Long Dan Xie Gan Tang
Specifically for Rosacea
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Why it works for Rosacea:
Pattern fit in TCM: Many rosacea presentations (persistent centro-facial redness, papules/pustules, burning/hot sensations, flares with alcohol/spicy food) map to Liver/Gallbladder “excess Heat” with Damp-Heat. LDXGT’s classical actions are to drain Liver/Gallbladder Fire and clear Damp-Heat—the exact pattern commonly assigned to inflammatory facial dermatoses in TCM. sacredlotus.com
Formula logic:
– Long Dan Cao (Gentiana), Huang Qin (Scutellaria), Zhi Zi (Gardenia) clear Heat/Fire;
– Ze Xie, Mu Tong/Chuan Mu Tong or Tong Cao, Che Qian Zi promote urination to drain Damp-Heat;
– Chai Hu guides to the Liver/Gallbladder;
– Sheng Di Huang, Dang Gui protect Yin/blood from over-drying;
– Gan Cao harmonizes the formula. This classic composition is consistent across materia medica write-ups. sacredlotus.com
Modern pathophysiology match (hypothesis): Rosacea involves innate-immune activation (TLR2 → KLK5 → LL-37), cytokine-driven inflammation, neurovascular dysregulation and barrier dysfunction. LDXGT includes herbs with anti-inflammatory and immunomodulatory constituents (e.g., baicalin from Scutellaria; geniposide from Gardenia; iridoids/seco-iridoids from Gentiana) that, in preclinical models, down-regulate NF-κB, NLRP3, and related cytokines implicated across inflammatory skin disease. While this is mechanistic plausibility rather than direct rosacea proof, it supports the TCM rationale. Frontiers
How to use for Rosacea:
Typical composition & amounts (decoction):
Long Dan Cao 6 g; Huang Qin 6–9 g; Zhi Zi 9 g; Ze Xie 12 g; (Chuan) Mu Tong or Tong Cao ~6 g; Che Qian Zi 9 g; Chai Hu 6 g; Sheng Di Huang 9–20 g; Dang Gui 3–8 g; (Zhi) Gan Cao 3–6 g. (Classical texts and modern monographs have small variations.) zhongyibaike.com
Preparation (decoction):
- Method: Soak herbs 20–30 min; decoct with ~600–800 mL water down to ~200–300 mL; divide 1 day’s dose into 2 servings. Course often 7–14 days, then reassess (avoid long-term continuous use due to bitter-cold nature). Fusheng Wuliang
- Patent forms: “Long Dan Xie Gan Wan” pills are common; adult dose typically 6–9 g, twice daily (follow the product label; products vary). zhongyibaike.com
When it fits for rosacea:
- Erythema/papules with a feeling of heat/burning, flushing, thirst and bitter taste, irritability, possibly oily skin or concomitant seborrhea/blepharitis, dark/scant urine, tongue red with yellow/greasy coat. American Dragon
Common modifications your clinician may consider:
- More Dampness: add Hua Shi, Yi Yi Ren;
- Marked Heat/Fire: add Huang Lian, Lian Qiao;
- Yin injured by prolonged Heat: raise Sheng Di, add Mai Men Dong;
- If using modern safer practice: replace Guan Mu Tong (Aristolochia; banned) with Akebia Caulis (Chuan Mu Tong) or Tetrapanax pith (Tong Cao). zhongyibaike.com
Scientific Evidence for Rosacea:
Direct, high-quality RCTs of LDXGT specifically for rosacea are lacking.
- A 2024 systematic review/meta-analysis of TCM + conventional therapy in rosacea found combined approaches reduced recurrence and symptom scores vs. conventional therapy alone—but it pooled varied formulas and did not isolate LDXGT-only trials. Treat it as supportive for the TCM approach overall, not definitive proof for this one formula. Frontiers
Adjacent clinical evidence (skin inflammation):
- Systematic review & meta-analysis (2021): LDXGT improved eczema outcomes across RCTs vs. controls, suggesting anti-inflammatory clinical utility in dermatology. Extrapolation to rosacea is hypothesis-generating, not proof. Wiley Online Library
Mechanistic/preclinical signals:
- Reviews and experimental studies show baicalin (Scutellaria) and geniposide (Gardenia) down-modulate NF-κB/NLRP3/TLR pathways; Gentiana iridoids have anti-inflammatory activity—mechanisms plausibly relevant to rosacea’s innate-immune and cytokine biology. Again, these are supportive mechanisms, not rosacea RCTs. MDPI
Rosacea pathogenesis reviews (for context): innate-immune (TLR2/LL-37), neurovascular and barrier abnormalities provide plausible targets for anti-inflammatory TCM formulas. Frontiers
Specific Warnings for Rosacea:
Absolutely avoid Aristolochia contamination (critical):
- Older or non-compliant “Long Dan Xie Gan Wan” products have been found contaminated with aristolochic acid (from Guan Mu Tong/Guang Fangji substitutions), which is nephrotoxic and carcinogenic (ESRD and urothelial cancer risk). Use suppliers that guarantee no Aristolochia and proper species ID; modern practice replaces with Akebia Caulis (Chuan Mu Tong) or Tong Cao. Medsafe
Bitter-cold formula—risk of injuring Spleen/Stomach or Yin if misused:
- Contraindicated in Spleen/Stomach deficiency & cold or pronounced Yin deficiency; avoid long-term or high-dose use without supervision. Watch for loose stools, fatigue, appetite loss. tcmhh.com
Licorice (Gan Cao) interactions and adverse effects:
- Licorice can cause hypertension, edema and hypokalemia (pseudo-hyperaldosteronism), and interact with diuretics, antihypertensives, digoxin and corticosteroids. People with hypertension, heart, or kidney disease need extra caution; consider deglycyrrhizinated products only where appropriate (though classic LDXGT uses raw/licorice). Medsafe
Pregnancy & lactation:
- Avoid unless specifically prescribed and monitored by a qualified practitioner; some components (e.g., Mu Tong substitutions) have historical cautions in pregnancy. zhongyibaike.com
General quality & sourcing:
- Use GMP-certified suppliers; check for heavy metals and adulterants; verify species (especially Gentiana scabra for Long Dan Cao and Akebia rather than Aristolochia in the Mu Tong slot). Regulatory advisories highlight the importance of proper sourcing. Medsafe
Comedication with conventional rosacea drugs:
- If you’re on tetracyclines, ivermectin, metronidazole, azelaic acid, etc., LDXGT is typically used adjunctively in integrated care settings. The 2024 meta-analysis found TCM + standard care improved outcomes versus standard care alone, but did not specify LDXGT; coordinate with your dermatologist/TCP. Frontiers
General Information (All Ailments)
What It Is
Long Dan Xie Gan Tang is a classical herbal formula from Traditional Chinese Medicine, first recorded in the Ming dynasty medical text Medical Formulas Collected and Analyzed (医方集解). It is primarily used to clear excess heat and damp-heat from the Liver and Gallbladder meridians.
The formula’s name translates roughly to “Gentiana Decoction to Drain the Liver,” with its chief herb, Long Dan Cao (Gentianae Radix), known for its strong heat-clearing properties.
Typical ingredients include:
- Long Dan Cao (Gentiana) – clears liver and gallbladder fire.
- Huang Qin (Scutellaria) and Zhi Zi (Gardenia) – assist in clearing heat and reducing inflammation.
- Ze Xie (Alisma), Mu Tong (Akebia), and Che Qian Zi (Plantago) – promote urination and drain dampness.
- Sheng Di Huang (Rehmannia) and Dang Gui (Angelica sinensis) – nourish yin and blood to prevent damage from heat-clearing herbs.
- Chai Hu (Bupleurum) – regulates Liver qi and relieves tension.
- Gan Cao (Licorice) – harmonizes the formula and moderates harshness.
How It Works
In TCM theory, the Liver and Gallbladder are susceptible to heat accumulation caused by emotional stress, poor diet, or external pathogens. This heat may manifest as irritability, headaches, red eyes, bitter taste, tinnitus, or even urinary discomfort.
Long Dan Xie Gan Tang works by:
- Clearing Excess Liver Fire: The chief herb Long Dan Cao directly purges fire from the Liver channel, reducing symptoms like anger, headache, and red eyes.
- Eliminating Damp-Heat: Herbs like Ze Xie and Che Qian Zi promote urination to expel dampness that often accompanies internal heat, addressing genital itching or urinary issues.
- Balancing Yin and Blood: Sheng Di Huang and Dang Gui nourish fluids and blood, protecting the body from the drying effects of strong heat-clearing herbs.
- Harmonizing and Supporting Qi Flow: Chai Hu ensures smooth Liver qi circulation, helping to alleviate emotional stagnation and tension.
The formula thus restores internal balance by simultaneously draining pathogenic heat and supporting the body’s yin and qi.
Why It’s Important
Long Dan Xie Gan Tang is significant in both historical and modern practice for its broad application in conditions of excess heat in the upper and lower body.
It is often prescribed for:
- Head and sensory issues: headaches, red eyes, tinnitus, dizziness.
- Emotional symptoms: irritability, anger, short temper due to Liver fire.
- Urinary and genital disorders: dark, painful urination, vaginal itching, or discharge associated with damp-heat.
- Skin conditions: eczema, rashes, or boils with redness and heat.
From a modern biomedical perspective, the formula demonstrates anti-inflammatory, antimicrobial, and hepatoprotective effects. It may help modulate liver enzymes, protect against oxidative stress, and regulate inflammatory pathways, supporting liver function and detoxification.
Considerations
While Long Dan Xie Gan Tang is powerful and effective, it must be used with care and proper diagnosis.
Key considerations include:
- Pattern Differentiation: It is suitable only for individuals with excess heat or damp-heat patterns in the Liver/Gallbladder. Those with deficiency, cold, or yin depletion should avoid it.
- Potential Side Effects: Overuse may cause dryness, fatigue, or digestive upset due to its draining nature.
- Duration of Use: Typically prescribed short-term (1–2 weeks) for acute symptoms; long-term use may weaken the body’s vital energy.
- Pregnancy and Weak Constitutions: It should be avoided or used only under professional guidance.
- Interactions: Because it affects liver metabolism, it may interact with pharmaceuticals processed by the liver—consult a qualified practitioner before combining with Western medications.
Helps with these conditions
Long Dan Xie Gan Tang is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
UTI
Pattern rationale (TCM): LDXGT “drains damp-heat from the lower burner,” a TCM pattern that can present with painful, burning urination, urgency, turb...
Rosacea
Pattern fit in TCM: Many rosacea presentations (persistent centro-facial redness, papules/pustules, burning/hot sensations, flares with alcohol/spicy...
Vertigo
Pattern it targets: The formula clears excess Heat/Fire in the Liver–Gallbladder (LV/GB) channels and drains Damp-Heat, patterns that classically pres...
Hepatitis
TCM rationale. LDXGT “drains Liver–Gallbladder fire” and “clears damp-heat,” patterns frequently seen in acute icteric hepatitis (jaundice, bitter tas...
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