Rosacea - Lung-Stomach Heat Excess Pattern

Dr. Li Wei, DACM

Rosacea · Lung-Stomach Heat Excess Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Face/Skin

Pattern Overview

Lung-Stomach Heat Excess is the most common pattern in rosacea, characterized by facial vasomotor dysfunction with inflammation, LL-37 overexpression, MMP-9 activation, facial erythema, papules, and pustules. The core pathogenesis is Heat in the Lung and Stomach channels ascending to the face, causing facial vasodilation, inflammation, and lesion formation.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Facial erythema, telangiectasia, papules, pustules, flushing |

| Associated Symptoms | Thirst, constipation, red face, irritability, yellow urine |

| Tongue and Pulse | Red tongue with yellow coating, slippery and rapid pulse |

| Pathogenesis | Lung-Stomach Heat ascending to the face |

| Etiology | Spicy and rich food intake, alcohol consumption, sun exposure, emotional stress |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Hegu (LI4) | Dorsum of the hand, between the 1st and 2nd metacarpals | Disperses Wind-Heat and clears the Lung |

| Quchi (LI11) | Lateral end of the elbow crease | Clears Heat and detoxifies |

| Chize (LU5) | On the elbow crease, lateral side of the biceps tendon | He-Sea point of Lung meridian; clears Lung Heat |

| Neiting (ST44) | Between the 2nd and 3rd metatarsal bones | Spring point of Stomach meridian; clears Stomach Heat |

| Dazhui (GV14) | Below the spinous process of C7 | Clears Heat and releases the exterior |

Clinical Recommendation: Filament needle, reducing method; may combine with facial local needling for erythema.

Herbal Formula

Base Formula: Pi Pa Qing Fei Yin (枇杷清肺饮) + Xie Huang San (泻黄散)

Composition:

Loquat Leaf (Pi Pa Ye), Mulberry Bark (Sang Bai Pi), Coptis (Huang Lian), Phellodendron (Huang Bai), Gypsum (Shi Gao), Gardenia (Zhi Zi), Saposhnikovia (Fang Feng), Agastache (Huo Xiang), Licorice (Gan Cao)

Action: Clears Lung and Stomach Heat, reduces facial inflammation, and stops flushing.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Facial erythema | Add Jin Yin Hua, Lian Qiao to clear Heat and detoxify |

| Papules | Add Bai Xian Pi, Ku Shen to reduce inflammation |

| Flushing | Add Dan Shen, Chi Shao to cool blood |

| Thirst | Add Tian Hua Fen, Ge Gen to generate fluids |

Western Mechanism Reference

Facial vasomotor dysfunction with inflammation, LL-37 overexpression, and MMP-9 activation. Lung-Stomach Heat Excess corresponds to rosacea with facial erythema and inflammation, where LL-37 overexpression and MMP-9 activation contribute to vascular dysfunction and inflammation.

References

  1. Dermatology of TCM - Rosacea with Lung-Stomach Heat Excess.

  2. Zang-Fu Pattern Differentiation: Stomach Fire Excess → Clearing Pathway.

  3. WHO. (2023). Skin health. World Health Organization.

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