MEDICAL ACUPUNCTURE
Volume 32, Number 1, 2020
# Mary Ann Liebert, Inc.
DOI: 10.1089/acu.2020.29136.cpl
How Do You Treat Adolescent Acne in Your Practice?
A cne vulgaris is a primary inflammatory disorder
involving the pilosebaceous unit. The pathophysiology
of acne vulgaris is multifactorial, including increased sebum
production, hyperkeratinization of the follicular infundibu-
lum, inflammation, and cutibacterium acnes.1 Acne vulgaris
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affects up to 85% of young adults aged 12–25 years and is
one of the three most prevalent skin conditions in the general
population. Acne vulgaris mostly affects adolescents but
may continue to adulthood, with 26% of women and 12% of
men reporting acne in their 40s.1,2
The diagnosis of acne vulgaris is done primarily through
clinical evaluations. Family history, symptoms and signs of
hyperandrogenism or other endocrine disorders, and use
of medications must be obtained. The primary lesion types
in acne are comedones (open or closed) and inflamma-
tory lesions (papules, pustules, and nodules). The typical
distribution involves the sebaceous gland-rich areas of the
face, upper back, chest, and shoulders. Secondary changes
such as scarring, post-inflammatory hyperpigmentation,
or erythema must also be noted. The severity of acne vul-
garis varies from mild to fulminant disease with systemic
involvements.1
The main therapy for acne vulgaris includes topical
agents, systemic antibiotics, and hormonal therapy. Topical
agents include benzoyl peroxide (BP), salicylic acid, anti-
biotics, a combination of antibiotics with BP, retinoids, ret-
inoids with BP, retinoids with antibiotics, azelaic acid, and
sulfone agents. Systemic antibiotics include tetracycline,
doxycycline, minocycline, trimethoprim/sulfomethoxazole,
Medical Acupuncture is pleased to continue this regular fea-
ture, Clinical Pearls, which we have found to be very useful for,
and practical to, the readership, and very popular. All of us are
confronted with clinical challenges, especially when dealing with
therapeutic strategies. We hope this ongoing collection of Clinical
Pearls will be easily accessible and ready to put into action for
the benefit of our patients, and even ourselves. How often do we
ask our colleagues: ‘‘How do you treat. ?’’ This time, we posed
the question: ‘‘How do you treat adolescent acne in your prac-
tice?’’ Herein lie your contributions. We trust that our readership
will continue to participate in this section by either asking the
questions or supplying the ‘‘Pearls.’’ If you have a ‘‘question’’
you would like to see answered, please send it to our managing
editor, Yael Ben-Porat, at: yaelbenporat@me.com We encourage
and welcome your input and participation. Please address your
answers to ‘‘Pearls’’ to our managing editor, Yael Ben-Porat, at:
yaelbenporat@me.com
45
CLINICAL PEARLS
trimethoprim, erythromycin, azithromycin, amoxicillin, and
cephalexin. Hormonal therapy includes the use of combi-
nation oral contraceptives. Spironolactone and isotretinoin
are also commonly used. Other therapies, including che-
mical peels, laser devices, intralesion injection of triam-
cinolone acetonide, and dietary control, are also used in the
therapy of acne vulgaris.3
Acupuncture has been shown to be effective in treating
acne vulgaris. In a systematic review and meta-analysis of
12 randomized controlled trials (RCTs) in 2018, acupunc-
ture was not significantly different compared to guideline
recommended treatments in treating acne vulgaris but had
fewer side effects, and thus it may be a treatment option.4
Another systematic review and meta-analysis in 2019 that
analyzed 10 trials with a total of 904 participants showed
that fire needling, a modality of acupuncture, combined
with pharmaceutical medication was better compared to
pharmaceutical medication alone in the treatment of
moderate-severe acne; fire needling alone was better than
pharmaceutical medication alone; and that that there was
no significant difference in the recurrence rate in both fire
needling and pharmaceutical medication. In addition, fire
needling was also associated with fewer adverse reactions.5
In the acupuncture treatment for acne vulgaris, both local
and distant acupuncture points are selected and stimulated
using sterile single-use filiformis needles. Aseptic and an-
tiseptic action using alcohol swabs are performed on the
location of the acupuncture points prior to needle insertion.
For the distant points, the needle is inserted perpendicularly
and manually stimulated until the needling sensation is felt
by the patient. The stimulation is repeated at the 5th and
15th minute by rotating the needle clockwise. For the local
points, the needle is inserted horizontally around the lesion,
0.5 cm from the edge of the lesion, without manual stimu-
lation. The needles on the local and distant points are then
retained for 20 minutes. The treatment is done twice a week
for the total of 12 sessions (6 weeks), and the patient is
evaluated for subjective and objective symptoms at the
3rd and 6th week. The distant acupuncture points used
are: LI 4 (Hegu), LI 11 (Quchi), SP 6 (Sanyinjiao), ST 36
(Zusanli), and LR 3 (Taichong). Other points that can be
added include: BL 13 (Feishu), LU 1 (Zhongfu), and SP 9
(Yinlingquan).
In circumstances where the patient cannot attend treat-
ment sessions regularly, the patient and his/her family are
 46
educated to perform independent acupressure in the time
of the scheduled session that is missed. The education
consists of:

Determining the location of the acupuncture points
used. The location of the acupuncture points used is
explained based on the World Health Organization
Standard Acupoint Location (2008). The measurement
in bone-cun (B-cun) of the distance from the elbow
to the wrist (12 B-cun) and the knee to the ankle (16 B-
cun) is also explained. After understanding the acu-
puncture point location and how to determine the point,
the patient is asked to show the location on his/her
body, and the doctor confirms whether the location is
correct.
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 Acupressure technique. The patient is taught simple
acupressure techniques: simple pressure, where the acu-
puncture point is pressed using the finger until a third
of the fingernail changes color, and kneading, where
pressure is applied to the acupuncture point using the
finger in a circular motion. Simple pressure is used on
the distant points, while kneading is used on the local
points. The acupressure is done for 30 seconds fol-
lowed by a resting period of 10 seconds. The pressure is
repeated until a 5-minute stimulation has been done on
all the acupuncture points used.
Twelve acne patients ranging from 16 to 19 years of age
came to our clinic in September and October 2019, most of
them students. They receive twice weekly acupuncture
sessions using the method described above. After 12 ses-
sions, all patients experienced improvements in their acne
symptoms. There was a reduction in inflammatory and
subjective symptoms such as erythema, pain, and less acne
on and around the face. During the acupuncture therapy and
2 months after the therapy session ended, no new acne ap-
peared, and the patients were generally satisfied with the
results.
REFERENCES
1. Zaenglein AL. Acne vulgaris. N Engl J Med. 2018;379(14):
1343–1352.
2. Lynn DD, Umari T, Dunnick CA, Dellavalle RP. The epide-
miology of acne vulgaris in late adolescence. Adolesc Health
Med Ther. 2016;7:13–25.
3. Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of
care for the management of acne vulgaris. J Am Acad Der-
matol. 2016;74(5):945–973.e33.
4. Mansu SS, Liang H, Parker S, et al. Acupuncture for acne
vulgaris: A systematic review and meta-analysis. Evid Based
Complement Alternat Med. 2018;2018:4806734.
5. Xing M, Yan X, Sun X, et al. Fire needle therapy for moderate-
severe acne: A PRISMA systematic review and meta-analysis
of randomized controlled trials. Complement Ther Med. 2019;
44:253–260.
CLINICAL PEARLS
Address correspondence to:
L. Yvonne Siboe, MD
Center of Development and Application
of Traditional Medicine
Indonesia. Jl. Kesehatan No. 10
RT.3/RW.6
Petojo Sel.
Kecamatan Gambir
Kota Jakarta Pusat
Daerah Khusus Ibukota
Jakarta 10160
E-mail: mamaipon@yahoo.com
Hasan Mihardja, MD, MHSc, PhD
Klinik Akupunktur Hasan Mihardja
Pulobidadari Raya Blok A6/16
Jakarta Timur
E-mail: hasanmihardja@gmail.com
Krisma Perdana Harja, MD
Apotik Restu
Jalan Pramuka Raya
Jakarta Pusat
E-mail: krisma_harja@yahoo.co.id
A dolescent acne vulgaris is a common skin disease
characterized by inflamed spots and blackheads on the
face, chest, and back. Cysts and scarring can also occur, es-
pecially in more severe cases of the disease.1 According to the
Global Burden of Disease study, approximately 85% of
teenagers are affected by this disease.2 It affects most ado-
lescents and has a major impact on their quality of life and
psychosocial well-being. In Western medicine, treatment of
acne involves topical or oral retinoids and antibiotics, as well
as topical BP.3 However, a dry mouth, dry skin, desquama-
tion, and gastrointestinal discomfort are common adverse
events following BP and retinoid treatment. Long-term an-
tibiotic treatment can also contribute to antibiotic resistance.
Retinoids have severe adverse effects such as teratogenicity
and should be used with caution in people of childbearing
age.4 A systematic review and meta-analysis conducted in
Australia showed there was no statistical difference in the
efficacy of acupuncture compared to guideline-recommended
pharmacotherapies for acne vulgaris. However, fewer ad-
verse effects were reported with acupuncture interventions.5
In other words, acupuncture may be an option for patients
desiring an alternative treatment to pharmaceuticals.
From the perspective of Traditional Chinese Medicine
(TCM), factors leading to acne development include over-
heating of the lung or stomach, stagnation of Qi and Blood, and
Phlegm–Heat obstruction due to excessive intake of spicy,
 CLINICAL PEARLS
sweet, fried, and oily food. As the condition progresses, heat
may increase and lodge in the skin and tissues, causing in-
flammation and acne lesions.6 Acupuncture benefits the
body by regulating the Qi and Blood, eliminating dampness,
relieving heat toxicity, and enhancing the immunologic
function to improve acne remission. Some studies have also
reported balancing of androgen levels after acupuncture
treatment, which could be a reason for the treatment’s effi-
cacy on acne reduction, as it inhibits over-secretion of the
sebaceous glands.7
According to the various clinical symptoms in patients,
the following three most common Zheng of acne with its
accompanying symptoms and the corresponding acupunc-
ture points can be used in clinical practice, three times a
week for 8 weeks (Table 1).
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1. Zheng of Wind–Heat invading lung: This type of acne
is similar to a grain in size and extrudes a white, oily
substance; it commonly develops on the nose and
forehead. Accompanying symptoms include black-
heads, mild local itching, thin white or yellow fur on a
reddish tongue, and a floating pulse. Hegu (LI 4),
Quchi (LI 11), Feishu (BL 13), and Dazhui (GV 14)
are usually selected to dispel wind and clear heat.
2. Zheng of Damp–Heat blocking in the stomach and
intestine: This type of acne mainly appears as a pimple
or pustule, and is distributed around the mouth and on
the face, the front chest, and the back. The inflam-
matory condition often worsens with an improper diet,
such as consuming peppers and high-calorie fried
foods. Accompanying symptoms include an oily face,
coarse pores, large appetite, bad breath, thirst, con-
stipation, yellow greasy fur on a red tongue, and a
slippery, rapid, powerful pulse. LI 4, Yingxiang (LI
20), Zusanli (ST 36), Weishu (BL 21), Dachangshu
(BL 25), and Neiguan (PC 6) are usually chosen to
eliminate the heat and dampness.
3. Zheng of Qi stagnation and Blood stasis: These le-
sions are present for a long time and are usually dark
red papules or nodules scattered on the cheeks and
the lower jaw. Anxiety, mental stress, and premen-
strual status are all aggravating factors. Accom-
panying symptoms include chest stuffiness, irregular
menstruation, dysmenorrhea with blood clotting, an
ecchymosed dark purple tongue, and an unsmooth
string-like pulse. LI 4, Quchi (LI 11), Sanyinjiao (SP
6), Xuehai (SP 10), and Taichong (LR 3) are gener-
ally chosen to promote the circulation of Qi and
Blood.
Case Presentation
A 17-year-old girl had been diagnosed with acne vulgaris
for 2 years. Previous treatment for her acne symptoms was
unsuccessful. She was even afraid of looking at her face in a
47
mirror. Her acne appeared as a pimple or pustule, and was
distributed around the mouth and on the face. The Zheng of
her condition was Damp–Heat blocking in the stomach and
intestine. She received acupuncture at LI 4, ST 36, and PC 6
three times a week. The acne lesions on her face were gone
without scarring, and she could look in the mirror to put on
makeup after 8 weeks of acupuncture treatment.
Acupuncture is an effective and alternative treatment to
reconstruct Yin and Yang harmonization in the human
body. Eating a balanced diet at regular hours, having a re-
laxed mood, and keeping the skin clean are also important in
adolescent acne care. Just as the Yellow Emperor’s Canon
mentions, ‘‘Abide to the changes of the four seasons, ac-
tively adapt to cold and heat and live in peace and harmony
emotion, then bring up the health in hand and keep the
disease away.’’
Table 1. Location of the Acupuncture Points
for Treatment of Adolescent Acne8
Acupoints Location
Hegu (LI 4) On the highest spot of the muscle when
the thumb and index fingers are
brought close together
Quchi (LI 11) Midpoint between lateral end of the
transverse cubital crease and the
lateral epicondyle of the humerus
Yingxiang (LI 20) In the nasolabial groove, level with the
midpoint of the lateral border of the
ala nasi
Zusanli (ST 36) 3 cun below the patella, one finger
width lateral from the anterior border
of the tibia
Sanyinjiao (SP 6) 3 cun directly above the tip of the
medial malleoulus on the posterior
border of the tibia
Xuehai (SP 10) 2 cun above the superior medial border
of the patella on the bulge of the
medial portion of quadriceps femoris
(vastus medialis)
Feishu (BL 13) 1.5 cun lateral to the lower border of
the spinous process of the T3
Weishu (BL 21) 1.5 cun lateral to the lower border of
the spinous process of the T12.
Dachangshu (BL 25) 1.5 cun lateral to the lower border of
the spinous process of the L4
Neiguan (PC 6) 2 cun above the wrist crease between
the tendons of palmaris longus and
flexor carpi radialis
Taichong (LR 3) On the dorsum of the foot in a depres-
sion, distal to the junctions of the 1st
and 2nd metatarsal bones
Dazhui (GV 14) On the midline of the base of the neck,
in the depression below the spinous
process of C7
 48
REFERENCES
1. Oge LK, Broussard A, Marshall MD. Acne vulgaris: Diagnosis
and treatment. Am Fam Physician. 2019;100(8):475–484.
2. Lynn DD, Umari T, Dunnick CA, Dellavalle RP. The epide-
miology of acne vulgaris in late adolescence. Adolesc Health
Med Ther. 2016;7:13–25.
3. Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of
care for the management of acne vulgaris. J Am Acad Der-
matol. 2016;74(5):945–973.
4. Janani S, Sureshkumar R, Upadhyayula SSN, Karthika C,
Vasanthi C. Will the polyphenol and adapalene combination be
a good strategy on acne vulgaris? Med Hypotheses. 2019;133:
109409.
5. Mansu SS, Liang H, Parker S, et al. Acupuncture for acne
vulgaris: A systematic review and meta-analysis. Evid Based
Downloaded by UPPSALA UNIVERSITETSBIBLIOTEK from www.liebertpub.com at 03/11/20. For personal use only.
Complement Alternat Med. 2018;2018:4806734.
6. Zhao S-H. Surgery of Chinese Medicine. Beijing, China: China
Science Publishing and Media Ltd.; 2004.
7. Chen Y-C. A study on the effect of acupuncture and mox-
ibustion on adult female acne patients. Acupuncture Mox-
ibustion Massage. 2004:1–33.
8. Acupuncture Point Locations. Online document at: www
.acupuncture.com/education/points/ Accessed January 2, 2020.
Address correspondence to:
Ming-Tui Tsai, MD
Kaohsiung Chang Gung Memorial Hospital
and School of Traditional Chinese Medicine
Chang Gung University College of Medicine
No. 123, Dapi Road
Niaosng Dist
Kaohsiung City 83301
Taiwan
E-mail: u100023426@cmu.edu.tw
Wen-Long Hu, MD, MS
Kaohsiung Chang Gung Memorial Hospital
and School of Traditional Chinese Medicine
Chang Gung University College of Medicine
No. 123, Dapi Road
Niaosng Dist
Kaohsiung City 83301
Taiwan
E-mail: oolonghu@gmail.com
Yu-Chiang Hung, MD, PhD
Kaohsiung Chang Gung Memorial Hospital
and School of Traditional Chinese Medicine
Chang Gung University College of Medicine
No. 123, Dapi Road
Niaosng Dist
Kaohsiung City 83301
Taiwan
E-mail: hungyuchiang@gmail.com
CLINICAL PEARLS
A dolescent acne is a condition equivalent to ‘‘Lung
Wind Pink Thorns’’ (fei feng fen ci) in TCM. It is a
chronic inflammatory condition of the sebaceous glands that
frequently occurs at puberty, often accompanied with se-
bum exudation. Because the lesions often break out on the
cheeks, forehead, neck, chest, and upper back, it affects the
appearance and can cause extreme psychological stress to
patients, especially young girls, whose self-esteem can be
seriously affected due to the facial skin damage caused by
long-term recurring acne. Clinically, acne can be catego-
rized into four types: Damp–Heat toxin, Lung and Stomach
Heat, Phlegm and Blood stasis, and disharmony of Chong
Ren. However, patients usually present complexed clinical
symptoms, among which Damp–Heat toxin and Blood stasis
is most commonly seen in clinic. Symptoms include le-
sions on the face, rashes spreading over the chest and back,
damaged skin with inflamed pimples or pustules, cysts that
are inflamed and painful, blackheads, itchy skin, and an
oily face often around the mouth, cheeks, and forehead.
Accompanying symptoms can include bad breath, consti-
pation, dark urine, red tongue, greasy yellow tongue coat-
ing, and a rapid and slippery pulse. The author combined
the customized formula ‘‘Xiao Zuo Tang’’ with modified
‘‘Dan Zhi Xiao Yao Wan’’ in conjunction with acupuncture
treatment to produce a highly effective treatment for acne
due to Damp–Heat toxin with Blood stasis.
Typical Case Study
A 17-year-old female patient had been suffering from
recurrent acne for 6 years, and it had worsened in the past
year. She had been to see a dermatologist several times and
was diagnosed with adolescent acne. She had tried various
topical ointments without any effect. There was a history of
acne on her father’s side of the family.
Clinical presentation. Her symptoms included oily
facial skin, several red pimples on both of her cheeks and
her jaw, pustules, itchy skin, several cysts on the lower jaw,
oily hair that required washing daily, low spirits, frequent
crying spells, reluctance to communicate, and feeling de-
pressed and withdrawn. She had stopped attending school
and stayed home for 6 months. She started her periods at the
age of 12, and her menstrual cycle was 3–5 weeks delayed.
Her menses lasted for 7 days, with heavy bleeding, red flow,
and dark clots. She also had lower abdominal distention and
breast tenderness before her period. Her last period was on
May 15, 2019. Her appetite was normal, but her sleep was
poor, and she went to bed late around 1:00–2:00am. She
preferred cold rather than heat. She had a bowel movement
every other day with dry stools. She was slightly overweight
and hairy. There was a 3 cm · 4 cm lump at her left groin,
with a hard bottom and red edge that was painful upon pal-
pation. The tip and sides of her tongue were red, with a thick
 CLINICAL PEARLS
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FIG. 1. Before treatment versus after treatment photos.
white coating in the middle and back. Her pulse was rapid and
slippery, but deep and thin at the right Chi position. Because
of years of unhealed acne, her current diet has been mainly
vegetarian for about 6 months. She disliked vegetables, meat,
seafood, and dairy products, but she liked sweets. She had
noticeable oily facial skin, large pores on the cheeks, grain-
sized red inflamed pimples on the cheeks and lower jaw, with
yellow and white pustules at the tip, and more pronounced
cysts and dark red pigmentation on the lower jaw.
Chinese medicine differentiation. This case demon-
strated Damp–Heat toxin, Blood stasis, and turbid Phlegm
and Liver Qi stagnation. Treatment aims to clear Damp–
Heat toxin, move Blood and dissolve stasis, and soften
49
nodules and disperse Liver Qi. Formula: Huang Qin 10 g,
Huang Lian 3 g, Shan Zhi Zi 10 g, Ye Ju Hua 15 g, Tu Fu
Ling 10 g, Xia Ku Cao 12 g, Di Ding 10 g, Pu Gong Ying
15 g, Bai Tou Wong 10 g, Bo He 6 g (add later), Lian Qiao
10 g, Jie Geng 10 g, Zhi Shi 6 g, Dan Shen 9 g, Tao Ren 10 g,
Chi Shao 10 g, Ze Lan 10 g, Dan Pi 10 g, Da Huang 3 g, Zao
Jiao Ci 6 g, Zhe Bei Mu 10 g, Han Lian Cao 15 g, Chai Hu
10 g, Yu Jin 10 g, and Raw Shan Zha 30 g. Three packs of
raw herbs were prescribed to be boiled and take orally as a
decoction, each pack for 2 days, along with topical use of
sulfur soap. She was also instructed to apply iodine solution
to the red swelling lump in the groin area twice a day.
Acupuncture prescription. LI 11, SP 9, SP 6, ST 40,
SP 10, LR 3, K 3, LR 14, Uterus, ST 29, TaiYang, DU 20, Ear
Shenmen, Ear Liver. Needle sizes #34, 0.5†, 1†, and 1.5† were
used respectively, with perpendicular insertion, without ma-
nipulation, using Wang Shao Bai’s Pleasant Acupuncture
technique.1 The patient fell asleep peacefully 5 minutes after
needle insertion. The needles were retained for 40 minutes.
Treatment was given once a week. The patient was advised to
avoid sugary foods, increase her intake of green vegetables and
fruit, and increase her exercise. In the meantime, supportive
psychological counseling was provided to help her understand
that adolescent acne is a common problem for adolescence,
and that there is no need to let it affect self-esteem.
After six treatments, her condition had improved re-
markably. Her facial acne had mostly disappeared, and the
hard nodule in the groin area had flattened and was a lighter
color (see Figure 1). Her menstrual cycles had normalized
to a 31-day cycle with biphasic pattern of basal body tem-
perature. Her menstrual flow was less heavy, without clots
and abdominal pain. Her moods were better, with no more
crying spells or anxiety. She asked to return to normal study
at school.
Discussion
Acne patients generally have Yang excess constitution.
Due to the body’s period of intense growth during adoles-
cence, the endocrine system becomes irregular, testosterone
levels increase, in turn stimulating the hypertrophy of the
sebaceous glands, resulting in significant increases in oil
secretion and clogging the hair follicles. These patients
tend to like greasy sweet foods with a robust flavor, which
causes Damp Heat in the middle Jiao, and have an oily skin.
Abundant heat in the Lung and Stomach meridians follows
the channel to break out as an external skin condition. The
Lung dominates the skin and hair, with Heat going upward,
Lung Heat steaming upward and accumulating on the face,
therefore forming more inflammatory pimples on the face.
An irregular diet leads to Heat in the Lung and Stomach
steaming upward, which together with Qi stagnation, Blood
stasis, and turbid Phlegm causes cysts and nodules to form.
The Lung and Large Intestine is internal-externally related,
 50 CLINICAL PEARLS

Damp Heat moves downward to the intestines, therefore
causing dry or sticky stools. A red tongue with a thick
white coating and a wiry and slippery pulse all indicate ac-
cumulated Heat in the Lung and Stomach, Damp Heat toxin,
and Blood stasis. The author customized a formula ‘‘Xiao
Zuo Tang’’ to clear Heat, drain dampness, and eliminate
toxin. Within the formula, Bai Tou Wong is an especially
effective herb used to treat different rashes and acne heads
with yellow white pus. Western pharmacological analysis
shows Bai Tou Wong possesses strong antioxidant, antimi-
crobial, anti-inflammatory, antiviral, anticancer, and immune-
enhancing properties. This herb has shown a strong inhibitory
effect against bacteria such as Staphylococcus aureus, Pseu-
domonas, Streptococcus mutans, and skin fungus.3 Shan Zha
is used extensively to tonify the Spleen, remove food stag-
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sponding with the lower Uterus, DU 20 sends a signal to the
ovaries to initiate the ovulation process.
The author combined treatment acupuncture with herbs to
treat adolescent acne. Not only was the acne removed and
beauty recovered, but also the normal female reproductive
axis was restored, regulating the endocrine system and
normalizing the menstrual cycle.
REFERENCES
1. Wang SB. The application of pleasant acupuncture in the
United States. New Chin Med. 2015;47(7):5.
2. Odom RB, James WD, Berger TG. Andrews Diseases of Skin.
9th ed. Philadelphia, PA: W.B. Saunders and Co.; 2000:284–

306.
nation, metabolize fat, and dissolve grease. Modern phar-
3. Mei QX. Modern Chinese Medicine Pharmacology and Clin-
macological research shows that the fatty acids contained in
ical Application Manual. China: Traditional Chinese Medicine
Shan Zha help digest fat, lower blood lipids, and improve Publishing House; 2019:35.
digestion by increasing the secretion of digestive enzymes in 4. Ma YB, Chen TY. Case study on treating damp heat toxin type
the stomach. It is extremely effective in treating adolescent of acne. Beijing Chin Med. 2011;30(10):752–754.
acne patients with oily facial skin.4 5. Zhang YX. Acupuncture treatment mechanism for depression
Acupuncture plays a vital important role in treating ad- and clinical research progress. Chin J Inform Trad Chin Med.
olescent acne. In terms of calming the spirit, dispersing 2008;15(5):96–98.
the Liver, and regulating moods, the effect is remarkable.
Modern research proves that needling Tai Yang, Ear Shen Address correspondence to:
Men, Ear Liver, and DU 20 can stimulate the brain to release Liang Dong Yun, DOM, Lac
more B-endorphins, serotonin, and melatonin, therefore Oriental Therapy Center
regulating the sympathetic nervous system, relieving pain, 8200 SW 117th Avenue
and relaxing the mind.5 LI 11 and ST 40 both clear Heat and Suite 308
dissolve Phlegm; LR 3 and LR 14 disperse the Liver and Miami, FL 33183
relieve stagnation; SP 9 and SP 6 tonify the Spleen, drain
dampness; SP 10 invigorates the Blood and dissolves stasis; E-mail: Orientaltherapycenter@gmail.com
CV 4 and ST 29 can increase blood flow to the uterus;
Uterus is extra meridian point, located 4 cun below the Vivian Shou-Litman, DAOM
umbilicus and 3 cun lateral on both sides, which reflects Longevity Acupuncture
the location of the ovaries on the surface of the body. Use 7000 SW 62nd Avenue
the surrounding needle technique with ample stimulation at Suite 204
Uterus during the ovulation phase can stimulate the ovaries Miami, FL 33143
and promote ovulation. Needling DU 20 can regulate the
brain center, calm the spirit, and benefit the mind. Corre- E-mail: Drshoulitman@gmail.com