Those annoying red rashes come and go just like the mysterious winds of spring. Feng zhen (wind rashes) is the Chinese name for urticaria. It is an allergic problem that can be acute or chronic.

An allergic constitution is the main internal cause while pathogenic energies outside play a trigger role, according to TCM. Reinforcing healthy energy while dispelling pathogenic energies is the principle used in treating urticaria.

Urticaria is one of the most common skin problems affecting people of any age. About 15 percent of the population will be afflicted with urticaria at least once in their lives. It can happen in any season though it seems to occur more often in spring.

Urticaria usually attacks and disappears unexpectedly, just like the wind. It itches at first, then rashes break out which spread quickly when you scratch. It can disappear without a trace and then flair up again in a few hours. The unbearable itchiness makes it difficult for people to work or sleep; the more you scratch the more rashes there will be. Patients can also suffer vomiting, diarrhea, sore throat, or breathing difficulties at the same time. It can be an acute ailment healing in a few days or weeks, and it can also be chronic and attack repeatedly without warning.

A deficit of "natural endowment" is the main internal cause of the problem in TCM, according to Dr Li Yongmei, chief physician of the Dermatology Department of Longhua Hospital attached to Shanghai University of TCM, just as Western medicine attributes it to an allergic constitution. And pathogenic wind plays a trigger role (external cause). When the healthy energy is weak because of another sickness or just fatigue, pathogenic energies outside like wind, cold and heat may invade the body and result in disturbed energy and blood flow and disharmony between the nutrient and defense systems. When the disordered energy condition reflects itself in skin, urticaria occurs.

Dr Li says that 35 percent of urticaria outbreaks are acute and caused by foods, medicines or drinks. They usually last no more than six weeks, and it happens more often to children. Fa wu (foods that tend to generate yang/hot energy) like seafood, some stale foods, and certain medicines can trigger urticaria in some people with deficient natural endowment immediately; unhealthy eating habits like overeating or over-drinking can result in pathogenic energies gathering inside in a short time and they reflect in the skin as urticaria; other inflammations like pollen allergy, flu, eczema and rhinitis can also trigger attacks.

Chronic urticaria happens more often to adults. Long-term psychological depression or chronic diseases can result in deficient yin/cold energy inside with pathogenic heat, which weakens healthy energy and leaves it unable to protect the body against pathogenic wind invasion. The healthy energy and pathogenic wind are blocked in a seesaw struggle and result in repeated urticaria attacks.

Dispelling pathogenic wind while reinforcing the healthy energy is the main principle for treating urticaria. If it is acute urticaria accompanied by a sore throat, Dr Li suggests herbal medicines that disperse wind and release exteriors such as Sang Ju Yin (mulberry and chrysanthemum drink) and Yin Qiao San (lonicera and forsythia pill). Patent TCM drugs like Xiaofeng Zhiyang Keli (dispelling wind and stop itchiness granules) and Fuyang Keli (skin itchiness granules) can help relieve itchiness. If the patient is bothered by repeat attacks of chronic urticaria, there will be damage to the kidneys and yin energy in the long term and patients will suffer from dry skin and constipation. In this case, Dr Li suggests herbal medicines that can both nourish the body while dispelling pathogenic wind, such as the patent drug Runzao Zhiyang Jiaonang (nourishing and relieving itchiness capsule). And of course, to avoid aggravation, patients should keep away from all fa wu such as sea food, mutton, alcohol and spicy or fried food. Eating more fresh vegetables and fruits can help relieve localized edema and relieve rashes.

To prevent a relapse of urticaria, Dr Li suggests keeping away from what you are allergic to. And of course, adapting a healthy life style with a balanced diet and regular exercise will improve the immune system and prevent relapses.

Sang Ju Yin

Ingredients: Mulberry leaves (6g), chrysanthemum (6g), sugar (20g)

Preparation: 1. Pour the ingredients into 250ml boiling water and leave it for at least five minutes before drinking.

2. Drink it as tea.

Function: Dispersing pathogenic wind and dispeling pathogenic heat. Relieving acute urticaria due to pathogenic wind and heat.

Mashed banana and walnuts

Ingredients: 2 bananas, and walnuts (15g)

Preparation: 1. Mash and mix the ingredients.

2. Eat it once a day.

Function: Dispersing pathogenic wind, unblocking energy stagnation, nourishing intestines and relieving constipation. Relieving chronic urticaria accompanied by constipation.

White gourd peel soup

Ingredients: White gourd peel (50g)

Preparation: 1. Cook the peel with water

2. Drink as tea

Function: Promoting urination and relieving edema. Relieving urticaria with rashes.

(Shanghai Daily March 17, 2009)