Urticaria - Wind-Heat Pattern

Dr. Li Wei, DACM

Urticaria · Wind-Heat Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Skin

Pattern Overview

Wind-Heat is a common pattern in urticaria, characterized by heat-induced vasodilation, red wheals, intense itching, triggered by heat, exercise, or emotional stress. The core pathogenesis is invasion of Wind-Heat pathogens into the exterior, causing mast cell activation, histamine release, and vasodilation.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Red wheals, intense itching, triggered by heat or exercise |

| Associated Symptoms | Feverishness, thirst, red face, irritability |

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

| Pathogenesis | Wind-Heat pathogens invading the exterior |

| Etiology | Heat exposure, exercise, spicy food intake, emotional stress |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Quchi (LI11) | Lateral end of the elbow crease | Disperses Wind-Heat and stops itching |

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

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

| Fengchi (GB20) | Depression below the occipital bone, between the sternocleidomastoid and trapezius | Disperses Wind and clears Heat |

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

Clinical Recommendation: Filament needle, reducing method; may combine with pricking at Dazhui to enhance Heat clearing.

Herbal Formula

Base Formula: Xiao Feng San (消风散) or Yin Qiao San (银翘散)

Composition:

Schizonepeta (Jing Jie), Saposhnikovia (Fang Feng), Arctium (Niu Bang Zi), Cicada Slough (Chan Tui), Anemarrhena (Zhi Mu), Gypsum (Shi Gao), Rehmannia (Sheng Di), Angelica (Dang Gui), Licorice (Gan Cao)

Action: Disperses Wind-Heat, clears the exterior, and stops itching.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Intense itching | Add Bai Xian Pi, Ku Shen to stop itching |

| Red wheals | Add Jin Yin Hua, Lian Qiao to clear Heat and detoxify |

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

| Feverishness | Add Shi Gao, Zhi Mu to clear Heat and generate fluids |

Western Mechanism Reference

Heat-induced vasodilation and mast cell activation, with histamine and bradykinin release causing increased vascular permeability. Wind-Heat corresponds to heat-induced or cholinergic urticaria, where heat exposure and mast cell activation contribute to histamine release and wheal formation.

References

  1. Dermatology of TCM - Urticaria with Wind-Heat.

  2. Zang-Fu Pattern Differentiation: Wind-Heat Invading the Exterior → Clearing Pathway.

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

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