bubble_chart Concept

Skin atrophy refers to the thinning and increased shininess of the skin compared to normal conditions. The surface texture disappears or differs from the normal state. There is no clear record of this condition in classical medical texts. Suwen. Wei Lun mentions "lung heat causing leaf scorch, leading to weakness and thinness of skin and hair," which seems similar to this condition.

Both physiological and pathological changes can lead to skin atrophy. This article mainly discusses skin atrophy caused by pathological changes; skin atrophy due to aging or physiological changes during pregnancy will not be elaborated here.

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1. Pathogenic Toxin Infiltration︰Initially, there is a clearly defined red macula and papule, ranging in size from a mung bean to a broad bean, with rapid central depression and atrophy. The surface appears light red and shiny, with normal skin texture disappearing or leaving behind grade I wrinkles. It commonly appears on the face but may also scatter across the chest, back, and shoulders. Early symptoms may include fever, headache, thirst, dry stool, scanty dark urine, a red tongue with yellow coating, and a rapid pulse. The pathogenic factors involved include solar heat toxins, syphilis, and pestilent qi, which gradually erode the local skin, leading to atrophy. Therefore, when diagnosing this condition, it is essential to consider the disease cause and identify key features such as the round, light-red, shiny atrophic surface, loss of normal texture, or grade I wrinkles. In the initial stage, toxic-heat pulse signs may also serve as supporting evidence. The primary treatment principle is to remove toxins and eliminate pathogens, though there is no specific formula or medication. Treatment should be tailored based on the underlying cause.
2. Cold Congealing Blood Stasis︰Atrophy often presents in a band-like pattern, initially appearing on the dorsum of the hands and feet, then gradually extending to the forearms or the anterior tibial regions of the lower limbs. The skin becomes thin, smooth, depressed, and pale gray or dull in color, feeling hard to the touch, accompanied by cold extremities, cold skin along the forearm, a pale purple or dark red tongue with thin white coating, and a deep, slow pulse. This condition is caused by the invasion of cold pathogens, stagnation of the collaterals, and obstruction of qi and blood, leading to local skin stasis. Therefore, the atrophy in this syndrome starts from the extremities and gradually spreads upward, presenting as a smooth, band-like area of atrophy with a pale or dull color and a hard texture, along with signs of cold extremities, cold forearm skin, a pale tongue, and a deep, slow pulse—indicators of {|###|}pudendal coldness{|###|} for differentiation. The treatment principle focuses on {|###|}warming the meridians and dissipating cold, invigorating the blood to unblock the collaterals{|###|}, and Angelica Cold-Extremities Decoction may be selected.
3. Deficiency of Both Qi and Blood︰It is commonly seen as atrophy on one side of the facial skin, which may involve muscles or even bones. The affected skin appears sunken, significantly thinner than the healthy side, and loses its normal texture, with no obvious subjective symptoms. If the affected area expands, the affected side may shrink compared to the healthy side, often accompanied by symptoms such as anorexia, loose stools, dull complexion, pale tongue, greasy coating, and thin, weak pulse. This condition arises from insufficient generation of qi and blood, impaired circulation and nourishment, leading to skin atrophy. The key points of differentiation include: atrophy that may involve muscles or even bones, sunken affected areas, pale and textureless atrophy, and, if occurring on the face, deviation of the mouth, eyes, or nose. There may also be accompanying symptoms of spleen-stomach weakness. Treatment focuses on tonifying the spleen and stomach, and medications such as Major Tonifying Pill or Shiquan Dabu Wan can be selected for gradual therapeutic management.
4. Liver-kidney Yin Deficiency︰The facial skin is thin, with linear atrophy, loose skin, disappearance of wrinkles, and a tendency to form large folds. The surface is dry with grade I scaling, appearing grayish-brown or brownish-red. This condition is more common in middle-aged individuals, whose faces resemble those of the elderly, and is often accompanied by senile freckles and hemangiomas. Men experience sparse hair growth, while women may develop facial hair. The tongue is thin, dry, red, and lacks moisture, with a deep and fine pulse. The kidneys store essence, and the liver stores blood; the liver and kidneys share the same origin (Ji and Gui), with essence and blood mutually transforming each other. If chronic illness lingers or one indulges in pleasure while suffering mentally, or bears heavy burdens, it can lead to deficiency of the liver and kidneys, insufficiency of essence and blood, and the skin losing its nourishment, resulting in gradual atrophy. The key points for diagnosis are: thin skin with linear patterns, disappearance of wrinkles, and due to skin laxity, a tendency to form large, deep folds that are grayish-brown or brownish-red, with dry skin and fine scaling. This manifests as premature aging. The treatment principle is to nourish water to moisten wood, using the prescription Six-Ingredient Rehmannia Pill.

Skin atrophy is generally a degenerative change of the skin caused by congenital or acquired factors, and its treatment is usually challenging. It is essential to identify the underlying cause and manage it gradually; otherwise, haste may lead to failure. Additionally, in clinical practice, skin atrophy caused by X-ray therapy, certain diseases, or trauma should be differentiated from the aforementioned common symptoms and signs.

bubble_chart Documentation

1. 《Classic of Atrophy-Flaccidity Disease》: "Lung atrophy refers to the withering of the skin and hair. It is caused by heat invading the lung metal, which internally leads to the scorching of the leaves, and externally results in the weakness of the skin and hair, making them thin and brittle. If the heat lingers and spreads to the tendons, vessels, bones, and flesh, it gives rise to atrophy-flaccidity disease."