A trip to see a (Chinese medical) dermatologist

Many people inquire as to what to expect when they come and visit me, so I thought I would take a few minutes to illuminate the process.

First off, although the title seems broad, as in what to expect seeing any Chinese medical dermatologist, this blog piece is really about what people can expect coming to see me.

I am a Doctor of Chinese medicine who specializes in the natural treatment of skin disorders and different allergic conditions like asthma and hayfever (allergic rhinitis) – which are often related. (To get an understanding as to the depth of my training you can read my bio).

Upon a first visit, I spend the majority of my time gathering information about you. This includes the current skin or allergic problem that you now face and all the different ways in which it manifests and is helped or aggravated. I want to know about your family history, as many problems do have a hereditary link which is important to understand (being genetic does not mean the condition cannot be treated however). I want to know what you do for a living, ie if you are a health care worker having to wash you hands a lot, how you manage stress, any emotional links to your health condition, etc. I then want to know your overall health state; the health of your digestion, menstruation, sleep, aches and pains, headaches, energy levels, breathing, etc.

In Chinese medicine we also take note of the colour and shape of your tongue and the quality of your pulse. The findings of these two ancient investigations help us understand the inner workings of your body.

The last, and by far the most modern, way I gather information is to photograph your skin. The pictures I collect help both of us tremendously. It helps me in the times you are not present in the clinic to look with closer detail at your problem. It helps both of us remember how you used to be, so that we can properly judge if you have made improvements or not. I feel that the addition of the camera into any Doctor’s clinic, focusing on skin, is a total must.

I remember an 11 month old baby, I treated a couple of years ago, who came into the clinic wearing socks on his hands (a very common occurrence with the youngsters) so that he wouldn’t would be able to scratch his body – which was covered head to toe in eczema. The mother was exhausted and overwhelmed with the care she was giving her son, claiming that he would wake about every 30 minutes through the night in agony from the itch.

I proceeded to gather all my information, ending as I mentioned with the photographs. Several months later the mother came in with her son, frustrated that he was still itchy and was unsure if the treatment had worked or not. We then dug up his photos and from the site of them the mother came to tears as she remembered how bad he used to be.

The baby was no longer head to toe in eczema, but rather only had a few patches on his inner wrists and ankles. Yes he was still itchy and uncomfortable, but certainly no where near the degree he was at upon his first visit. The baby was also sleeping much better, now that the itch was much less. He only woke about 1 or 2 times in the night, rather than every 30 minutes as had been doing. (Improved sleep in toddlers is a good indicator that their level of comfort is improving).

The photographs in this babies case proved to be a powerful tool to monitor progress. Without them the child’s mother would have left feeling totally depleted and without any hope that her son would ever recover. Seeing the photos gave her increased faith in the power of herbal medicines. She was recommitted to the work of administrating the medicines to her child.

After I have gathered enough information, I then need to come up with a diagnosis. First off, I need to determine exactly what it is that you have. Do you have eczema or a fungal infection? Do you have vitiligo or tinea versicolour? The diagnosis of the actual skin disorder, in combination with your overall health state, allows me to create a detailed diagnosis of your problem. The diagnosis is what determines your treatment plan.

A sample diagnosis may look something like the following:

Psoriasis due to heat in the blood with fire toxin and wind.

You can see that the above diagnosis uses a well defined and known western disease name (Chinese medicine also has many names for psoriasis, but we usually stick to the western name in english), along with some added Chinese medical terminology that refers to distinct and deeper qualities of the psoriasis – thus making the original diagnosis of psoriasis much more refined.

A step further would like this:

• Psoriasis – skin rash with well defined characteristics and behavior
• Blood heat – refers to psoriasis lesions that are quite red in colour, probably still quite active, and has an easy to elicit auspitz sign (easily bleeds with pinprick points when scratched)
• Fire Toxin – the psoriasis is particularly aggressive, more widespread on the body, thicker lesions, and possibly a browner looking scale
• Wind – refers primarily to itch (not everyone with psoriasis has an itch) and the amount of scaling that is produced.

The above diagnosis is also just referring to unique characteristics of the psoriasis itself. The information gathered about digestion, sleep, and other general health related findings will be used when it comes to designing a tailor made treatment plan.

After the diagnosis is finished, the treatment plan is designed. This will usually include some dietary and lifestyle adjustments, but most importantly (and unique to Chinese medicine) a herbal formulation will be made. Herbs may be prescribed to be used just as a wash, a tea to drink, or both. I may also prescribe one or more creams that I make specifically for my patients needs.

This whole process takes about an hour. Afterwards, it is really all up to you – the patient. Follow up visits are only about 20 minutes or so and are just a means to gather more information and monitor progress. They happen about every 2 to 3 weeks.  I encourage everyone to try to stick with their treatment plan for the length of time that I recommended. This is truly the only way we are going to know if the program will work for you or not.

Wishing you the best of health.

Dr. Trevor Erikson