Case Study : Traditional Chinese Herbal Medicine Treatment for Pityriasis Rosea

Case Study : Treatment of Pityriasis Rosea with Traditional Chinese Herbal Medicine

HN321*
Gender: Female / Age: 45 years
Weight: 73 kg / Pulse: 79/min / Blood Pressure: 115/64 mmHg

First Visit: March 15

The patient has had a rash accompanied by itching all over the body for over one month.
About one month ago, the rash began on the back, then spread to the abdomen, chest, and limbs, with itching. Previously treated by a Western medical doctor and diagnosed with pityriasis rosea. Was prescribed oral antihistamines (hydroxyzine) and topical steroid cream.

Currently, the itching persists, especially at night, with new rashes continuously appearing. Sleep is disturbed due to itching.
Patient tends to eat greasy, fried foods, experiences frequent belching, has bitter taste in the mouth in the morning, and normal daily bowel movements. Menstrual cycle is normal.

Tongue: Red with red tip, dry yellow coating on both sides, swollen
Pulse: Thin and rapid

Treatment:
Prescribed herbal decoction with properties to clear heat, eliminate toxins, expel dampness, dispel wind, and relieve itching — for 6 days.
Also prescribed herbal topical cream.

Second Visit: March 22

After taking the herbal medicine, some rashes faded in color and flattened. Itching remains on the abdomen, and new rashes on the left arm appeared but are not itchy.
Patient took hydroxyzine twice in the past week and still used topical steroids.
When sweating, itching worsens with a pricking sensation. Sleep has improved.
Now avoids greasy foods, less frequent belching, bitter taste in the morning reduced.

Tongue: Dark red and swollen with dry white coating
Pulse: Deep, thin, rapid

Treatment:
Continue with modified herbal formula — for 7 days

Third Visit: March 29

Increased itching this week. Excessive sweating and night sweats, disturbing sleep.
Three days ago, new red, raised rashes appeared on inner arms and thighs with severe itching.
Bowel movements normal, no bitter taste.

Tongue: Pale red sides, sticky dry white coating
Pulse: Deep, thin, rapid

Treatment:
Continue with modified herbal formula — for 5 days

Fourth Visit: April 3

Rashes have subsided and flattened, some areas show peeling dry skin.
Itching persists in inner upper arms. Rashes on both thighs have turned light brown and flattened.
Localized itching at night.
Hydroxyzine used twice. Now experiences dry mouth.
Sleep is restful. No night sweats. Bowel movements normal (once daily).

Tongue: Pale red with thin white coating, not moist, swollen
Pulse: Thin and weak

Treatment:
Continue with modified herbal formula — for 7 days

Fifth Visit: April 10

No new rashes this week. Rashes on the back and left arm have faded; some areas show peeling.
Still some itching on both inner thighs. Took antihistamines twice. Still has dry mouth.
Sleep remains restful. Bowel movements normal.

Tongue: Pale red with thin white coating, not moist, swollen
Pulse: Deep, thin, weak

Treatment:
Continue with modified herbal formula — for 9 days

Sixth Visit: April 20

Rashes have faded significantly; some areas have returned to normal skin.
Light residual rashes remain on arms and thighs.
Skin is slightly dry. No itching reported. No antihistamines taken this week.
Bowel movements and sleep normal.

Tongue: Pale red with thin white coating, not moist, swollen
Pulse: Thin, weak but with strength

Treatment:
Continue with current formula for 10 days.
In the second week, reduce dosage to once daily.
End of treatment.

Treatment Summary

Although pityriasis rosea is typically self-limiting and resolves naturally within 6–8 weeks, in some cases, the itching can severely disrupt sleep and daily activities, especially in the early stages when new lesions continue to emerge.

Through Traditional Chinese Medicine (TCM) treatment, it was observed that although new rashes occasionally appeared, older lesions began to fade and itching gradually reduced.
TCM emphasizes restoring internal balance, combining herbal prescriptions with lifestyle adjustments and appropriate self-care.

Patients are advised to:

- Avoid spicy, oily, and greasy foods
- Drink plenty of water
- Get adequate rest
- Avoid scratching or irritating the skin

This helps prevent flare-ups and supports faster recovery and rebalancing of the body's systems.

Progress of Rash on the Back Throughout Treatment

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Written by:

黄美清 中医师
TCM Dr. Mananya Anurakthanakorn (Huang Mei Qing)