Acne that appears on the face before menstruation, characterized by raised bumps on the skin that subside after the period, is referred to as premenstrual facial acne, also known as "premenstrual facial acne," and commonly occurs during adolescence.

bubble_chart Pattern Analysis

1. Dampness-heat in Liver Meridian︰Small, scattered bumps appear on the forehead and face, some of which may be itchy or painful, and a milky-white fluid can be squeezed out. In severe cases, they may suppurate and form boils. Symptoms may include early menstruation, persistent yellowish leukorrhea, a feeling of fullness in the stomach with reduced appetite, or a sticky, dry mouth. The tongue coating may appear normal or slightly yellow, and the pulse may feel soft and thin or fine and slippery. This condition is often associated with dampness, typically seen in patients who frequently consume sugary, spicy, or meat-heavy foods. The combination of liver heat and spleen dampness affects the blood aspect, leading to acne.
2. Liver Channel Stagnation Heat︰Papules or yellowish-white small pustules appear on the premenstrual face, accompanied by breast distending pain, irritability, dry stools, or unsmooth menstruation, reddish tongue texture, and wiry-rapid pulse. This is caused by liver qi depression, which transforms into heat and toxins over time, steaming the skin. The clinical characteristics are: pattern of dampness-heat in the liver meridian. In addition to the aforementioned local symptoms, there may be continuous yellowish leukorrhea, advanced menstruation, or symptoms of liver-spleen dampness-heat such as chest tightness and reduced appetite. Treatment should focus on {|###|}clearing heat and draining dampness{|###|}, using Gentian Liver-Draining Decoction with modifications. For the syndrome of stagnant fire in the liver meridian, in addition to the aforementioned local symptoms, there are often accompanying symptoms of liver depression transforming into fire, such as breast distending pain, irritability, dry stools, and wiry-rapid pulse. Treatment should focus on {|###|}clearing fire and resolving depression{|###|}, using Peony and Gardenia Peripatetic Powder with modifications.
3. Lung Heat︰Small papules with follicular openings appear on the front of the face, which may become red, swollen, and painful, discharging a white, powdery fluid. This is accompanied by a dry cough without phlegm, sore throat, dry mouth, or flushed cheeks. The tongue texture is red with thin, white, and scant coating, and the pulse is thin and rapid. Yizong Jinjian and Waike Xinfa record on acne: "This condition arises from blood-heat in the lung channel, often manifesting on the face and nose as scattered, grain-like papules that are red, swollen, and painful, discharging a white, powdery fluid. Over time, these may turn into white, scaly particles resembling millet. In addition to the aforementioned local symptoms, clinical signs and symptoms often include dry cough without phlegm, flushed cheeks, or dry stools, indicating lung heat damaging body fluids. Treatment should focus on clearing lung heat, supplemented by removing toxins. The recommended formula is Lung-Clearing Decoction minus Ginseng, with the addition of Chinese Angelica, Red Peony Root, raw Coix Seed, and wild chrysanthemum flower, along with external application of the Diandao Powder."