to it,” Friedman said. “If there are enough people actually seeing results, that’s a testament that this medicine does work. We just have to be more open-minded in how we’re going to look at it in terms of research.”
Since eczema impacts each person so uniquely, Friedman cautioned that no single medicine will fix everyone’s AD issues and all treatments take time to work.
“A lot of people are looking for a quick fix, but I liken it to exercise in that you can’t just go to the gym and do a few sit-ups and have a six-pack of abs. Herbs take time, so I always caution people that it’s not an overnight fix,” she said. “I usually tell my patients to give themselves three months, and you should see changes all along the way.”
Even if you are a good candidate for herbal medicine, treatments can get expensive because TCM is not covered by most insurance companies. Some insurers might allow health spending accounts or flexible spending accounts to be used for appointments and herbs, but others may not.
“Because people have to pay out of pocket, it’s not the easiest solution, and it can be financially hard for some,” Friedman said.
Accredited TCM dermatologists like Friedman are a relatively small (but growing) specialty, which can make it difficult to find a licensed practitioner. That’s why Friedman offers telemedicine — video conferencing — to see patients across the country who don’t have access to a local provider.
“I feel strongly that this medicine can offer help and hope to a lot of different people,” she said, “so my hope is that we can make this medicine more accessible.”
Dr. Olivia Hsu Friedman, DACM, LAc, Dipl. OM, owns Amethyst Holistic Skin Solutions in Chicago where she treats dermatology patients with Chinese herbal medicine. She serves on the board of directors of the American Society of Acupuncturists, the advisory board of LearnSkin, and the faculty of the Chicago Integrative Eczema Support Group.