Understanding Your Skin Pattern
Why the same skincare routine works differently for different people
You follow the same skincare routine as your friend.
Their skin clears up. Your acne gets worse—or nothing changes.
You both use the same products. So why the different results?
Because clear skin isn't just about what you put ON your skin. It's about what's happening INSIDE your body.
Two people can use identical products and have completely different results. One person's acne is from inflammation. Another's is from depletion.
It's not the products. Your bodies work differently—and once you understand YOUR pattern, you can address it properly.
Why Topical Treatments Often Fail
The common approach: "Just use this cream/serum/cleanser!"
So you try everything. Benzoyl peroxide. Salicylic acid. Retinoids. The latest $200 serum.
Maybe it helps a little. Maybe it dries out your skin. Maybe nothing changes.
You think: "I must need a stronger product. Or a different brand."
But here's the truth: if acne is coming from inside, treating only the surface won't fix it.
Your skin is showing you what's happening internally. The acne isn't the problem—it's the signal.
The Four Skin Patterns
Traditional medicine identifies four main patterns that cause acne. Each has different internal causes, different characteristics, and—most importantly—different solutions.
Let's identify which pattern describes you.
Pattern 1: The Inflamed Type (Damp-Heat 濕熱型)
Your imbalance: Accumulated "dampness" that has turned into inflammation
How This Works
When your digestive system (Spleen-Stomach) is weak, it can't properly transform food into clean energy and nutrients. Instead, it creates "dampness"—a thick, sticky residue that accumulates in your body.
What is "dampness" actually? It's not just a metaphor. You can see and feel it:
- 🧈 Excess oil on your skin (sebum overproduction)
- 💩 Sticky stools that cling to the toilet
- 👅 Thick, greasy coating on your tongue
- 💧 Puffiness and water retention
- 🤧 Excess mucus or phlegm
- Heavy, sluggish feeling in your body
Over time, this accumulated dampness "ferments" like food left out too long—it generates heat and inflammation. This is called damp-heat.
Think of it like a swamp on a hot day—humid, sticky, breeding bacteria and inflammation. That's what's happening inside your body, and your skin shows it.
What it looks like:
- Red, inflamed acne with white pus
- Very oily skin (shiny T-zone)
- Cystic or nodular acne
- Acne around mouth, chin, and nose (digestive zone)
- Skin feels greasy even after washing
- Often accompanied by digestive issues
- May have body odor or bad breath
- Worse after greasy or spicy foods
Common in: People with weak digestion, those who eat lots of greasy/sweet/dairy foods, humid climates
Real example: This was my pattern. White pustules around my mouth, chin, and nose. Very oily skin. Weak digestion. The acne was my body trying to push out the internal "dampness" and inflammation that my digestive system couldn't process properly.
Pattern 2: The Hormonal Type (Blood Heat 血熱型)
Your imbalance: Excess heat in the blood
How This Works
Heat in the blood comes from different sources—hormonal fluctuations, stress, or eating too many heating foods. This heat rises up to your face, creating red, inflamed acne.
Think of it like your blood "boiling over"—the heat has to go somewhere, and it manifests as red, hot inflammation on your skin.
What it looks like:
- Deep red or purple acne (not white heads)
- Hot to the touch, painful
- Worse before menstrual period
- Concentrated on cheeks and jawline
- Face feels hot, may be flushed
- Worse with stress or heating foods
- May have heavy, dark menstrual bleeding
- May feel hot in general, prefer cold
Common in: Women with hormonal imbalances, people who eat lots of spicy/fried foods, those with high stress, people who feel hot
Pattern 3: The Sensitive Type (Yin Deficiency 陰虛型)
Your imbalance: Depleted cooling reserves creating "false fire"
How This Works
Your body's cooling reserves (Yin) are depleted from chronic stress, overwork, or burnout. When these reserves run low, "false fire" rises—creating heat symptoms even though you're actually depleted.
Think of an engine overheating when coolant runs low. The heat isn't from excess energy—it's from depletion. Your skin becomes hypersensitive and reactive.
What it looks like:
- Dry, sensitive, easily irritated skin
- Small red bumps or pustules (not large cysts)
- Skin gets worse with any new product
- Redness that comes and goes
- Dry patches mixed with occasional breakouts
- Worse when tired or stressed
- Often have insomnia, anxiety, or restlessness
- Afternoon/evening face flushing
Common in: People with chronic stress or burnout, those in their 40s+, people who are exhausted but wired
Pattern 4: The Scarring Type (Blood Stasis 血瘀型)
Your imbalance: Poor circulation creating stagnation
How This Works
When blood doesn't circulate properly—from chronic stress, tension, or old trauma—it "stagnates." This stagnant blood creates dark marks, slow healing, and persistent problems in the same spots.
Think of a traffic jam where nothing moves. That blockage prevents fresh blood from reaching your skin to heal it, and old damage lingers.
What it looks like:
- Dark spots and hyperpigmentation that won't fade
- Scars that take forever to heal
- Acne keeps coming back in the SAME spots
- Purple or brownish marks
- Dull, uneven skin tone
- May have visible broken capillaries
- Often have menstrual clots or pain
- Chronic, persistent acne (not acute)
Common in: People with chronic stress, those who've had acne for years, people with poor circulation
Which Pattern Are You?
Use these checklists (be honest about what you see and feel):
Inflamed Type (Damp-Heat) Checklist
- □ Red acne with white pus
- □ Very oily skin
- □ Around mouth/chin/nose
- □ Weak digestion or bloating
- □ Sticky stools
- □ Thick tongue coating
3+ checks? Likely Damp-Heat pattern
Hormonal Type (Blood Heat) Checklist
- □ Deep red/purple acne
- □ Painful, hot to touch
- □ Worse before period
- □ On cheeks and jawline
- □ Feel hot in general
- □ Heavy or dark periods
3+ checks? Likely Blood Heat pattern
Sensitive Type (Yin Deficiency) Checklist
- □ Dry, sensitive skin
- □ Small red bumps
- □ Reacts to everything
- □ Redness comes and goes
- □ Worse when stressed/tired
- □ Insomnia or anxiety
3+ checks? Likely Yin Deficiency pattern
Scarring Type (Blood Stasis) Checklist
- □ Dark spots won't fade
- □ Scars heal very slowly
- □ Same spots break out repeatedly
- □ Purple/brown marks
- □ Dull, uneven tone
- □ Menstrual clots or pain
3+ checks? Likely Blood Stasis pattern
Mixed Patterns Are Common
Many people have combinations:
Damp-Heat + Blood Stasis: Oily, inflamed acne that leaves dark scars. Very common.
Blood Heat + Yin Deficiency: Hormonal acne with sensitive, reactive skin. Common in stress + hormonal issues.
Damp-Heat + Yin Deficiency: Oily but also dehydrated. Looks like my case evolved—started as damp-heat, added depletion from stress.
Why Generic Skincare Often Fails
The Common Approaches
"Just dry it out with benzoyl peroxide!"
"Use retinoids!"
"Try oil cleansing!"
Why They Work for Some and Fail for Others
Harsh drying products:
- Might help: Damp-Heat (if mild and combined with internal support)
- Makes worse: Yin Deficiency (dries out already-depleted skin), Blood Heat (can increase inflammation)
Oil cleansing:
- Might help: Yin Deficiency (needs moisture)
- Makes worse: Damp-Heat (adds more oil when you already have internal dampness)
Vitamin C serums:
- Might help: Blood Stasis (improves circulation, fades marks)
- May irritate: Yin Deficiency (sensitive skin can't handle acids)
One approach doesn't fit all patterns.
Your Skin's Natural Clarity
Here's what's important to understand:
Your skin is designed to be clear. Acne is your body's way of signaling an internal imbalance.
Once you understand your pattern, you can address it from the inside:
Damp-Heat: Strengthen digestion → Stop creating dampness → Clear inflammation → Skin clears
Blood Heat: Cool the blood → Balance hormones → Heat subsides → Inflammation resolves
Yin Deficiency: Rebuild reserves → Cool false fire → Sensitivity calms → Skin balances
Blood Stasis: Move circulation → Fresh blood reaches skin → Scars heal → Tone evens
This isn't about finding the perfect face wash or serum. It's about supporting your body's natural ability to have clear, healthy skin by addressing what's actually causing the problem.
Your acne isn't random. It's a signal.
Understand the signal, address the imbalance, and your skin can return to its natural clarity.