Cosmetic acupuncture

JOURNAL OF CHINESE MEDICINE NUMBER 72 JUNE 2003

CLINICAL EXPERIENCE

COSMETIC ACUPUNCTURE by Radha Thambirajah I began my acupuncture practice in Sri Lanka in 1971 by offering a free clinic a few hours daily for patients who had difficulties in managing payment. Many of these patients would have more than four treatment sessions a week, following the then Chinese fashion. One such patient was 46 year old Mrs. X. She had been a rheumatoid arthritis sufferer for over 6 years, and while having regular acupuncture treatments with me over some 12 weeks, she had gradually reduced and then come off steroids and anti-inflammatory medications. Mrs. X had had a characteristic limp when she first came, and her face was always knotted with pain. Naturally, over the treatment period she lost these. One day I noticed something more - I noticed that Mrs. X was beautiful! Her skin was smooth, her hair shiny, her eyes were bright and her posture was great. When I heard my staff remarking the same thing, I had to attribute this change to her newly-found healthy state of balance. From then on, I began to notice patients who were on long term therapy for chronic illness - polyarthritis, eczema, acne, menstrual problems, post menopausal problems, asthma etc. Apart from those cases of eczema or acne I was not treating their skin, yet all patients taking prolonged energy-balancing treatment, with no special points for enhancing beauty, went through this gradual but very noticeable metamorphosis. metamorphosis. It was not until after 10 years of practice (when I had became a better known acupuncturist in my country) that I began getting some diplomats and film stars as my patients. Here, for the first time I was requested to treat not a disease, but some imperfection in their appearance. Overweight or accumulating fat in one part of body, cellulitis, abdominal distention, fine and deep wrinkles, hanging skin, the tendency to form stretch marks, unclean complexion, sagging breasts and abdomen were some of these conditions. I accepted the challenge and had to work backwards on the results I had produced on my sick patients in the past. I found the work very rewarding, as one sees results very quickly and the fees I received for beauty treatments were higher than for back pain! At this point in time, there was no literature I could refer

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to, and I had to discover and develop my own methods. I would like to share some of my experience with you. The most common problem that patients complain of is fine wrinkles around the eyes and mouth. One factor that accelerates the ageing process of the facial skin is smoking. Smoking dries the Lungs and skin - and this leads to the loss of fluid in the superficial epidermal layer of the skin. So the less pulpy and more delicate areas such as the eyelids and perioral region show signs of ageing due to stress or overuse (for example screwing the eyes or tightening the lips around the cigarette). Educating the patient, helping them to stop smoking with or without the aid of acupuncture and rehydrating the skin is the essence of therapy in these cases. This means that I tonify Lung yin with needles, and make sure the patient drinks enough water throughout the day and humidifies their living area. My patients have made fashion statements by spraying Evian water around their sitting area in the office and impressing their workmates! White rice is good nutrition for Lung yin. This is one reason why people living in tropical countries eat white rice - because they need to sustain yin in the skin against exposure to the sun. Finally, most patients with dry, fine wrinkly skin also happen to be rather thin. This suggests a blood deficiency due to Spleen deficiency, which is therefore unable to nourish the son (Lung). In order to moderately increase nourishment, I recommend these patients to drink butter-milk (or lassi for my Asian patients) daily. The wrinkles smooth out within weeks and the face looks fuller. They are so happy with the results that their motto has become “ a (drink of) buttermilk a day keeps the wrinkles away”. The acupuncture points I use for Lung yin tonification are Zhongfu LU-1, Taiyuan LU-9, Shanzhong REN-17, Neiguan P-6 and Taibai SP-3. Naturally, some points are added or changed according to the specific needs of each patient. The Seven Star or Plum-Blossom Needle is also very useful. It can make superficial punctures over larger areas very quickly. This helps to either improve local blood circulation (when used with light tapping to produce a red skin reaction), or to release heat by bleeding (by using heavy tapping).


We do not seem to use the plum-blossom needle very often nowadays, but I find it a great “connective tissue tightener” and a perfect “fat stagnation buster”.

The Spleen tones connective tissue Often after losing weight or entering middle age, many parts of the body tend to sag, especially the jaws, chin, and upper eyelids which are of course visible outside clothing. Our connective tissue is firmed largely by Spleen qi which helps thus increase adherence of the skin to the muscles, resulting in tautness. When this is lacking, the skin sags away from the muscles. Unlike muscles, the connective tissue cannot be firmed up through exercise, and these patients need Spleen qi tonification. Besides needling, I also recommend them to eat wholemeal grains instead of refined grains, eat warm cooked food instead of raw, drink warm water instead of cold drinks, and take big breakfasts and smaller evening meals. If I advised this to a patient with chronic digestive problems I would have had many objections and little compliance. But say this to a patient having cosmetic acupuncture, and they will hang onto every word, because after a few days of living “badly” they begin to see their body sag again. The acupuncture points I use to tonify Spleen qi are: Pishu BL-20, Yinbai SP-1, Zusanli ST-36, Zhongwan REN-12 (with moxibustion) and Fenglong ST-40. Again, points are added or changed according to the special needs of the patient. For example, a patient suffering from gastric acidity will not receive moxibustion on Zhongwan REN-12 as this may increase the Stomach heat. The local treatment for loose connective tissue is plum blossom tapping in the areas beneath the chin and on the lower abdomen. Both should be performed when the patient is standing, when maximum sagging occurs. Beneath the chin, a triangular area should be tapped in lines towards the ear. The three corners of the triangle can be defined as a. anterior to Lianquan REN-23 (just beneath the point of the chin), b. just above the adam's apple, c. Yifeng SJ-17. The patient should raise and tilt the chin when the tapping is performed. The whole lower abdomen can be tapped in downward and lateral lines, approximately 3cm apart. In these modern days of Botox and collagen injections, as well as cosmetic surgery, acupuncture still stands out as a safe and longer-lasting method. There are no side effects, no mask-like appearance and no scars. But the technique and the know-how to make it last is in the hands of the patient. If our interior is healthy and balanced, and if we have inner tranquillity and contentment, if we are well nourished and exercise moderately, our beauty will shine through.

Cosmetic acupuncture is not about beauty, but about health I have learned that cosmetic acupuncture is not about beauty, but about health. Every part of our body needs good blood circulation, moisture, free movement of fluid and ability to eliminate secretions, and no stagnation of damp-

ness (puffy appearance). The skin however, which is the outermost covering of our body, is visible in a very large area, and therefore is the most important place to manifest beauty. When treating skin problems, one has to take into account the various organs that influence the Lungs.

Fire - Heart & Small Intestine The skin has a complex relationship with zangfu other than the Lung and cannot be singularly considered or treated. For instance, the Heart nourishes and circulates blood. A deficiency of Heart blood and qi would cause paleness and cold, dry and dead-looking skin. The treatment would be to tonify blood - with Geshu BL-17 (hui-meeting point of blood), Xuehai SP-10, Juque REN-14 (front-mu point of the Heart), Xinshu BL-15 (back-shu point of the Heart) and give a suitable tonic to nourish the blood. These patients usually do not come to us for cosmetic acupuncture - in fact, they could not care less how they look. They would approach us with symptoms of endogenous depression, anxiety, mental fatigue and sleep problems. As Heart blood and qi are tonified, their mood, complexion, sleep, and confidence all improve, and their skin glows pink with warmth.

Earth - Spleen & Stomach The Spleen nourishes the body with the food that is received by the Stomach, and the Spleen qi distributes the nutrition to all organs and tissues. The Spleen function of circulating blood and nutrition, especially to the periphery, is responsible for the capillary circulation of blood. A deficiency of Spleen qi and yang can cause a marbling effect on the skin (a mixture of blue and pink colours), and coldness of the extremities. This can be treated by needling points Pishu BL-20, Weishu BL-21, Zusanli ST-36, Yinbai SP-1 and Taiyuan LU-9 (hui-meeting point of the vessels) and applying moxibustion at Zhongwan REN-12. It is essential to take warm foods and drinks so as to keep the middle jiao warm, as it is the warmth of the Spleen and Stomach that is circulated to the periphery. The Spleen also circulates body fluid. If the Spleen qi is deficient, this can result in stagnation of body fluid, more so in the periphery - the eyelids, hands and feet.

Water - Kidney & Urinary Bladder The Kidneys store water and irrigate the body. If the Kidney yin is deficient, and the body is dry, the Kidney will not hesitate to draw the water from its mother the Lung. This will result in dryness of skin. This is specially apparent in menopausal women, who suffer with general dryness at a time when their female hormones (Kidney yin) are on the decline. Treatment should focus on points such as Yingu KID-10, Sanyinjiao SP-6 and Zhongji REN-3, and patients should drink water regularly and make sure to take a moderate amount of sea salt in the diet so that the water can be retained.

Wood -Liver & Gall Bladder Liver blood deficiency can cause dryness of skin directly,

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but more importantly Liver wind generated in the interior can cause skin irritation and itching, for example accompanied by jaundiced skin in hepatitis. The palliative treatment for the itching can include points such as Xuehai SP-10, Baihui DU-20 and Geshu BL-17, but it is also necessary to calm the interior wind and regulate blood. When treating most skin disorders due to Liver wind, some of which are allergic in nature, one needs to re-establish the relationship between metal and wood. In health, metal controls wood. But if metal has a weak yin, then it loses control over wood, and uncontrolled wind-heat rises and counter-powers metal. Treatment would be to support Lung yin and reduce Liver yang using Xingjian LIV-2 and Yangfu GB-38 with reducing method. Other wind eliminating points such as Fengchi GB-20, Fengshi GB-31, Bingfeng SI-12, Bafeng (M-LE-8) and Baxie (M-UE-22) could be used depending on the affected areas. It is also necessary to avoid acidic and citrus fruit and alcohol that can increase the Liver wind.

Metal - Lung & Large Intestine The function of the Lung (besides that of respiration) is to ascend and descend water. The Lung descends water to the Kidney, and when this function is impaired, it can manifest as excessive mucus in the Lungs. This may be treated in two ways: either by sending this excess water from the Lung by reducing Chize LU–5 (the water point), or by inducing diuresis by tonifying Kidney qi with points such as Shenshu BL-23, Taixi KID-3 and Yinlingquan SP-9, thus encouraging water to flow from the Lung to the Kidneys. The ascending function of the Lung pertains more directly to skin problems. It is the Lung qi that disperses moisture to the skin surface, and a combination of thick but dry skin shows that there is excess Lung yin below the skin, but inadequate qi to disperse it to the surface. Treatment should focus on helping to open the skin pores and ascend the moisture to the skin surface with point such as Hegu L.I.-4, Feishu BL-13 (back-shu point of the Lung) and Quchi L.I.-11. A moderate amount of spices like ginger will also help the skin to sweat. An illustration of this impeded ascending function is found in acne vulgaris, common among teenagers and in a few older patients. In moderate to severe acne, there appear pustular and cystic lesions mostly on the face, back, chest and shoulders (mainly in the area of the upper jiao). Residual scars make the skin look very uneven. In my opinion this shows a damp-heat condition of the skin. The skin produces excessive sebaceous secretions (dampness) which cannot be eliminated effectively because the opening-eliminating function of the skin is poor. This stagnating dampness can create heat or inflammation over a period of time - causing the papules and pustules. The treatment I use on my patients is to improve elimination, decrease dampness, and if necessary, eliminate heat. To improve elimination, it is of first importance to make sure that the patient has regular and good bowel movements. Many youngsters do not empty their bowels regu-

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larly. I use Hegu L.I.-4, Zhigou SJ-6, Tianshu ST-25 and paravertebral tapping with a plum-blossom needle between lumbar vertebra 2 and sacral vertebra 2 to produce a red skin reaction. To help skin elimination I sometimes add Feishu BL-13 and Quchi L.I.-11. To decrease dampness, I select Fenglong ST-40, Yinlingquan SP-9, and occasionally Chize LU–5 and advise patients to avoid refined sugar and fatty milk products (milk, cream and chocolate). Eliminating heat is not necessary most of the time, because once the dampness and elimination are improved, there is no basis from which heat can be generated. However if it is still a problem, I prick Chize LU-5 to induce bleeding, usually on one side at each treatment, bleeding the other side the next treatment if necessary. The key part of the acne therapy however, is local treatment. I use many .20 gauge 15mm needles around the areas of the acne - mostly on the face. The needles are inserted very superficially and left in place for 20 minutes. This helps promote circulation of the stagnant dampness and helps to smooth the skin. The general points that are used seem to improve the inflammation of skin, but it is the local needles that make the difference, and at the end of a course of 12 treatments, the effect lasts much longer than if no local needles were used. I treat my acne patients twice weekly, for about 12 sessions. The results are striking and long-lasting.

Conclusion Finally, a word of caution about choosing patients for cosmetic acupuncture. In my practice, I have had good experiences with treating many cosmetic problems mostly in women. The majority are aged 45-65, and are working women who have had acupuncture treatment in the past. They use other complementary therapies and are comfortable with needles, enjoy their sessions and feel the benefit on their health as well. They work together with me in making our therapy successful, and take responsibility for themselves, for their eating and living habits for example. There are others however, who want a “quick-fix” because of a wedding or a holiday for example. They come at the last minute, do not have time to eat or sleep properly - let alone cook, and expect a great deal out of the acupuncture. These are not the best candidates for cosmetic acupuncture. Even if the treatment works on them, the results will not last very long. Radha Thambirajah was born in Sri Lanka. She studied medicine, specialising in acupuncture, at the Military Medical College, Shanghai, and graduated in 1970. She founded the Academy of Chinese Acupuncure in Sri lanka in 1980, and in Berlin in 1986. She lives and practises SuttonColdfield, West Midlands, and lectures to doctors and health professionals in the United Kingdom, Germany, Switzerland, Spain and Italy. She can be contacted on [email protected]

Cosmetic acupuncture

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