Study On Skin Classification And Physiological Quantitative Index Based On Skin - Body Correlation Theory Of Traditional Chinese Medicine

Background:Skin is an important organ of the human body and plays a vital role in health and beauty. In Traditional Chinese Medicine (TCM), viscera, qi, blood and meridian are considered as the principle factors for the well-being of skin. At the same time, the status of skin also reflects the condition of the internal environment of the human body. TCM believes that "The internal organs will manifest themselves externally". Based on the Constitution theory in TCM as well as the rich clinical experience in the diagnosis and treatment of skin diseases, Professor Wang Qi proposed the "Body-Skin Correlation Theory", that is, body constitution is closely correlated with the state of skin. With the advancement of research in dermatology and the development of modern testing technology, it is important and also technically possible to investigate the relationship between TCM body constitution and skin using modern classifications of skin types as well as the physiological and pathological indicators of skin.Objectives:To identify the correlation between TCM constitution and Baumann Skin Types; to investigate the relationship between TCM constitution and eight physiological indicators of skin; to evaluate the effect of body constitution modification with acupuncture on skin status.Methods:Participants included 446 female long-term residents aged between 17 and 74 years in Tokyo, Japan. All participants completed the Constitution in Chinese Medicine Questionnaire (CCMQ) and classified according to the Standards of Classification and Determination of Constitution of Chinese Medicine. All participants received VISIA complexion analysis and 187 of them (aged 18-74 years) also completed the Baumann Skin Type Questionnaire. Skin type was characterized using the Baumann skin-type indicator (BSTI). SPSS 17.0 andJMP10.0 were used for statistical analysis to assess the association between CCMQ constitution, BSTI skin type, eight physiological indicators of skin, and age., which included Cronbach’s alpha for internal consistenc, Pearson correlation, multivariable linear regression, stepwise regression, test for homogeneity of variance, and indpendent samples t-test.Results:For the association between body constitution and skin types:(1) BTSI Oily/Dry parameter score was positively correlated with the Damp-heat and Phlegm-dampness constitution (more likely to be oily skin); and negatively correlated with the Blood-stasis and Qi-depression constitution (more likely to be dry skin). (2) BTSI Sensitive/Resistant parameter score was positively correlated with the Balanced constitution (more likely to be resistant skin) and negatively correlated with all the eight unbalanced constitutions (more likely to be sensitive skin). (3) BTSI Pigmented/Non-pigmented parameter score was positively correlated with the Blood-stasis, Phlegm-dampness, Damp-heat constitution, and Qi-depression constitution (more likely to be pigmented skin); and negatively correlated with the Balanced constitution (more likely to be non-pigmented skin); (4) BTSI Wrinkled/Tight skin parameter score was positively correlated with the Blood-stasis, Qi-deficiency, Yin-deficiency constitution, and Sensitive constitution (more likely to be wrinkled skin).For the association between body constitution, physiological indicators of skin and age:(1) Spots:the spots score was positively linearly correlated with the Balanced constitution, Phlegm-dampness, Damp-heat, Qi-deficiency, Blood-stasis, Qi-depression, and Yin-deficiency constitution (more likely to have spots); and negatively correlated with Yang-deficiency constitution (less likely to have spots); (2) Wrinkles:Balanced constitution tended to have more wrinkles while Qi-depression constitution was less likely to have wrinkles; (3) Texture: Phlegm-dampness and Damp-heat constitutions were more likely to have rough skin texture while Yang-deficiency and Blood-stasis constitutions were more likely to have even skin texture; (4) Pores:Phlegm-dampness and Damp-heat constitutions tended to have enlarged pores while Blood-stasis and Yang-deficiency constitutions tended to have better pore condition; (5) UV spots:Yin-deficiency constitution was more likely to UV spots while Blood-stasis constitution had less UV spots; (6) Brown spots:Balanced, Qi-deficiency, Blood-stasis, Qi-depression, Yin-deficiency, and Phlegm-dampness constitutions were more likely to have brown spots, while Yang-deficiency constitution had less brown spots; (7) Redness:Damp-heat and Yin-deficiency constitution tended to have more redness while Yang-deficiency constitution had less redness; (8) Porphyrin:Damp-heat constitution had higher porphyrin content in the skin, while the Balanced, Yang-deficiency, Blood-stasis, and Qi-depression constitution had lower porphyrin content.Conclusion:CCMQ constitution was correlated with Baumann skin types,with different constitutions manifesting different skin characteristics. CCMQ constitution was also associated with the eight indicators of VISIA complexion analysis system, providing objective support to the concept of "Body-Skin Correlation Theory" and suggesting VISIA complexion analysis system as a reliable quantitative method for the theory. The most significant correlation was found between oily skin and Damp-heat constitution, spots and Blood-stasis constitution, sensitive skin and Sensitive constitution.