Cosmetic Acupuncture for facial wrinkles and fine lines

INTRODUCTION

People in the western countries have been using anti-aging methods for centuries. It is said that Cleopatra in ancient Egypt was known to take baths in donkey’s milk to smooth and soften her skin. The early Greeks were said to use algae and mineral-rich seaweed for anti-aging and weight loss treatments, while the Romans would slather themselves in olive oil after long sweating sessions in their sauna-like bathhou­ses. But ancient Chinese medicine could probably be considered to be the golden standard. It developed some of the most effective methods to conquer aging and postpone it for many years based on Cosme­tic Acupuncture and Chinese Acupressure Massage.

Acupuncture has proven itself through several thousands of years to treat a wide variety of illnesses for millions of people. Even from as early as 960-1127 BC during the Tzun Dynasty acupuncture rejuvenation was used for the empress and other high-ranking members of society. The Ancient Masters understood that by manipulating the flow of qi in the body, it would stimulate the processes necessary for longevity and youth. The effects of acupuncture, is to manipulate the body’s qi to balance and increase qi in certain meridians, or organ systems in the body.

It is by manipulating qi in the meridians in the face as well as in organ systems related to those meridians that makes it possible to reduce wrinkles and fine lines in the face.

With Cosmetic Acupuncture, disharmony in the body can be identified and by applying a holistic treatment plan, re-balancing and harmonizing of proper body’s organ systems and functions can be achieved. This is then manifested in the reduction of facial wrinkles and fine lines.

Chinese medicine considers that healthy skin is beautiful skin. Beautiful skin means: firm, smooth and bright skin, with even coloration, less or no wrinkles and fine lines for one’s age, less or no age spots for one’s age, no puffiness, no dryness, no cracked lips, no acne, and no rashes.

Beauty is generally thought of as skin deep, but in the eyes of traditional Chinese medicine, of which Cosmetic Acupuncture is only but just a small part, beautiful skin reflects a healthy body both internally and externally.

Western Medicine aspect of facial wrinkles and fine lines

Wrinkles and fine lines in the face are a result of aging but there are other factors that promote aging, facial wrinkles and fine lines, these are:

  • Smoking – regular smoking accelerates skin aging because it reduces blood supply to the skin. The result is the fast development of skin aging signs like facial wrinkles and fine lines. It also causes premature skin aging signs causing the appearance of wrinkles and fine lines even when a person is still in his/her early 30s.

  • Genetics – if a person has parents who developed facial wrinkles and fine lines and other skin aging signs early, there is a higher chance that this will also happen to that person.

  • Skin color – people who have light skin color suffer more from sun damage to the skin. This also accelerates the development of facial wrinkles and fine lines and other skin aging signs

  • Hair – there are hairstyles that provide more shade which protects the face from the sunlight.

  • Clothes – people who usually wear hats and long sleeves has more protection from the sun, so they tend to develop facial wrinkles and fine lines later in life.

  • Exposure to ultraviolet light (UV) – there are jobs that increase exposure to sunlight causing an accelerated development of facial wrinkles and fine lines and other skin aging signs. This includes construction workers, gardeners, fishermen, farmers, and sailors. There are also other ways to be exposed to UV light like people who enjoy outdoor activities and those who regularly use a tanning booth.

  • Facial expressions – people who repeatedly squint, frown or smile develop facial wrinkles faster compared to those who usually do not make these facial expressions. The Mayo Clinic states that every time a facial muscle is used, grooves form just underneath the skin’s surface. When one is young the skin can spring back immediately but as one gets older flexibility and elasticity is lost causing more permanent grooves and the eventual appearance of facial wrinkles and fine lines.

  • Harsh chemicals – there are also skin care products that contain harsh chemicals or other harmful substances that can damage the skin and significantly accelerate the aging process of the skin.

Wrinkles and fine lines are inevitable and will sooner or later appear. What one can do is to delay its appearance or somehow reduce its severity if it is already visible. There are also a number of ways the appearance of wrinkles and fine lines can be reduced or even eliminated. Billions of dollars are spent each year on different treatments to remove facial wrinkles and fine lines. There are many products and procedures that make great claims but a lot do not really offer significant wrinkles and fine lines redu­cing effects.

According to a research study conducted at the University Hospital of Liege in Belgium, which was published in the International Journal of Cosmetic Science 2006, there are four specific types of wrinkles and fine lines. They are:

  • Atrophic Crinkling Rhytids – these are fine lines that are parallel to each other which can show up on different areas of the face. They tend to disappear when the skin is stretched, for example when the body posture of the person changes. These are wrinkles and fine lines that are closely connected to reduced skin elasticity.

  • Permanent Elastic Creases – these are creased lines that eventually become permanent. It is mostly due to unprotected sun exposure. They usually develop on the cheeks, base of the neck and upper lip. Smoking is one of the major factors that causes this type of wrinkles and fine lines.

  • Dynamic Expression Lines – these are wrinkles and fine lines that are a direct result of facial muscle movement. They are commonly known as frown or smile lines and crow’s feet which appear on the edges of the eyes and mouth.

  • Gravitational Folds – these are lines that develop as a result of gravity and they become more obvious when the skin starts to fold and to sag. These wrinkles and fine lines show up on different parts of the face depending on the thickness of the skin. Researchers found that a plumper face tends to show fewer gravity folds compared to a lean face.

Fig.1. Wrinkles and fine lines

Fig.1. Wrinkles and fine lines


Crow’s feet wrinkles (eye wrinkles), forehead wrinkles, wrinkles around lip and mouth, as well as other wrinkles and fine lines are inevitable for aging skin, especially after middle age, when signs of our body organs aging become noticeable. The biggest organ of our body, our skin ages along with the rest of organs. See Fig. 1. Wrinkles and fine lines.

Cosmetic Acupuncture aspect of facial wrinkles and fine lines

In general, for both males and females, in their 40s, the collagen and elastin in their skin begins to break down. Their skin becomes dryer, blood flow begins to slow down and new cell production decreases. All these factors help to increase wrinkles and fine lines formation. At the same time, the underlying fat cells in their face shrink and the excess skin produced, begins to sag.

According to ancient Chinese medical books, it is believed most women after 35 years old, their Kidney Yang starts to become weak, skin starts getting dull and suffers from lack of moisture and nutrition. Most women’s Kidney Yang drops sharply and skin tone noticeably worsens after age 42.

External pathological factors influence wrinkles and fine lines

External pathological factors such as the climate, lifestyle, and living environment have a major impact on the functionality of each of the body’s organ systems. The skin is one of these organs. 

Wrinkles and fine lines due to temporary skin dehydration are shallow and thin. This type is usually distributed around the eye, mandible and/or corner of mouth. The skin tone is lusterless due to lack of fluids.

Wrinkles and fine lines due to qi and blood deficiency are shallow. This type is usually distributed around the eyes, lips and forehead.

Wrinkles and fine lines due to aging and kidney essence deficiency are deep, extending to the dermis layer of the skin. This type is usually distributed as eye crow’s feet, around the mouth, forehead, cheek and neck areas.

According to Cosmetic Acupuncture there are 5 main reasons for skin aging, with the exception of external skin damage due to the sun. These are:

  • Kidney essence/qi deficiencyThe significance of kidney in terms of Chinese medicine is more complex than simply the kidney organ system. It refers to the reproductive system, hormones, growth and bone marrow, which produces red and white blood cells and which are responsible for antibody production; therefore the immune system must be considered as part of the TCM concept of kidney.
  • Stomach and spleen imbalance
    If we say kidney qi is the natural essence, the stomach and spleen qi will be the postnatal sources of our body qi, blood and body fluids. If the spleen and stomach qi has a deficiency, then our internal body organ systems as well as our skin cannot get enough moisture and nutrition. This imbalance leads to an aging process.
  • Heart qi deficiency
    There are 12 meridians which are related to our different body organ systems. The heart is the dominant organ system for blood, blood vessels and facial complexion. As blood vessels deliver loaded supply to the facial area, the color and luster of the complexion usually reflects the sufficiency or insufficiency i.e. deficiency of blood supply and heart qi.
  • Lung qi obstruction
    Lung is in charge of qi, breathing, connecting externally with skin and hair. The lung is related to defensive qi, and its function is to distribute the essential nutrients to the skin and hair. If lung qi is weak and deficient, defensive qi is not dispersed and descending and essential nutrients are not distributed. This causes hypoactivity of the defensive qi resulting in rough skin, dry skin and dry hair.
  • Emotional imbalance
    Emotions are mental stimuli that, in extreme cases, can disturb the mind and spirit which then alter the balance of the internal organ systems and the harmony of qi and blood. These extremes can be caused by stressful lifestyle, overworking, overthinking, etc. which may result in severe to prolong physical and mental disorders.

The symptoms from these disorders can manifest in the form of facial wrinkles and fine lines in various locations on the face. These locations are directly related to an internal organ system.

cosmetic-treatment-3

See Fig.2. Face Mapping.

Cosmetic Acupuncture is not only concerned with treating the face but also with treating the whole body i.e. holistic treatment. Cosmetic Acupuncture helps to reduce stress, strengthens Stomach qi, Spleen qi and the immune system, tonifies Kidney qi, harmonizes Lung qi and Liver qi, and stimulates proper circulation of qi, blood, lymph and other body fluids to maintain healthy skin and muscle tone.

Cosmetic Acupuncture can also stimulate the body’s natural processes of cell reproduction and growth. Needling facial skin brings about an active production of collagen, the structural protein which holds the skin together and helps to keep it tight. Although needling the skin causes short-term injury, this heals quickly and is in fact a wakeup call for collagen production.

Balancing of the meridians and the internal organ systems as well as harmonizing qi and blood to maintain healthy function within the body is one of the main concepts of Cosmetic Acupuncture.

DIAGNOSIS

Both Dermatologists and Cosmetic Acupuncturists will carry out a facial diagnosis for wrinkles and fine lines, simply by inspecting the affected area on the face. The Cosmetic Acupuncturists will how­ever diagnose further.

Since the Cosmetic Acupuncturist’s treatment will be a holistic one, wrinkles, fine lines and location on the face will be considered and associated with internal organ systems and meridians imbalances. Ge­nerally, tongue and pulse diagnosis will also be done as well as gathering of relating patient’s information such as: medical history, medications, diet and lifestyle.

There are different stages of wrinkles and fine lines.

  • Stage 1: Dry skin. Wrinkles and fine lines might not yet be visible

  • Stage 2: Lusterless skin, loss of elasticity in skin. Minimum wrinkles and fine lines can be seen.

  • Stage 3: Loss of skin tone. Shallow wrinkles and fine lines begin to appear.

  • Stage 4: Very visible deep wrinkles and fine lines.

TCM Pattern Differentiation

  • Heart blood deficiency

When heart blood fails to nourish the skin the thin shallow wrinkles and fine lines will appear. The skin will have a lusterless complexion. The person will have blurred vision. Tongue is pale, Pulse is thin. The patient may experience: palpitations, insomnia, dream-disturbed sleep, poor memory, dizziness, vertigo, anxiety, startles easily, dull-pale complexion, pale lips.

  • Liver qi and blood stagnation

Suppressed emotions cause liver qi stagnation, which blocks free flow of qi and blood in the meridians and collaterals. The blockage of qi and blood result in wrinkles and fine lines as well as general fatigue, irritability and irregular menstrual cycle.

Distention of hypochondrium and chest, hypochondriac pain, sighing, hiccups, depression, irritability, nausea, vomiting, diarrhea, epigastric pain, poor appetite, plum pit sensation in throat, belching, sour regurgitation, abdominal distention, irregular periods, distention of the breasts, PMS.

  • Kidney qi deficiency

This is the main reason for aging process of the skin. The skin becomes sagging, wrinkles and fine lines are visible.

soreness of lower back, weakness of lower back, weakness of knees, clear urination, frequent urination,

incontinence, dribbling after urination, enuresis, nocturia, nocturnal emissions without dreams, premature

ejaculation, spermatorrhea, prolapse uterus, leucorrhea-chronic vaginal discharge.

  • Spleen qi deficiency

The function of transportation and transformation of food will be impeded. The entire body will be malnourished. This is seen on the face as sagging skin, puffy eyes and sometimes dark brownish spots on the face.

Poor appetite, emaciation, abdominal distention after eating, fatigue, lassitude, sallow complexion, weakness of limbs, loose stools, nausea, stuffiness of the chest and epigastrium and feelings of heaviness.

  • Irregular lifestyle

Smoking, alcohol consumption, sleep deprivation and greasy high-fat food can all add toxins to our body, which will affect healthy qi and proper blood circulation. As a result, the face will suffer from dark discoloration, wrinkles, fine lines and other unhealthy conditions.

 TREATMENT

Dermatologist approach to reduce facial wrinkles and fine lines

There are several treatments options to reduce the appearance of facial wrinkles and fine lines. The most popular ones are: moisturizers, mechanical or chemical peeling of the skin, implants to lift the skin, Botulinum Toxin (Botox) and cosmetic surgery.

Cosmetic Acupuncture approach to reduce facial wrinkles and fine lines

Cosmetic Acupuncture Treatment is based on TCM pattern differentiation. It means that a Cosmetic Acupuncturist first finds out the root cause of the facial wrinkles and fine lines from inside of the body, then use TCM theories to analyze and to give an individual treatment that is specific for that patient.

A combination of facial and body acupuncture points would be selected to regulate and balance the affected zang fu organ systems. By doing so, a reduction of facial wrinkles and fine lines can be achieved.

The main functions of these acupuncture points are to expel cold, wind and damp, to clear heat and to promote qi and blood circulation.

Depending on the locations of the facial wrinkles and fine lines the meridians and corresponding organ systems are treated by needling specific acupuncture points on the face and other parts of the body to support the healing process.

In addition to acupuncture, herbs and facial creams are also used but this article concentrates on Cosmetic Acupuncture treatments.

For example, on specific areas of the face, the facial wrinkles and fine lines are directly related to the following meridians and organ systems. See Fig.2:

  • Cheeks — stomach and large intestine, lung

  • Chin — kidney, bladder and Ren mai

  • Nose — lung and large intestine, Du mai

  • Forehead (above the eyebrow) — gallbladder and bladder

  • Around the lips — stomach, spleen , liver, large intestine

  • Centre of the forehead — bladder

Needling facial wrinkles and fine lines

  • Needle the full length of and along the wrinkles and fine lines.

  • The directions of the needles must be upward. This is done to achieve a lifting effect.

  • Always needle the body points first and the face points afterward. When removing needles, remove first the face points then the body points.

Treatment based on TCM pattern differentiation

  • Heart blood deficiency

Facial points: add local points according to location of wrinkles and fine lines

Body points: HT7,(PC7 & SP4), REN4, REN14, REN15, SP6, ST36, BL15, BL17, BL20

  • Liver qi and blood stagnation

Facial points: add local points according to location of wrinkles and fine lines

Body points: LV3, LV8, LV13, LV14, (GB34 & SJ6), GB40, GB41, PC6, SP6, SP20, BL17, BL18.

  • Kidney qi deficiency

Facial points: add local points according to location of wrinkles and fine lines

Body points: KI3, KI7, DU4, REN3, REN4, REN6, SP6, SP10, BL23, BL52

 

  • Spleen qi deficiency

Facial points: add local points according to location of wrinkles and fine lines.

Body points: SP3, SP6, ST36, REN12, BL20, BL21, LV13

 

  • Lifestyle

Regular exercise, sufficient rest and normal sleep pattern are beneficiary to preserving the skin or is good for health and anti-aging effects.

Avoid stressful situations and environments, a balanced lifestyle of work and rest is extremely necessary and important for a long and healthy life.

Do something different and enjoyable every day to relieve stress whenever possible.

Daily facial exercise for 5 – 10 minutes can help skin to stay young.

Use humidifier at home or at work to minimize skin dryness.

Avoid environmental exposure to air pollutants, dust, chemicals and harsh lights. These can cause facial wrinkles and fine lines over a period of time.

 

Acupuncture points which in general support collagen production for facial wrinkles and fine lines

Acupuncture points on face:

  • Tian Mu (1 cun above Yin Tang) – this point is commonly used for lifting the forehead as well as reducing wrinkles and fine line in the forehead.

  • SI18 – this point strongly promotes qi and blood flow in the facial area.

  • ST4 – this point clears wind from the face, lifts and soothes wrinkles and fine lines around the mouth.

  • REN23 – this point reduces swelling of the face, promotes circulation of qi and blood.

Acupuncture points on the body (distal points):

Choose points from the Yangming and Bladder meridians. The Yangming meridian is full of qi and blood, activating them can quickly send nutrients to the facial area. The Bladder meridian back shu points connect to the corresponding organ systems. These points regulate the internal organ systems and stimulate healthy functioning of the skin.

The skin can be richly nourished, resulting in the skin becoming more vibrant, smoother and tighter when the Yangming and Bladder meridians are stimulated together.

Alternate 2 to 3 pairs of points from the following during treatment:

  • ST36 – this points tonifies center body qi and support a healthy immune system. It has strong anti-aging effects. It improves skin complexion and smoothes wrinkles and fine lines.

  • ST39 – this point firms the skin and nourishes dry skin.

  • ST41 – this point sends qi to the facial areas, it clears heat from the face, reduces swelling of the face and promotes skin healing in the face.

  • LI9, LI10 – these points are very effective points to promote qi and blood flow to the face, thereby supporting healthy skin cell renewal.

  • SP6 – this points tonifies kidney, liver and spleen organ systems. It also clears away damp heat. This is a major point used for anti-aging/anti-wrinkle and fine lines purposes.

  • SP10 – this point tonifies, detoxifies and promotes blood circulation in the whole body. By needling this point, the skin is cleansed and rejuvenated at the same time.

Acupuncture points on the ear:

  • Use needles or ear seeds on these points or areas on the ear: heart, kidney, lung, face, Pi Zhi Xia, internal secretion.

In addition to the acupuncture points listed above, during treatment sessions, add the following procedure to every other treatment:

  • Use finger stimulation/massage on points from DU14 to DU2. Repeat up and down 5 times until the skin is red.

  • Needle the following points: BL13, BL15, BL17, BL20, BL22 and BL23 to promote qi and blood circulation in the lung, heart, diaphragm, spleen, san jiao and kidney organ systems.

 

 

Diet advice

  • Drink 6 to 8 glasses of water per day.

  • Consume whole, unprocessed foods i.e. whole grains, legumes, vegetables and fruits.

  • Fresh fruits and vegetables are excellent sources of vitamin A and C, while oils, seeds and nuts provide vitamin E, essential antioxidants, which increases cell renewal rate, normalizes cell growth and stimulates blood flow and collagen formation.

  • Avoid foods containing trans-fatty acids such as milk, milk products, margarine, shortening and other synthetically hydrogenated vegetable oils.

  • Avoid unrefined sugars, fried, raw, cold foods and cold drinks that stress spleen and stomach functions.

  • Eliminate alcohol, caffeine and smoking.

  • Boost zinc intake, this is an important mineral in production of collagen. Beef, calves’ liver, lean beef, lamb, sunflower seeds, brazil nuts, peanuts and dark-meat turkey are excellent sources of zinc.

  • A source of vitamin D, in the form of soaked almonds eaten daily can enhance skin tone.

Contraindications and cautions

During the first interview, screen the patient to make certain that he/she is not contraindicated for Cosmetic Acupuncture treatment. Patient with underlying constitutional issue such as severe acute migraine headaches, liver or stomach fire rising will have to be treated first for any of these complaints.

Other contraindications are: high blood pressure, Parkinson’s disease, diabetes mellitus, hemophilia, cold, flu, hepatitis, herpes, vertigo, cancer, AIDS, skin diseases and pregnancy.

Females with menopausal symptoms require yang to be well anchored to avoid triggering hot flashes and yin should be nourished with herbs.

At the start of facial treatment clean the face to remove any barriers, for example moisturizer, cream, etc. Needle should be inserted slowly without lifting, twisting, thrusting or rotating. After needle insertion do not tighten or reinforce the needle.

When removing needles, avoid twirling, loosening or tugging. If there is a resistance, needle should be slowly removed with care, press next to the needle to relax the skin. In the event of hematoma or blood leak, apply pressure immediately on the affected area.

Anchoring qi

Since all yang meridians either begin or terminate in the face, when needling local areas on the face, precaution must be taken to avoid the patient from fainting, having headaches or getting dizzy after a treatment. In order to prevent this from occurring, anchoring or grounding of the entire body qi must be done.

Needle the legs and feet first, bilaterally. LV3, ST36, SP6, GB41 and ST44. These points give a good anchoring and should be needled for every facial treatment. They are retained throughout the treatment and are the last to be removed.

Needle the hands and arms secondly, bilaterally.LI4, PC4 and SJ8. LI4 promotes the arrival of de-qi while PC4 and SJ8 have a calming effect on the patient.

Then needle the areas to be treated i.e. the local facial areas where the wrinkles and fine lines are located.

CONCLUSION

Cosmetic Acupuncture treatment is a non-surgical option to reduce the appearance of facial wrinkles and fine lines, without the risk of side effects.  The treatment promotes the circulation of Qi and Blood in the face. Increased blood circulation to the face moistens the skin and promotes collagen production for increased muscle tone and elasticity.

Needles are placed in specific acupuncture points on the face and body. Using small facial needles creates micro-traumas in the skin which boosts the production of more collagen and elastin. 

Both Western medicine and Chinese medicine agree that facial wrinkles and fine lines are due to the body’s natural aging process. The approach to reduce the appearance of wrinkles and fine lines differs and the risks of permanent side effects are greater with some of the Western medicine approach.

In general, acupuncturists are trained to view the body, mind, emotions, and spirit as one, and to address the exterior symptoms by treating the underlying internal root cause. In TCM the common knowledge is that superficial symptoms whether allergies, menstrual disorder, low back pain, sagging face muscles, facial wrinkles and fine lines, and other signs of aging is a reflection of a deeper internal imbalance.

Cosmetic Acupuncture treats face and body holistically in order to reduce stress, strengthens Stomach qi, Spleen qi and the immune system, tonifies Kidney qi, harmonizes Lung qi and Liver qi, and stimulates proper circulation of qi, blood, lymph and other body fluids to maintain healthy skin and muscle tone.

The goal of a Cosmetic Acupuncturist is to help patients to live a healthier and happier live. Their reason for seeking treatment should not be criticized or denied but to acknowledge and to treat in the best way possible based on TCM principles and concepts.

BIBLIOGRAPHY

 

  • A Comprehensive Handbook for Traditional Chinese Medicine Facial Rejuvenation, by Ping Zhang, pages 169 – 176.

  • Acupuncture Desk Reference Volume 2, by David J. Kuoch, pages 285 – 286 and pages 295 – 296.

  • Cover page picture, www.tcmclineek.com/cosmetic-acupuncture

  • Figure 1 and 2 from wikipedia

  • Facial Enhancement Acupuncture Clinical use and application, by Paul Adkins

  • International Journal of Cosmetic Science (2006), researchers at the University Hospital of Liege, Belgium (Journal 2006, volume 28, pages 389 – 395)

  • The Mayo Clinic website