Acne · Phlegm-Dampness Congealing Pattern

Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Face/Skin


Pattern Overview

Phlegm-Dampness Congealing is a pattern in acne, characterized by nodular cystic acne, sebaceous gland duct hyperkeratosis, deep inflammation, fibrosis, and persistent lesions. The core pathogenesis is Phlegm-Dampness congealing in the skin, causing sebaceous gland duct hyperkeratosis, deep inflammation, and nodule formation.


Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
Primary SymptomsNodular cystic acne, persistent lesions, fibrosis, scarring
Associated SymptomsSticky mouth, heavy sensation, fatigue, loose stools
Tongue and PulsePale and swollen tongue with white greasy coating, slippery pulse
PathogenesisPhlegm-Dampness congealing in the skin
EtiologyChronic acne, poor diet, constitutional Phlegm-Dampness, inadequate treatment

Acupuncture Point Prescription

PointLocationFunction
Fenglong (ST40)8 cun above the lateral malleolus, 2 cun lateral to the tibial crestTransforms Phlegm and Dampness
Yinlingquan (SP9)Below the medial condyle of the tibiaTransforms Dampness and promotes diuresis
Sanyinjiao (SP6)3 cun above the medial malleolusRegulates Dampness and nourishes Blood
Zhongwan (RN12)4 cun above the umbilicusFront-Mu point of Stomach; harmonizes the Stomach
Hegu (LI4)Dorsum of the hand, between the 1st and 2nd metacarpalsRegulates Qi and promotes circulation

Clinical Recommendation: Filament needle, even method; may combine with cupping to transform Phlegm and drain Dampness.


Herbal Formula

Base Formula: Er Chen Tang (二陈汤) + Hai Zao Yu Hu Tang (海藻玉壶汤)

Composition:
Tangerine Peel (Chen Pi), Pinellia (Ban Xia), Poria (Fu Ling), Sargassum (Hai Zao), Kelp (Kun Bu), Fritillaria (Zhe Bei Mu), Forsythia (Lian Qiao), Licorice (Gan Cao)

Action: Transforms Phlegm, softens nodules, and resolves masses.

Modifications

Associated SymptomsAdditions/Subtractions
Nodular lesionsAdd Xia Ku Cao, Zhe Bei Mu to soften and resolve masses
FibrosisAdd San Leng, E Zhu to break up stasis
ScarringAdd Dan Shen, Ji Xue Teng to improve microcirculation
Heavy sensationAdd Huo Xiang, Pei Lan to transform Dampness

Western Mechanism Reference

Nodular cystic acne with sebaceous gland duct hyperkeratosis, deep inflammation, and fibrosis. Phlegm-Dampness Congealing corresponds to nodular cystic acne, where sebaceous gland duct hyperkeratosis and deep inflammation contribute to persistent nodular lesions and fibrosis.


References

  1. Dermatology of TCM - Acne with Phlegm-Dampness Congealing.
  2. Xiong Jibai: Phlegm-Dampness uses Er Chen Tang.
  3. WHO. (2023). Skin health. World Health Organization.

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