Symptom family: Skin Pigmentation & Discoloration Issues

Did you mean? Macules

What is Melasma?

Melasma is a common skin condition characterized by dark, discolored patches on the skin, most often appearing on the face. It typically manifests as symmetrical brown or grayish-brown patches on the cheeks, forehead, bridge of the nose, chin, or upper lip. Melasma is often associated with sun exposure, hormonal changes such as those occurring during pregnancy or with oral contraceptive use, and is more prevalent in women and people with darker skin tones. Although melasma is harmless, it can cause significant cosmetic concern and distress.

How does TCM view melasma?

In Traditional Chinese Medicine (TCM), melasma is not seen as merely a skin condition but rather a manifestation of underlying internal imbalances. Unlike Western medicine, which focuses on external factors like UV exposure or hormonal changes, TCM attributes melasma to various patterns of disharmony within the body, such as Qi And Blood Stagnation or Liver and Kidney Yin Deficiency.

Identifying and treating the correct underlying pattern is crucial in TCM, as each pattern requires a different therapeutic approach. This holistic perspective emphasizes the importance of addressing the root cause to achieve long-lasting results.

Root Causes of Melasma in TCM

TCM identifies several internal patterns that may lead to melasma. For example, Liver Qi Stagnation is often implicated when melasma is accompanied by emotional disturbances such as mood swings, irritability, or hypochondriac discomfort. When Liver Qi becomes stagnant, it can eventually lead to Blood stasis, further complicating the condition and resulting in more severe or persistent discoloration.

On the other hand, Liver and Kidney Yin Deficiency may contribute to melasma by failing to nourish the skin properly, leading to symptoms such as dark brown patches of varying sizes and irregular shapes appear on the face, particularly on the cheeks, in front of the ears, and in the temple area. Other symptoms includes soreness and weakness in the lower back and knees, dizziness, tinnitus, dry eyes, irregular menstruation, a sensation of heat in the palms and soles, a pale red tongue with little coating, and a deep, thin pulse.

Explore below more details about what might cause Melasma according to TCM.

  • By Syndrome
  • By Organ
  • Liver
  • Kidney
  • Spleen
Detailed description of the cause

Qi Stagnation

Qi Stagnation in TCM is like having a traffic jam in your body's energy system. Qi, the vital life force that flows through your body, is supposed to move smoothly to maintain health and balance. But with Qi Stagnation, this flow gets blocked or slowed down, like cars stuck on a highway. This can lead to symptoms like feeling stressed, emotional mood swings, and physical discomfort, often described as a feeling of fullness or tightness, especially in the chest or abdomen. It's as though the body's internal energy circulation is disrupted, causing various issues. TCM sees this as an energy flow problem, different from modern medicine's focus on specific physiological processes.... see more

Qi Stagnation Patterns That Can Lead to Melasma

Common Symptoms: Chest Distension Abdominal Distention Depression Mood Swings Irregular Periods Pre Menstrual Tension Menstrual Cramps Irritability

Pattern Name Relevant Symptoms Relevant Formulas
Liver Qi Stagnation Melasma, Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia, Depression, Mood swings, Irregular periods, Globus sensation, Pre menstrual breast distension, Pre menstrual tension, Anxiety, Anger... see more Yi Guan Jian | Xiao Yao San | Jia Wei Xiao Yao San | Yue Ju Wan | Chai Hu Shu Gan San
Qi And Blood Stagnation Melasma, Chest distension, Chest pain, Stabbing fixed pain, Dark face, Purple lips, Purple nails, Irritability, Mood swings, Depression, Mottled skin, Foot edema, Abdominal masses, Melena black tarry stool, Menstrual cramps, Amenorrhea, Dark menstrual clots, Dark menstrual blood, Prolonged lochia, Irregular periods... see more Chai Hu Shu Gan San | Xue Fu Zhu Yu Tang | Shen Tong Zhu Yu Tang | Shao Fu Zhu Yu Tang | Ge Xia Zhu Yu Tang | Shi Xiao San | Qi Li San | Dan Shen Yin | Guo Qi Yin | Tao Hong Si Wu Tang
Detailed description of the cause

Yin Deficiency

Yin deficiency in TCM is a pattern of disharmony characterized by a depletion of the body's Yin energy, which represents the cooling, moistening, and nurturing aspects of our physiology. This condition often arises from factors like chronic stress, overwork, insufficient rest, or prolonged illness. Symptoms of Yin deficiency can include a sensation of heat, especially in the afternoon or evening, night sweats, insomnia, a dry mouth or throat, and a red tongue with little coating. There might also be a general feeling of restlessness or irritability. Since Yin is essential for balancing the body's active and warm Yang energy, its deficiency leads to a relative excess of Yang, manifesting as heat or dryness symptoms.... see more

Yin Deficiency Patterns That Can Lead to Melasma

Pattern Name Relevant Symptoms Relevant Formulas
Kidney and Liver Yin Deficiency Melasma, Dizziness, Tinnitus, Hearing loss, Lower back pain, Vertical headaches, Occipital headache, Insomnia, Limb numbness, Tingling of limbs, Dry eyes, Blurry vision, Dry throat, Dry hair, Skin dryness, Withered and brittle nails, Vaginal dryness, Night sweats, Dry stools, Nocturnal emission, Scanty menstruation, Amenorrhea, Late menstruation, Infertility... see more Zuo Gui Wan | Qi Ju Di Huang Wan | Liu Wei Di Huang Wan | Qing Gu San | Yi Guan Jian | Zhen Gan Xi Feng Tang
Detailed description of the cause

Blood Stasis

Blood Stasis in TCM is a concept where the blood flow in the body is not as smooth or efficient as it should be. Imagine a river that's supposed to flow freely, but instead, it's getting blocked or moving too slowly in some parts. This can lead to various health issues, like pain that feels sharp or stabbing, dark bruises, and a complexion that looks purplish. TCM believes that good health relies on the smooth and vibrant flow of Qi and blood throughout the body, so when blood gets stuck, it's like a traffic jam in your body, leading to discomfort or health problems.... see more

Blood Stasis Patterns That Can Lead to Melasma

Pattern Name Relevant Symptoms Relevant Formulas
Qi And Blood Stagnation Melasma, Chest distension, Chest pain, Stabbing fixed pain, Dark face, Purple lips, Purple nails, Irritability, Mood swings, Depression, Mottled skin, Foot edema, Abdominal masses, Melena black tarry stool, Menstrual cramps, Amenorrhea, Dark menstrual clots, Dark menstrual blood, Prolonged lochia, Irregular periods... see more Chai Hu Shu Gan San | Xue Fu Zhu Yu Tang | Shen Tong Zhu Yu Tang | Shao Fu Zhu Yu Tang | Ge Xia Zhu Yu Tang | Shi Xiao San | Qi Li San | Dan Shen Yin | Guo Qi Yin | Tao Hong Si Wu Tang
Detailed description of the cause

Qi Deficiency

Qi Deficiency in TCM is like running low on battery power. Qi is the vital energy that powers every function in your body. When there's a Qi Deficiency, it means your body doesn't have enough of this essential energy. This can make you feel tired all the time, weak, or even cause shortness of breath. It's similar to how you feel when you haven't had enough sleep or nutritious food. Your body just doesn't have the energy it needs to perform at its best. Unlike modern medicine, which often focuses on specific physical causes for fatigue and weakness, TCM views Qi Deficiency as an overall energy depletion that affects your entire well-being, and it seeks to replenish and balance this vital energy.... see more

Qi Deficiency Patterns That Can Lead to Melasma

Pattern Name Relevant Symptoms Relevant Formulas
Spleen Qi Deficiency Melasma, Slight abdominal distension after eating, General weakness, Desire to lie down, Slight abdominal pain, Excessive gas and flatulence, Bloated abdomen, Dyspepsia, Swollen complexion, Obesity... see more Si Jun Zi Tang | Liu Jun Zi Tang | Fei Er Wan | Shen Ling Bai Zhu San
Detailed description of the cause

Liver

In TCM the Liver is viewed as the organ responsible for the smooth flow of Qi, Blood, and emotions throughout the body. It plays a key role in regulating mood, storing blood, supporting digestion, and ensuring the health of tendons and eyes. When the Liver malfunctions or is imbalanced in TCM, it can lead to a range of issues such as irritability, mood swings, menstrual irregularities, eye problems, and muscular stiffness or pain. A malfunctioning Liver in TCM reflects not only physical disturbances but also emotional and mental disharmony, emphasizing the holistic approach of TCM in addressing health and wellness.... see more

Liver Patterns That Can Lead to Melasma

Common Symptoms: Scanty Menstruation Headaches Dizziness Tinnitus Hearing Loss Lower Back Pain Vertical Headaches Occipital Headache

Pattern Name Relevant Symptoms Relevant Formulas
Kidney and Liver Yin Deficiency Melasma, Dizziness, Tinnitus, Hearing loss, Lower back pain, Vertical headaches, Occipital headache, Insomnia, Limb numbness, Tingling of limbs, Dry eyes, Blurry vision, Dry throat, Dry hair, Skin dryness, Withered and brittle nails, Vaginal dryness, Night sweats, Dry stools, Nocturnal emission, Scanty menstruation, Amenorrhea, Late menstruation, Infertility... see more Zuo Gui Wan | Qi Ju Di Huang Wan | Liu Wei Di Huang Wan | Qing Gu San | Yi Guan Jian | Zhen Gan Xi Feng Tang
Liver Qi Stagnation Melasma, Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia, Depression, Mood swings, Irregular periods, Globus sensation, Pre menstrual breast distension, Pre menstrual tension, Anxiety, Anger... see more Yi Guan Jian | Xiao Yao San | Jia Wei Xiao Yao San | Yue Ju Wan | Chai Hu Shu Gan San
Detailed description of the cause

Kidney

In TCM the Kidneys are regarded as the body's most fundamental reservoir of Essence, known as Jing, which influences growth, reproduction, and aging. They are not just organs for filtering blood, but a holistic system governing vital life forces. When the Kidneys malfunction in TCM, it can manifest as a variety of health issues, such as chronic fatigue, reproductive problems, imbalances in fluid metabolism leading to edema or dryness, lower back pain, and a sense of fear or insecurity.... see more

Kidney Patterns That Can Lead to Melasma

Pattern Name Relevant Symptoms Relevant Formulas
Kidney and Liver Yin Deficiency Melasma, Dizziness, Tinnitus, Hearing loss, Lower back pain, Vertical headaches, Occipital headache, Insomnia, Limb numbness, Tingling of limbs, Dry eyes, Blurry vision, Dry throat, Dry hair, Skin dryness, Withered and brittle nails, Vaginal dryness, Night sweats, Dry stools, Nocturnal emission, Scanty menstruation, Amenorrhea, Late menstruation, Infertility... see more Zuo Gui Wan | Qi Ju Di Huang Wan | Liu Wei Di Huang Wan | Qing Gu San | Yi Guan Jian | Zhen Gan Xi Feng Tang
Detailed description of the cause

Spleen

In TCM the Spleen plays a vital role in digestion and transformation, converting food into energy and nutrients, and overseeing the distribution of Qi and Blood. It's also crucial in maintaining the health of muscles and limbs and ensuring the blood remains within the vessels. When the Spleen malfunctions in TCM, it can lead to a variety of issues such as digestive disorders, fatigue, weak muscles, bloating, and a feeling of heaviness. It can also cause a pale complexion, poor appetite, and a tendency to bruise easily. Emotionally, a Spleen imbalance is often associated with excessive worry or overthinking, reflecting its role in the interplay between physical and mental health.... see more

Spleen Patterns That Can Lead to Melasma

Pattern Name Relevant Symptoms Relevant Formulas
Spleen Qi Deficiency Melasma, Slight abdominal distension after eating, General weakness, Desire to lie down, Slight abdominal pain, Excessive gas and flatulence, Bloated abdomen, Dyspepsia, Swollen complexion, Obesity... see more Si Jun Zi Tang | Liu Jun Zi Tang | Fei Er Wan | Shen Ling Bai Zhu San

TCM Herbal Formulas for Melasma

Treatment of melasma in TCM relies on the use of specific herbal formulas tailored to the individual's pattern of disharmony. For Liver Qi Stagnation, formulas such as Xiao Yao San or Chai Hu Shu Gan San are often recommended to promote the movement of Qi and alleviate emotional stress.

In cases where Yin deficiency is the primary concern, Zuo Gui Wan or Liu Wei Di Huang Wan may be prescribed to nourish the Yin and cool the body.

Each formula contains a carefully balanced combination of herbs that work synergistically to address both the symptoms and the root cause of the condition. For instance, Xiao Yao San harmonizes the Liver and Spleen, while Zuo Gui Wan focuses on replenishing Kidney Yin. The choice of formula is highly individualized, emphasizing the personalized nature of TCM treatment in addressing melasma.

Explore below some TCM herbal formulas used to address melasma, organized by cause and by formula type.

  • By Cause
  • By Formula Type
  • Formulas that invigorate blood and dispel blood stagnation
  • Formulas that nourish yin and tonify
  • Formulas that tonify qi
  • Formulas that harmonize liver-Spleen
  • Formulas that promote qi movement
  • Formulas that tonify blood
  • Formulas that clear heat from deficiency
  • Formulas that pacify and extinguish internal wind
  • Formulas that regulate blood
  • Formulas that reduce food accumulation and transform stagnation

All Formulas Recommended for Melasma Caused by Qi Stagnation

Formula Patterns Suitable For
Chai Hu Shu Gan San Liver Qi Stagnation, Qi And Blood Stagnation
Yi Guan Jian Liver Qi Stagnation
Xiao Yao San Liver Qi Stagnation
Jia Wei Xiao Yao San Liver Qi Stagnation
Yue Ju Wan Liver Qi Stagnation
Xue Fu Zhu Yu Tang Qi And Blood Stagnation
Shen Tong Zhu Yu Tang Qi And Blood Stagnation
Shao Fu Zhu Yu Tang Qi And Blood Stagnation
Ge Xia Zhu Yu Tang Qi And Blood Stagnation
Shi Xiao San Qi And Blood Stagnation
Qi Li San Qi And Blood Stagnation
Dan Shen Yin Qi And Blood Stagnation
Guo Qi Yin Qi And Blood Stagnation
Tao Hong Si Wu Tang Qi And Blood Stagnation

All Formulas Recommended for Melasma Caused by Yin Deficiency

Formula Patterns Suitable For
Yi Guan Jian Kidney and Liver Yin Deficiency
Zuo Gui Wan Kidney and Liver Yin Deficiency
Qi Ju Di Huang Wan Kidney and Liver Yin Deficiency
Liu Wei Di Huang Wan Kidney and Liver Yin Deficiency
Qing Gu San Kidney and Liver Yin Deficiency
Zhen Gan Xi Feng Tang Kidney and Liver Yin Deficiency

All Formulas Recommended for Melasma Caused by Blood Stasis

Formula Patterns Suitable For
Chai Hu Shu Gan San Qi And Blood Stagnation
Xue Fu Zhu Yu Tang Qi And Blood Stagnation
Shen Tong Zhu Yu Tang Qi And Blood Stagnation
Shao Fu Zhu Yu Tang Qi And Blood Stagnation
Ge Xia Zhu Yu Tang Qi And Blood Stagnation
Shi Xiao San Qi And Blood Stagnation
Qi Li San Qi And Blood Stagnation
Dan Shen Yin Qi And Blood Stagnation
Guo Qi Yin Qi And Blood Stagnation
Tao Hong Si Wu Tang Qi And Blood Stagnation

All Formulas Recommended for Melasma Caused by Qi Deficiency

Formula Patterns Suitable For
Si Jun Zi Tang Spleen Qi Deficiency
Liu Jun Zi Tang Spleen Qi Deficiency
Fei Er Wan Spleen Qi Deficiency
Shen Ling Bai Zhu San Spleen Qi Deficiency

All "formulas that nourish yin and tonify" recommended for melasma

Formula Patterns Suitable For (if applicable)
Yi Guan Jian Kidney and Liver Yin Deficiency, Liver Qi Stagnation
Zuo Gui Wan Kidney and Liver Yin Deficiency
Qi Ju Di Huang Wan Kidney and Liver Yin Deficiency
Liu Wei Di Huang Wan Kidney and Liver Yin Deficiency

All "formulas that promote qi movement" recommended for melasma

Formula Patterns Suitable For (if applicable)
Chai Hu Shu Gan San Liver Qi Stagnation, Qi And Blood Stagnation
Yue Ju Wan Liver Qi Stagnation

All "formulas that invigorate blood and dispel blood stagnation" recommended for melasma

Formula Patterns Suitable For (if applicable)
Xue Fu Zhu Yu Tang Qi And Blood Stagnation
Shao Fu Zhu Yu Tang Qi And Blood Stagnation
Ge Xia Zhu Yu Tang Qi And Blood Stagnation
Shi Xiao San Qi And Blood Stagnation
Qi Li San Qi And Blood Stagnation
Dan Shen Yin Qi And Blood Stagnation

All "formulas that tonify qi" recommended for melasma

Formula Patterns Suitable For (if applicable)
Si Jun Zi Tang Spleen Qi Deficiency
Liu Jun Zi Tang Spleen Qi Deficiency
Shen Ling Bai Zhu San Spleen Qi Deficiency

All "formulas that harmonize liver-Spleen" recommended for melasma

Formula Patterns Suitable For (if applicable)
Xiao Yao San Liver Qi Stagnation
Jia Wei Xiao Yao San Liver Qi Stagnation

All "formulas that tonify blood" recommended for melasma

Formula Patterns Suitable For (if applicable)
Guo Qi Yin Qi And Blood Stagnation
Tao Hong Si Wu Tang Qi And Blood Stagnation

TCM Herbs for Melasma

Explore below some TCM herbs used to address melasma, organized by herb category.

  • By Herb Category
  • Herbs that invigorate the blood
  • Tonic herbs for qi deficiency
  • Tonic herbs for blood deficiency
  • Herbs that expel parasites
  • Herbs that cool the blood
  • Cool/Acrid herbs that release the exterior
  • Aromatic herbs that transform dampness
  • Herbs that stop bleeding
  • Herbs that drain dampness

"Tonic herbs for Qi Deficiency" recommended for melasma

Herb Formulas they belong to (if applicable)
Ginseng (Ren Shen) Si Jun Zi Tang | Liu Jun Zi Tang | Shen Ling Bai Zhu San
Atractylodes Rhizomes (Bai Zhu) Shen Ling Bai Zhu San
Liquorice (Gan Cao) Shen Ling Bai Zhu San

"Tonic herbs for Blood Deficiency" recommended for melasma

Herb Formulas they belong to (if applicable)
Prepared Rehmannia (Shu Di huang) Zuo Gui Wan | Qi Ju Di Huang Wan | Liu Wei Di Huang Wan | Guo Qi Yin
Dong Quai (Dang Gui) Guo Qi Yin

"Herbs that expel parasites" recommended for melasma

Herb Formulas they belong to (if applicable)
Quisqualis Fruits (Shi Jun Zi) Fei Er Wan
Areca Nuts (Bing Lang) Fei Er Wan

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