Vitiligo - Qi-Blood Disharmony Pattern

Dr. Li Wei, DACM

Vitiligo · Qi-Blood Disharmony Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Skin

Pattern Overview

Qi-Blood Disharmony is a common pattern in vitiligo, characterized by autoimmune attack on melanocytes, CD8+ T-cell activation, anti-melanocyte antibodies, and progressive depigmentation. The core pathogenesis is disharmony of Qi and Blood failing to nourish the skin, leading to autoimmune-mediated melanocyte destruction and depigmentation.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Depigmented patches, progressive lesions, well-defined borders |

| Associated Symptoms | Fatigue, pale complexion, poor sleep, dry skin |

| Tongue and Pulse | Pale tongue with thin white coating, thready or hesitant pulse |

| Pathogenesis | Qi-Blood disharmony causing autoimmune melanocyte destruction |

| Etiology | Stress, immune dysfunction, autoimmune predisposition, trauma |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Hegu (LI4) | Dorsum of the hand, between the 1st and 2nd metacarpals | Regulates Qi and promotes circulation |

| Quchi (LI11) | Lateral end of the elbow crease | Clears Heat and regulates the immune system |

| Xuehai (SP10) | On the medial thigh, 2 cun above the patella | Nourishes Blood and regulates immunity |

| Geshu (BL17) | Lower back, 1.5 cun lateral to T7 | Back-Shu point of the Blood; harmonizes Blood |

| Ashi points | Borders of depigmented patches | Local blood invigoration and melanocyte stimulation |

Clinical Recommendation: Filament needle, even method; may combine with local cupping on the lesions to promote microcirculation.

Herbal Formula

Base Formula: Bai Dian Feng Wan (白癜风丸) or Tong Qiao Huo Xue Tang (通窍活血汤)

Composition:

Psoralea (Bu Gu Zhi), Angelica (Dang Gui), Salvia (Dan Shen), Chuanxiong (Chuan Xiong), Peach Kernel (Tao Ren), Safflower (Hong Hua), Licorice (Gan Cao)

Action: Harmonizes Qi and Blood, regulates immunity, and promotes melanocyte regeneration.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Progressive depigmentation | Add Huang Qi, Dang Shen to supplement Qi and regulate immunity |

| Fatigue | Add Huang Qi to enhance Qi supplementation |

| Dry skin | Add Dang Gui, Bai Shao to nourish Blood |

| Stress-related exacerbation | Add Chai Hu, Bai Shao to soothe Liver-Qi |

Western Mechanism Reference

Autoimmune attack on melanocytes with CD8+ T-cell activation and anti-melanocyte antibodies. Qi-Blood Disharmony corresponds to active vitiligo, where CD8+ T-cell-mediated autoimmune attack and anti-melanocyte antibodies contribute to melanocyte destruction and depigmentation.

References

  1. Dermatology of TCM - Vitiligo with Qi-Blood Disharmony.

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

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