When a patient starts treatment with Chinese herbal medicine, I am often asked if their skin will worsen before it improves. While the so-called healing crisis may be a commonly held belief within other healing modalities, it is not one that I am looking for. The idea that the skin will worsen before it gets better seems to be rooted in the idea that, as the body eliminates toxins, aggravation of symptoms will be witnessed. Many patients have told me that this had happened to them after trying other ‘natural medicine’ approaches. The problem is that, in more times than not, their skin never actually improved after the healing crisis. Plain and simple I want to see my patient’s skin improve, not worsen.
Basically, when I prescribe herbal medicines it is my expectation that, upon the first 2 week follow-up appointment, noticeable improvements should be seen. Sometimes improvements take longer, even up to 8 weeks for such stubborn conditions as psoriasis, but I never really like to see a condition worsening. If a condition does worsen then it possibly tells me a few things:
- Steroid use: Depending on how much and how often someone has used steroid creams, the skin may flare up when they are stopped. This is because steroids only suppress inflammation, they may not completely get rid of it. The ‘rebound effect’ is a well know experience for people stopping steroids, whereby the skin flares up again, sometimes even worse then before. This is not due to herbal medicines, but rather the body not knowing how to fend for itself anymore after being so strongly suppressed with the steroid. Given enough time, most patients are able to transition over to herbal medicines, finding that their skin begins to clear even better than when they used the steroid.
- Wrong treatment: Herbal medicines are custom fit to the individual and may not actually be the right ones for you. There are many herbs to choose from, and even more combinations for those herbs to be mixed together. If the herbs are the wrong fit for the person, then a worsening of their condition may be experienced. It may also be that the herbs were just not strong enough to control an already in progress flare up, and thus a bigger dosage is needed. If I see this happen, then it gives me much information as to how to redesign the next herbal prescription. Medicine is an art, and hence why we call it the ‘practice of medicine’. Finding the right fit for the individual may take a couple tries, but once it is found, results are seen.
- Coincidence: Sometimes other factors in ones life – like alcohol drinking, stress, over-eating of sugary or deep-fried foods, or applying certain kinds of moisturizers and make-up – may coincide with a flaring of the skin. If we don’t pay attention it would be easy to assume that this was due to the herbal medicines, but in reality it was due to other factors. Sometimes we cannot even figure out what the culprit is that is influencing the skin to flare, as is the case in some people with environmental allergies to things like dust or pollen, and so we just have to keep plodding through with treatment until the skin comes under control, refining the prescription as needed.
Of all the conditions that I treat, Acne is one that may get a bit worse before getting better. Some people whose acne tends to be rather deep-seated, rarely coming to a head, may find that as their acne clears they have more pustules – ie. that their acne comes to a head more often. This is a good thing, as it shows that the acne is improving by becoming less deep, and would not be considered a worsening. Overall, I would say that when you start a treatment you should see your condition progressively improve, not worsen. So again, when I treat skin conditions with Chinese herbal medicine I am NOT looking for any healing crisis! (Please read enough is enough for more for treatment expectation ideas)
Wishing you health,
Dr. Trevor Erikson
Copyright © 2019 Dr. Trevor Erikson