From the perspective of Traditional Chinese Medicine, any facial skin issue is an external manifestation of an internal health imbalance. Each area of the face is affected by specific organs and body systems, their energy channels, and the emotions linked to them.
After identifying the type of imbalance, it can be addressed through herbal medication, lifestyle and dietary changes, and direct manipulation of energy flow in the corresponding meridian on the face. One such direct technique is facial scraping (Gua Sha).
Traditional Chinese medicine-inspired “Beauty Hacks” have gone viral on social media in recent years. Browse skincare Instagram, YouTube, or TikTok for even a few minutes, and you’ll come across celebrities and beauty experts showcasing their facial routines with jade rollers and flat stones.
The growing global popularity of ancient Chinese skincare practices, however, has a downside: simplification and trivialization. Many “Chinese facial massage guides” merely highlight a few basic techniques for all situations, neglecting the underlying principles of traditional Chinese medicine (TCM) that are essential for their effective use.
The spotless and youthful porcelain complexions of Chinese beauties are largely the result of using a jade roller or special flat stone that target acupuncture points on the face and open up meridian blockages. The benefits of this ancient skincare practice extend beyond radiant facial skin, promoting overall body health.
While simply rolling a jade roller or scraping with a Gua Sha tool across your face, similar to random dry brushing, can indeed boost circulation, promote lymphatic drainage, and reduce puffiness (possibly even improve texture), an “authentic” Chinese Facial goes beyond the surface. It targets the invisible energetic processes believed to influence the health and appearance of your skin.
Let’s peel back the layers and discover the TCM foundation of Chinese facial care! But be prepared that traditional Chinese medicine has a whole different way of seeing things than what people are used to in the West!
A bit of TCM theory
If you want to know more about the core concepts of TCM, check out this article for all the details:
The basic concepts of traditional Chinese Medicine
In the meantime, here’s a quick rundown:
Everything in the natural world, including the human body and mind, contains five interconnected aspects of functioning or qualities, symbolically called Wood, Fire, Earth, Metal, and Water Elements. For example, Wood represents growth and development, while Water is linked to fluidity and conservation.
In the human body, each of the five elements corresponds to a specific pair of organs and a basic emotion. For example, the Wood element is associated with the Liver and Gallbladder, and the emotion of anger. Excessive frustration and anger can cause disease in the Liver and result in multiple ailments, including migraines, dizziness, menstrual pain, and eye conditions. On the other hand, an imbalance in the Liver may manifest as quick irritability.
An imbalance of certain organs and emotions is much more likely to manifest on the face than others if the energy channel (meridian) associated with that organ passes through the face. This is because vital energy (Qi) flow and blood circulation along the meridian can affect the health and appearance of the skin in the areas it traverses.
Any facial skin issue is a manifestation of an imbalance in a particular aspect of vital energy (“Fire”, “Earth”, “Metal”, “Water”, or “Wood”), linked to specific body organs and emotion
Now, let’s break down how each element and its associated organs and emotions affect the skin of the face
Not feeling the deep dive? No worries! You can skim this long and a bit boring part and skip to the conclusion at the end.
1. The Earth Element: Stomach, Spleen, and the Emotion of Anxiety
The Earth element represents a core principle of stability, nourishment, grounding, and support. It gives a human being the ability to take in and receive “nourishment” on a physical, mental, or emotional level, and store and distribute this “nourishment” within the body.
When the Earth element is balanced, there is a feeling of trust, openness, and contentment. Individuals with a deficient Earth element are prone to worrying, overthinking, ruminating, being pensive,full of anxiety, and sensitive to criticism.
Prolonged exposure to these emotions can create the following lines and wrinkles on the face:
● Forehead: Worrying and overthinking often cause the frontalis muscle to contract, leading to horizontal forehead lines or wrinkles. Persistent furrowing of the brow can make the forehead appear tense and lined.
● Eyebrow area: Anxiety and rumination can lead to the repeated contraction of the corrugator supercilii muscles, which pull the eyebrows together, creating vertical frown lines (glabellar lines) between the eyebrows.
● Nasal area: The procerus muscle, located between the eyebrows and the upper part of the nose, can become overactive due to chronic stress and anxiety, contributing to a persistent furrowed look and vertical lines on the bridge of the nose.
● Eye area: Chronic worrying can cause tension in the orbicularis oculi muscles around the eyes, leading to crow’s feet and a tense appearance around the eyes.
● Mouth area: Chronic anxiety and rumination can cause tension in the orbicularis oris muscle, leading to a pursed or tightened appearance of the lips. The depressor anguli oris muscle can become more active with prolonged negative emotions, pulling the corners of the mouth downward and contributing to a sad or worried expression.
On the physical body level, the Earth is associated with the Stomach and Spleen, which are responsible for digestion – the Stomach takes in nourishment from outside the self, and the Spleen transforms it into Qi energy and blood. That’s why the main physical symptoms of Earth element deficiency are a lack of appetite, excessive burping or gas, loose stools, and chronic fatigue.
The Stomach has the greatest effect on the facial skin because its energy pathway extensively covers the face. Issues in the Stomach Meridian can result in facial acne, dullness, and poor muscle tone, particularly around the forehead, eyes, nose, cheeks, and under the chin and jaw.
Imbalances in the Spleen Meridian typically lead to a pale, puffy, sallow face complexion because the Spleen is responsible for promoting healthy moisture balance. The skin may appear lackluster, lacking vitality and natural glow, and may feel clammy or damp to the touch. This deficiency can also manifest as slow wound healing.
To treat an Earth element deficiency, one should practice mindfulness and meditation, consume warm, easily digestible foods like root vegetables and whole grains, and stimulate the energy flow in the Stomach and Spleen meridians through acupuncture or acupressure.
2. The Metal Element: Lungs, Large Intestine, and the Emotion of Grief
Metal represents strength, structure, and boundaries, which are normally flexible but become solidified when unbalanced. It differs from Earth Element in its emphasis on action and outward expression, compared to Earth’s focus on receiving and internal stability. The Metal element gives a human being the ability to let go of what is no longer needed, refining and purifying one’s life on a physical, mental, or emotional level.
When the Metal element is balanced, the individual is ambitious, forceful, and self-reliant. When unbalanced, it is associated with prolonged grief, sadness, feelings of loss, loneliness, dwelling on the past, and an inability to move forward. Long experience of these feelings can create the following lines and wrinkles on the face:
● Forehead: Prolonged grief and sadness can cause the frontalis muscle to contract frequently, leading to horizontal lines or wrinkles on the forehead. This persistent muscle tension can make the forehead appear tense and lined.
● Eyebrow area: Sadness and feelings of loss can lead to the repeated contraction of the corrugator supercilii muscles, which pull the eyebrows together, creating vertical frown lines (glabellar lines) between the eyebrows.
● Eye area: Chronic grief can cause tension in the orbicularis oculi muscles around the eyes, leading to a tightened appearance and crow’s feet.
● Nasal area: The procerus muscle, located between the eyebrows and the upper part of the nose, can become overactive due to prolonged sadness, contributing to a persistent furrowed look and vertical lines on the bridge of the nose.
● Mouth area: Chronic sadness and feelings of loss can cause tension in the orbicularis oris muscle, leading to a pursed or tightened appearance of the lips. Depressor anguli oris can become more active with prolonged negative emotions, pulling the corners of the mouth downward and contributing to a sad or worried expression.
● Jaw area: Masseter and Mentalis can become tense due to emotional stress, leading to clenching or grinding of the teeth (bruxism), which can result in discomfort or pain in the jaw area.
The Metal Element governs the Lungs and Large Intestine. Symptoms of Metal Element deficiency in the physical body include respiratory issues such as shortness of breath, skin problems, constipation, and a weakened immune system.
Although the Lungs communicate with the nose and mouth, the Lung meridian travels through the upper body and both arms, not traversing the face. Its influence on facial skin is indirect: by regulating the dispersal of fluids throughout the body, the Lung is responsible for skin hydration, and therefore for its tightness, elasticity, and overall vitality.
An imbalance in the Lung meridian can lead to insufficient moisture in the skin, initially causing redness, dryness, rough texture, flakiness, and wrinkles in the lung area of the face, specifically the cheeks and around the nose. In severe disharmony of lung fluids, one may also experience a dry mouth, lips, nose, scratchy throat, or hoarse voice.
The Large Intestine is responsible for cleansing the body, mind, and spirit by eliminating what is not needed, such as waste products, toxins, and negative emotions. Efficient detoxification prevents the buildup of impurities that can manifest as skin issues, such as acne, pimples, and other blemishes, particularly on the cheeks and around the mouth and nose, where the meridian passes.
To treat a Metal Element deficiency, one should practice breathing exercises, consume white foods (white rice, cauliflower, garlic, etc.), and stimulate the energy flow in the Lungs and Large Intestine meridians through acupuncture or acupressure.
3. The Fire Element: Heart, Small Intestine, and the Emotion of Joi
The Fire element embodies the core principles of warmth, energy, drive, and transformation. Like Earth, Fire provides a source of energy, but in a more dynamic and outward-facing way. Similar to Metal, Fire encourages action and change, but Fire focuses on initiating and expressing, while Metal emphasizes refining and letting go.
It gives human beings the ability to transform themselves with inspiration to take action, fueling personal growth and self-expression. When balanced, Fire allows a person to experience joy and approach life with enthusiasm and passion. When unbalanced, it can lead to easy excitability and impulsiveness, or even destructive behavior like aggression.
Joy is the only positive emotion that leaves a visible imprint on the face. Experiencing Too much joy for a prolonged period generally leads to expressions of happiness and vitality, but also creates the following lines and wrinkles on the face:
● Forehead: When experiencing prolonged joy, the frontalis muscle may be more relaxed, reducing the appearance of horizontal forehead lines and contributing to a more serene and smooth forehead.
● Eye area: Joy often engages the orbicularis oculi muscles, creating “crow’s feet” or smile lines around the eyes. These lines are typically viewed positively as they indicate genuine happiness and frequent smiling.
● Nasal area: Nasalis and Levator Labii Superioris Alaeque Nasi contract, slightly scrunching the nose and adding to the expression of joy.
● Cheek area: Zygomaticus Major pulls the corners of the lips outward towards the ears, creating a smiling expression. This results in the characteristic “smile lines” or nasolabial folds.
● Mouth area: Orbicularis oris is involved in shaping the mouth during smiling. Prolonged joy keeps the orbicularis oris muscle active in a positive way, enhancing the natural contour of the lips and contributing to a pleasant and inviting expression. Levator labii superioris and Risorius help elevate the upper lip and widen the mouth, respectively, during smiling, leading to a more open and cheerful facial expression.
Prolonged activation of these muscles due to sustained happiness results in the classic features of a happy, laughing face. Over time, this can lead to static facial features such as smile lines between the nose and the corners of the mouth, crow’s feet at the sides of the eyes, and bunny lines at the sides of the nose.
The Fire element is associated with the Heart and its partner organ, the Small Intestine. Physical symptoms of a Fire imbalance include high or low blood pressure, weak or erratic pulses, chest pain, buzzing in the ears, shortness of breath, a flushed complexion, hastiness, and a constant sense of urgency.
The Heart meridian does not travel through the face and does not directly impact facial skin. However, an imbalance in the Heart meridian can manifest as symptoms in the periorbital area, such as red and swollen eyes. Conversely, dysfunction of the Small Intestine meridian, which plays an important role in separating pure from impure substances, might lead to acne, rashes, or a dull complexion, particularly around the cheeks and forehead.
To treat a Fire Element deficiency, one should practice calming exercises like meditation, consume red foods (such as tomatoes, strawberries, and red beans), and stimulate the energy flow in the Heart and Small Intestine meridians through acupuncture or acupressure.
4. The Water element: Kidney, Bladder, and the emotion of Fear
Water embodies depth, adaptability, potential, and the capacity to store and conserve. It influences a human being’s ability to process emotions, navigate change, absorb information and experiences, and remain flexible.
When the Water element is balanced, the individual is adaptive, easygoing, creative, self-reflective, and has strong willpower and determination. When unbalanced, it is associated with fear, isolation, suspicion, and insecurity. Long experience of these negative feelings can create the following lines and wrinkles on the face:
● Forehead: Chronic fear can cause the frontalis muscle to contract frequently, leading to horizontal lines or wrinkles on the forehead, giving it a tense and worried appearance.
● Eyebrow area: Fear can lead to the repeated contraction of the procerus, depressor supercilii, and corrugator supercilii muscles, which pull the eyebrows together, creating vertical frown lines (glabellar lines) between the eyebrows.
● Eye area: Prolonged fear can cause tension in the levator palpebrae superioris muscle, leading to a widened or alert look in the eyes, often making them appear larger and more exposed.
● Mouth area: Chronic fear can cause the risorius muscle to tighten, leading to a pursed or tense appearance of the lips and a worried or distressed expression.
● Jaw area: Fear can cause the masseter muscle to tense up, leading to a drawn or hollow appearance in the cheeks, often contributing to a gaunt look.
The two water organs are the Kidneys and the Bladder. The Bladder’s primary function is to store and eliminate urine. While the Bladder meridian runs along the back and head, it’s not directly linked to facial skin health. However, imbalances in the Bladder can lead to fluid retention, potentially causing puffiness and swelling in the face.
The Kidneys, however, play a more significant role in skin health. They remove waste and excess fluids from the body through urine. Although the Kidney meridian bypasses the face directly, imbalances can manifest indirectly through dark circles or bags under the eyes, dull complexion, puffiness, sagging skin, or dehydration lines on the forehead or around the mouth.
To treat a Water element imbalance, one should focus on nourishing and restorative practices: stay hydrated with warm water, eat dark-colored foods (such as black beans, black sesame seeds, and blueberries) and warm, salty foods like soups and sea vegetables, prioritize rest and relaxation, and consider gentle exercises like swimming, walking or yoga to nourish the body’s energy and promote a sense of calm and inner strength. Additionally, stimulating the energy flow in the Kidney and Bladder meridians through acupuncture or acupressure will also be helpful.
5. The Wood Element: Liver, Gallbladder, and the Emotion of Anger
Earth embodies stability, grounding, growth, nourishment, and support. It influences a human being’s ability to feel supported, build a foundation, and establish a sense of home and belonging.
When the Earth element is balanced, the individual is stable, nurturing, practical, centered, and has strong self-care habits and a connection to their physical environment. When unbalanced, it is associated with anger, stubbornness, frustration, aggression, and resentment.
Experiencing anger for a prolonged period can affect specific facial muscles in the following ways:
● Forehead: Chronic anger can cause the frontalis muscle to contract frequently, leading to horizontal lines or wrinkles on the forehead, giving it a furrowed and tense appearance.
● Eyebrow area: Anger can lead to the repeated contraction of the corrugator supercilii muscles, which pull the eyebrows together, creating vertical frown lines (glabellar lines) between the eyebrows. This often results in a scowling or intense expression. The Procerus muscle, located between the eyebrows and the upper part of the nose, can also become overactive, contributing to the deepening of vertical lines on the bridge of the nose.
● Eye area: Tension in the orbicularis oculi muscles around the eyes can cause a tightened appearance, leading to a crow’s feet and a squinting or glaring look.
● Mouth area: Chronic anger can cause the orbicularis oris muscle to tighten, leading to a pursed or tense appearance of the lips, often contributing to a frowning expression. Depressor Anguli Oris can become more active with prolonged anger, pulling the corners of the mouth downward and contributing to a severe or grim expression. Risorius muscle can also be affected, causing the corners of the mouth to be pulled sideways, which can contribute to a forced or sarcastic smile.
● Jaw area: Anger often leads to clenching or grinding of the teeth (bruxism), causing overactivity and hypertrophy of the masseter and temporalis muscles. This can result in a more pronounced jawline and potential discomfort or pain in the jaw area.
Although it is the most active and energetic of the five elements, its associated organs, the Liver and Gallbladder, do not directly affect facial skin. As the Liver is responsible for the circulation of Qi and fresh oxygenated blood throughout the body, Liver Qi stagnation and blood stasis may result in a lack of healthy skin tone, dullness, and dark circles under the eyes.
Harmony within the Wood element is primarily achieved through stress-reduction practices such as massage, yoga, and meditation. The Liver and Gallbladder meridians can also be supported with acupuncture, herbal remedies, and dietary adjustments.
Ren Mai and Du Mai Energy Vessels
The extraordinary meridians don’t have direct associations with the five elements and organs like the primary meridians do. Instead, they regulate and influence the overall energy flow in the body. Among these, the Ren (Conception) and Du (Governing) Meridians, also known as the Ren Mai and Du Mai, have the most significant impacts on skin condition.
The Ren Meridian influences the reproductive and hormonal systems. Hormonal imbalances can lead to skin issues such as acne and dryness, particularly around the mouth and chin, which are areas along the Ren Meridian pathway. The Du Meridian enhances circulation and vitality.
Treatments that stimulate these meridians, such as acupuncture and specific herbal formulas, can help improve the condition of facial skin by ensuring the proper flow and balance of energy throughout the body.
Chinese medicine is based on the belief that the body is a complex system of interconnected channels and organs, viewing any skin condition as an external manifestation of internal health imbalances caused by lifestyle, eating habits, and recent emotional experiences.
Bringing it all together
Here’s what the face skin is telling us about our internal health:
● Forehead
This area mainly represents the bladder and intestines. Spots, rashes, color changes, fine lines, or a dull complexion on the forehead could indicate constipation, irritable bowel syndrome, or urinary tract infections. Stress, irritability, and poor sleep can also trigger imbalances in the heart and liver, leading to breakouts around the forehead area.
● Between the eyebrows and sides of temples
Common issues such as breakouts, redness, or irritation in these regions can suggest liver qi stagnation or excessive liver activity. Stress, poor diet, and emotional disturbances often contribute to these imbalances. These symptoms may also be linked to hormonal fluctuations and digestive problems, as the liver plays a crucial role in detoxification and hormone regulation.
● Under eyes
Under-eye bags, dark circles, and puffiness can indicate kidney swelling, often due to overwork, stress, lack of sleep, or aging. Excessive intake of liquids and stimulating foods can also contribute to eye bags. Additionally, liver and spleen imbalances can lead to fluid retention and inadequate nourishment, resulting in these under-eye concerns.
Face mapping, or Mien Shiang, is the diagnostic technique of TCM that correlates different areas of the face with various organs and systems in the body, allowing practitioners to identify any health imbalances that may be present. For example, diagnosing abdominal pain might involve examining the forehead, or evaluating constipation issues might mean looking at the cheek area.
● Cheeks
The upper cheeks are connected to the stomach and spleen. Skin issues in this area may indicate digestive problems, such as poor diet, overeating, or the consumption of unhealthy foods. The lower cheeks are associated with the lungs. Acne, pimples, and rashes in this area are often caused by respiratory issues, including asthma, pollution, smoking, and allergies. Stress and emotional disturbances can exacerbate upper and lower cheek skin problems.
● Mouth
Swollen and inflamed lips, or painful, red, and inflamed sore on the tongue, gums, or inside the mouth is most likely caused by an excess of ‘heat’ in the stomach, spleen, or liver. This can be due to poor diet (too many spicy/greasy foods), weakened immunity, and emotional disturbances. As the heart is in TCM considered the ‘Emperor’ of the organs, the mouth area is primarily associated with the heart.
● Chin
Lastly, the chin and jawline area are linked to the reproductive system. Many women experience breakouts in this area around the time of their monthly cycle or during periods of stress, which can throw their hormones out of balance. From a TCM perspective, hormonal imbalances are caused by deficiencies in the kidney and liver systems.
Chinese medicine healing practices for skin issues
The primary goal of any traditional Chinese skin practice is to restore balance to those elements and their associated body organs that have been diagnosed by a practitioner as imbalanced (either excessive or deficient). Several options can help achieve this, typically starting with herbal medication and lifestyle and dietary changes.
However, most effective is considered the direct stimulation of the flow of Qi, the vital energy that maintains this balance, throughout the corresponding energy channels (meridians) and energy points (acupoints). These methods include facial acupuncture, cupping, and massage.
In facial acupuncture, also known as cosmetic acupuncture or facial rejuvenation acupuncture, specific acupoints on the face corresponding to various physiological functions are stimulated with very fine needles.
Facial Gua Sha is a simple yet powerful massage technique in which a tool, usually made from jade, is scraped along the meridian pathways on the face — and even further down — to manipulate energy flow.
The advantage of this technique is that it can be used for health and beauty maintenance at home as part of a daily routine. The key is to understand which pathways to stimulate and why!
