Rosacea - Yin Deficiency with Internal Heat Pattern

Dr. Li Wei, DACM

Rosacea · Yin Deficiency with Internal Heat Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Face/Skin

Pattern Overview

Yin Deficiency with Internal Heat is a chronic pattern in rosacea, characterized by chronic inflammation post-skin barrier damage, TRPV1 channel abnormal activation, neurovascular hyperreactivity, and flushing triggered by mild stimuli. The core pathogenesis is Yin deficiency failing to control Yang, leading to internal Heat, neurovascular hyperreactivity, and flushing.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Chronic flushing, heat sensation, dry skin, sensitivity to mild stimuli |

| Associated Symptoms | Heat in palms and soles, dry mouth, night sweats, irritability |

| Tongue and Pulse | Red tongue with little coating, thready and rapid pulse |

| Pathogenesis | Yin deficiency with internal Heat, neurovascular hyperreactivity |

| Etiology | Chronic rosacea, prolonged inflammation, aging, constitutional Yin deficiency |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Taixi (KI3) | Depression between medial malleolus and Achilles tendon | Source point of Kidney meridian; nourishes Kidney-Yin |

| Zhaohai (KI6) | 1 cun below the medial malleolus | Nourishes Yin and clears deficiency heat |

| Sanyinjiao (SP6) | 3 cun above the medial malleolus | Nourishes Blood and Yin; regulates the Spleen and Kidney |

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

| Xuehai (SP10) | On the medial thigh, 2 cun above the patella | Cools Blood and reduces erythema |

Clinical Recommendation: Filament needle, reinforcing method for Yin-nourishing points, reducing method for Heat-clearing points.

Herbal Formula

Base Formula: Zhi Bai Di Huang Wan (知柏地黄丸)

Composition:

Anemarrhena (Zhi Mu), Phellodendron (Huang Bai), Rehmannia (Shu Di), Dioscorea (Shan Yao), Cornus (Shan Zhu Yu), Poria (Fu Ling), Moutan (Mu Dan Pi), Alisma (Ze Xie)

Action: Nourishes Yin, clears deficiency heat, and reduces neurovascular hyperreactivity.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Chronic flushing | Add Zhi Mu, Huang Bai to clear deficiency heat |

| Dry skin | Add Mai Dong, Tian Hua Fen to generate fluids and moisten dryness |

| Night sweats | Add Mu Li, Fu Xiao Mai to stabilize the exterior |

| Sensitivity | Add Bai Shao, Gan Cao to relax and soothe |

Western Mechanism Reference

Chronic inflammation post-skin barrier damage, TRPV1 channel abnormal activation, and neurovascular hyperreactivity. Yin Deficiency with Internal Heat corresponds to chronic rosacea with neurovascular hyperreactivity, where TRPV1 channel abnormal activation and neurovascular hyperreactivity contribute to flushing triggered by mild stimuli.

References

  1. Dermatology of TCM - Rosacea with Yin Deficiency and Internal Heat.

  2. Zang-Fu Pattern Differentiation: Kidney-Yin Deficiency → Cross-layer.

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

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