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INTRODUCTION

KEY POINTS

  • Traditional Chinese medicine (TCM) involves herbs, dietary therapy, massage, and acupuncture.

  • Herbal remedies are often effective but may cause allergic reactions and side effects, including dermatitis.

  • Traditional Asian practices of cupping, coining, and moxibustion can cause bruises and lesions that are sometimes mistaken for physical abuse; however, these are distinguishable by their regular circular appearance.

  • Physicians should realize that TCM is not quackery; many of the therapies in this chapter are currently used in Western hospitals, and some have shown efficacy in double-blind studies.

It is important for dermatologists to be familiar with the traditional cultural practices of the Asian and Asian American population in the United States. According to the 2010 Census report, the Asian and Pacific Island population currently represents about 5.6% of the U.S. population but is projected to increase to more than five times the current size by the year 2050, reaching 41 million people. The Asian population would then represent 10.3% of the U.S. population.1 Because Asians represent a fast-growing segment of the population, dermatologists should become familiar with the specifics regarding the treatment of Asian skin of color and also have a basic knowledge of some of the more common cultural practices of Asians.

The history of the Asian population in the United States displays a long tradition of using alternative medicine. Asian immigrants, like many other immigrants and refugees who settle in the United States, tend to visit physicians within their local communities. Therefore, many cultural practices may go unnoticed by healthcare providers outside of the Asian community. A study of a Vietnamese refugee community in San Diego, California, showed that most of the Vietnamese participants preferred both Vietnamese entertainment and health services, even after settling in the United States. These refugees continued to use traditional health practices, such as coining, steam inhalation, and acupuncture.2 However, sometimes an emergency or moving locations requires patients to seek treatment from dermatologists outside of their habitual communities. Therefore, the dermatologist should be aware of the potential side effects of traditional Asian treatments. In the current milieu of alternative medicine, both Asian and non-Asian patients may present with side effects to certain remedies, including contact allergic and irritant dermatitis. This chapter reviews some of the more common cultural habits and practices within the Asian culture, including traditional Chinese medicine, acupuncture, and the practice of coining. As with most communities, there are also myths and misconceptions which abound. Many patients seek out “natural” remedies, believing that no side effects will occur as a result of their use. However, as this chapter illustrates, this is not always the case; some of the side effects and reactions resulting from certain alternative treatments can be extremely serious.

TRADITIONAL CHINESE MEDICINE

As an alternative method of therapy, traditional Chinese medicine (TCM) is practiced throughout China and East Asia by millions of people. Until the middle of the ...

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