Q The itching is so severe I can't sleep. What treatment do you start with at the beginning?
A The first 4 weeks are a stage of lowering internal heat-toxin and calming skin inflammation signals with clearing-heat and detoxifying (cheongyeol-haedok) prescriptions. Combined with cooling moisturizing, the sleep-disrupting itch eases quickly.
Detailed Answer
In the acute phase, when itching is severe enough to disrupt sleep, the priority is to quickly lower heat-toxin with clearing-heat-and-draining-fire (cheongyeol-sahwa) and wind-dispelling-itch-stopping (geopung-jiyang) prescriptions. For the Wind-Damp-Heat (pungseupyeol) type accompanied by redness, oozing, and swelling, we use formulas in the Sopung-san family; for the blood-deficiency type with mainly dryness and scaling, we use formulas in the Danggwi-eumja family. When a cold-compress and immediate-moisturizing routine is combined at this stage, nighttime itching decreases markedly within 2-4 weeks.
Korean Medicine Clinic Perspective
At Dongjedang, at the first visit we carefully check the patterns of redness, oozing, dryness, and nighttime worsening to accurately determine the pattern. The prescription works quickly only when the pattern differentiation is correct. If there is severe sleep disturbance, we also include a sleep-supporting prescription early on.
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