| Face Treatment | acupuncturists, physical therapist, chiropractors, doctors, nurses, nurse practitioners, massage therapists, estheticians, etc. |
| Cosmetic facial acupuncture | |
| facial cupping | |
| facial guasha | |
| red-light therapy | |
| scalp acupuncture | |
| microneedling | |
| Head is yang | yang channels end in the face |
| 72 face muscles | connect to skin, not bone |
| CN VII | Facial nerve |
| CN V3 | masseter and temporalis, mandible, buccinator |
| Scalp points | Head area (Ren 24)- emotional problems, insomnia, poor memory and concentration, anxiety, depression |
| Liv/GB area: shingles, gallstones, hepatitis |
| Stomach area: stomach pain, discomfort |
| Thoracic area: chest, lungs, upper abdomen |
| Large intestines area (ST8): colon, diarrhea, constipation |
| Reproductive area: menstrual cramps, excess bleeding, UTI |
| Entry Exit points (E/E) | It can help people stuck behind a single thought, reframe conclusions about who they are and how life is. |
| BL1 |
| GB1 |
| ST1 |
| SI19 |
| LI20 |
| TB22 |
| These help the spirit and ability to express the face. |
| 5 elements | Creation cycle and controlling cycle is heavy in this face system using Worsley’s method. CSOE (color, sound, odor, emotion) of the patient. |
| You need to have a strong knowledge of the 5 elements and their attributes. |
| Look at patients face, voice, eyes, try to find their element and spirit. |
| Spirit of the points | Going beyond the conventional use of the points for example GB34 is used for tendon issues, but can be used on someone who is inflexible mentally. |
| Understand patients might be regressing emotions, we want to treat the emotions for better well being. |
| Xi-cleft points for stuck emotions. |
| If emotions are strong use creation or controlling cycle on the same meridian. |
| Example anger patient, use the wood point, sedate fire point, or use a metal point on wood channel. |
| Window of sky points | Strong in connecting the heart and mind, spiritual blockages that hinder a personals growth and repressed issues seen in the face. |
| Like clearing out clouds to reveal a clear blue sky. |
| Related to divergent channels. A divergent channel might re-route emotional trauma to a body part like the elbow so that it will not damage a organ. |
| si16: tian chuang, heavenly window, open heart clarity so person can experience joy and laughter. |
| si16, tian rong, heavenly appearance: help a depressed person move forward with fresh perspective. |
| Bl10: tian zhu, Heavenly pillar, help a person hold themselves up, have strength and move forward. |
| Pc1: tian Chi, Heavenly pond, helps a person feel more connected to their heart to reconnect with others. |
| LU3: tian fu, heavenly palace, for Lung imbalances causing depression and anxiety, uplifting to re-evaluate life. |
| Li8: Fu tu, support and rush out, allows a patient to have free flow of expression, especially if overworked, frustrated, bogged down. |
| ST9: Ren ying, Welcome people, receive and welcome people again if patient closed themselves off from society. |
| Ren22: Tian Tu, Heaven rushing out, when a patients spirit is under a dark cloud and have no outlet for creativity. |
| Ren 16: Feng fu, Wind palace: broaden perspective and move on especially if they are depressed. |
| Upper kidney points: | Communication between heart and kidney. Kidneys grasp the qi (breath) of heaven. |
| kd23 shen feng, spirit seal, Seals off the shen to relieve life distractions so we can recognize our true self with authenticity and power. |
| kd24 Ling xu, spirit burial ground, rescues the spirit when resigned, transforming old self to new. |
| kd25 Shen Cang, Spirit storehouse, strengthens a spirit that feels worn down. |
| kd26 Yu zhong amid elegance clears the way we see ourselves and appreciate our beauty. |
| kd27 Shu fu storehouse, greater sense of connection, new fuel for life, store of jing. |
| other significant points | Si6: yang lao, nourish old, xi-cleft. Old traumas of the heart, stagnation, for clarity of experience |
| si19 ting gong listening palace, hear what the heart of self and others is saying. |
| BL1, Bright eyes, for minds stuck in overthinking and facilitates communication between conscious and unconscious. |
| BL2, Cuan Zhu collect bamboo, gathers virtues and resources to deal with anxiety |
| TB17 Yi feng, wind screen, helps us be less susceptible to peoples opinions. |
| TB23: si zhu kong, Silk bamboo hallow, help return to self when extended outward with too much social interaction. |
| TB22: Er He liao, harmony bone, people driven to experience inappropriate intimate connections or avoiding intimacy. |
| Gb1 tong zi liao, Pupil crevice. Drain heat due to emotional frustration. People to make decisions, hard to see big picture, clarity. |
| Gb14, Yang Bai, Yang brightness: encouragement in wood types who feel stuck. |
| Gb18, cheng ling, receiving spirit: for eyes, CNVI, calm and settle spirit, emotional, mental, restless, anxiety, agitation. |
| Gb34, Yang Ling Quan: helps the face to lift up. |
| Gb41, Zu lin qi, foot above tears: emotional release of frustration and anger. Release constraint for healthy flow of qi. 1st point she uses! |
| Liv2 xing jian walk between: clear liver fire for relaxing, treats face dark spots and heat. |
| Liv3 tai chong supreme rushing, happy calm: calm the patient, release stagnation. |
| LU7 Lie que Narrow Defile/Broke Sequence: benefits skin, pores, body hair, Luo point relieves grief held inside. |
| Li4 He gu Joined valleys: for senses (eyes, ears, nose, mouth, face), detox, anxiety, letting go unwholesome attachments. Contraindicated pregnancy. |
| Li20 Ying Xiang Welcome fragrance: opens nose for smells which stimulate memory, letting go stagnant old emotions. |
| St1, Cheng qi, Receive Tears: opens level of mind and spirit starts journey of processing and digesting thoughts, ideas, and emotions. |
| St4: Di Cang, earth granary: for frowns, eating disorders, oral fixation like overeating and smoking (add Du 26,27,28, and Ren24), food intolerance. |
| St8 Tou Wei, head tied: overthinking and worry, easy worry of obsessing over things. |
| ST9: Ren ying, Welcome people: open energy of the face, boundaries, resolve resentment, welcome others, qi to body and head. |
| ST36 Zu san Li,leg 3 mile: sea of nourishment for qi, blood, spleen, calms the spirit. |
| ST40, Feng long, Abundant splendor: damp-phlegm in face, contentment of being. |
| SP6 San yin Jiao, three yin crossing: calms spirit and invigorates blood, makes things right in the kingdom. |
| Ren6 Qi hai, Sea of Qi: spirit and mental exhaustion, depression, lack of will, restores yang and yuan qi. |
| Ren17 Tan zhong shan zhong, middle hall: shen to radiate from heart, open energy to face, with ren6 and ST36 it tonifies Qi and clears damp. |
| Du20 Bai Hui, One hundred meetings: raise qi and yang to head and face, sea of marrow/brain calming of spirit. With Du24, yintang strongly calms |
| | Du26 Ren zhong, Middle man: revive. Shock, fainting, back pain, calm spirit and mind. |
| Clearing Blockages | Ling Shu: “Only when the stagnation is cleared away, can the channels be vented and yin and yang harmonized.” |
| This helps with adverse effects when working on the face. |
| Emotions: | Clear the face from repressed emotions. |
| diagnosis: | Excess or Deficiency in the pulse, there history, face, eyes. |
| Possession: shen | Internal: strong emotion, trauma, phlegm in the heart. Tx: Ren15, St25, St32, and St4. (internal dragon points) |
| External: extreme weather, climate, like cold stuck in body. Tx: Du20, BL11, BL23, BL61 (external dragon) |
| Aggressive energy (AE) | clear the possession first. |
| Use the back shu points of the yin organs. |
| Lung BL13 |
| Pericardium BL14 |
| Heart BL15 |
| Liver BL18 |
| Spleen BL20 |
| Kidney BL23 |
| Husband-Wife blockage | Degenerative disease, lack of healing resource in the body, yin and yang losing function. |
| right side pulse is stronger that the left. |
| Tx: BL67 and KD7 (metal to water), KD3 and Liv4 (Earth to water), SI4 and HT7 (yuan source fire) |
| Exit and Entry points: | movement of qi through the channels via the body clock: HT- Si- BL-Kd-PC-TB-GB-Liv-Lu-Li-ST-Sp |
| 6 main: | TB22 and GB1: uptight patient, compassion not getting in. migraines, TMJ, teeth grinding, jaw clenching. Anger and judgment constrain perspective. |
| Si-19 and BL1, listening and seeing. Not Listening to self and others due to fear. TMJ, tinnitus, ear infection, dizziness, headache. |
| Li20 and ST1: Inability to release the undigested parts of the past, especially tears. Chronic sinus, facial rash, allergies. Cry to relieve loss. |
| Kd22 and Pc1: those who cannot look straight into someone’s eyes due to shyness, emotional wall. Palpations, cancer, anxiety, insomnia, depression. |
| Liv14 and Lu1: Anger, feeling bad about themselves, low self-esteem, unresolved anger, hard to let go, process feeling from a relationship lost. |
| SP21 and HT1: emotional instability, inability for intimacy and receiving nourishment. Bulimia, anorexia, oral compulsions, insomnia. |
| Diagnostic | Use pulse and the body clock. Tonify in principle (needle direction, clock/counter clock, close or not close hole). |
| Pulse style is just feel if each organ is excess or deficient. Then, |
| Tonify exit point on the organ channel that is strongest, and tonify the entry point on the weaker channel. |
| Reduce the organ channel if it is very excess before adding the next entry point. |
| Ren/Du | tonify all: Ren1, Ren24, Du1, du28*: for person with physical, sexual, trauma, they appear to have energy but pulse is very weak and thin, deep. |
| | *sub ren 1 and du1 with Lu7/kd6 and si3/bl62 |
| 5 elements and the Face | |
| Fire | passionate expression, connect with others, love |
| excess: mania, hyperactivity, restless, insomnia, excess talking |
| deficiency: depression, lack motivation, emotionally cold, withdrawn |
| Red complexion, crows feet from excess smiling, laughter’s, scorched smell, |
| heat conditions, acne, shingles, herpes, blushing, swelling/puffiness. |
| Facial lines: nasolabial folds, crow’s feet |
| Earth | Worry, pensive, one of sincerity |
| Facial lines at the eyes or dropping mouth. |
| Excess: worry, overthink, need for reassurance, digestive bloating, weight gain, compulsion |
| Deficiency: lack of grounding and focus, poor appetite, loose stools, neediness, need for sympathy |
| Distention in face, muscle atrophy, weakened muscles, stiffness, loss of elasticity, |
| changes in muscle distribution, changes inability for facial expression, oral and speech muscle changes. |
| Metal | Excess: grief, sadness, melancholy, difficult to let go |
| Deficiency: weak immune system, respiratory weakness, emotionally cold |
| Dry skin, has many expression lines |
| Water | Depth, wisdom, adaptability |
| Excess: fearful, paranoia, solitude, insecurity |
| Deficiency: lack willpower, cold, disconnected from emotions, low libido, chronic fatigue |
| Facial lines: wrinkles on forehead, dark bags under eyes, |
| Good hydration is supple and plump. Dimples in the chin. |
| Premature aging, loss of elasticity, dryness, darkness in the face, circles around the eyes. |
| Essence, yin and yang. |
| Wood | Growth, determination, vitality |
| Excess: anger, irritability, aggression, HBP, tension. |
| Deficiency: lack assertiveness, stuck, low energy, muscle weakness. |
| Facial lines: at brow, nose, liver spots. |
| | Facial redness, acne, dark spots, poor vision, dry itchy eyes. |
| Inner brow raiser | Frontalis (par medialis) |
| Outer brow raiser | Frontalis (par lateralis) |
| Brow lower | Depressor glabellae, depressor supercillii, corrugator supercillii |
| Upper lip raiser | Levator palpebrae superioralis |
| Cheek raiser | Orbicularis oculi (par orbitalis) |
| Lid Tighener | Orbicularis oculi (par palpebralis) |
| Lips towards each other | Orbicularis oris |
| Nose wrinkler | Levator labii superioris alaeque nasi |
| Upper lip raiser | Levator labii superioris, caput infraorbitalis |
| Nosolbial deepener | Zygomaticus minor |
| Lip corner puller | Zygomaticus major |
| Sharp lip puller | Levator angulii oris |
| Dimpler | Buccinator |
| Lip corner depressor | Depressor anguli oris |
| Lower lip Depressor | Depressor labii inerior |
| Chin Raiser | Mentalis |
| Lip pucker | Labii superior and labii inferior |
| Tongue Show | |
| Lip stretcher | Risorius with pltysma |
| Neck tightener | Platysma |
| Lip funneler | Orbicularis oris |
| Lip tightener | Orbicularis oris |
| Lip pressor | Orbicularis oris |
| Lips part | Depressor labii inferior |
| Jaw drop | masseter, relaxed temporalis |
| Mouth stretch | Pterygoids, digastric |
| Lip suck | Orbicularis oris |
| Muslce dysfunctions | |
| Atrophied | |
| Hyper tonic | |
| Hypo tonic | |
| Spastic | |
| Flaccid | |
| Contracted | |
| Fibrotic | |
| Dyskinetic | |
| Fasciculating | |
| Weak | |
| Paralyzed | |
| Stiff | |
| Fatigued | |
| tight | |
| Uncoordinated | |
| Cramped | |
| Points for different muscle groups | |
| for lines from excess smiling | Orbicularis oculi: GB1, BL2, Qiuhou Jiang ming (between ST2 and inner canthus of eye), TB23, yuyao, needle upward, |
| Surprise (water element) | Frontalis: gb14 |
| Depressor labii inferior: Jia cheng jiang (1 cun from centerline below the lip) |
| Levator labii superior: motor point between Li20 and ST2 |
| Superior Tarsal and levator: needle up under eye brow to yuyao |
| Lateral pterygoid: GB2 |
| Fear (Water element) | Corrugator: BL2 |
| Zygomatic minor: halfway between ST2 and ST3 |
| Depressor labii inferior: Jia cheng jiang (1 cun from centerline below the lip) |
| Risorius: ST4 |
| Platysma: ST5, ST9, ST10 |
| Disgust (Earth element) | Corrugator: BL2 |
| Procerus: yintang |
| Depressor supercilii: BL2 |
| Zygomatic minor: halfway between ST2 and ST3 |
| Levator labii superior alaeque nasi: motor point between Li20 and ST2 |
| Orbicularis oculi: ST2, Qiuhou (lateral to ST2), and motor point between GB1 and TB23 |
| Depressor anguli oris: motor point inline and inferior to ST4 and lateral to Ren24 |
| Mentalis: 0.5 cun lateral to ren24 |
| Sadness (Metal element) | Frontalis: gb14 |
| Corrugator: BL2 |
| Depressor supercilii: BL2 |
| Depressor anguli oris: motor point inline and inferior to ST4 and lateral to Ren24 |
| Contempt (can be any) | Zygomatic major: SI18 |
| Orbicularis oculi: Qiuhou, and motor point between GB1 and TB23 |
| Anger (wood) | Corrugator: BL2 |
| Procurus: yintang |
| Depressor supercilii: BL2 |
| Levator superior: motor point between Li10 and ST2 |
| Superior Tarsal and levator: needle up under eye brow to yuyao |
| Orbicularis oris: Li19 and between St4 and Ren24 |
| Mentalis: 0.5 cun lateral to ren24 |
| Rage | Corrugator: BL2 |
| Procerus: yintang |
| Depressor supercilii: BL2 |
| Levator superior: motor point between Li10 and ST2 |
| Orbicularis oculi: Qiuhou, and motor point between GB1 and TB23 |
| | Depressor labii inferior: Jia cheng jiang (1 cun from centerline below the lip) |
| Skin as we age: | Reduction in essential skin components: fat, collagen, elastin |
| Thinning of dermis: more delicate with age, thinner skin more prone to damage |
| Reduced collagen production: 1% lost a year starting at age 25., decreasing structural support, forming wrinkles and sagging. |
| Damaged skin fibers: diseases, injuries, chronic inflammation, excess sun exposure, regeneration slows down with age. |
| Declining HA production: loss of skin fullness and increasing dryness. |
| Reduced oil production: sebaceous glands become more less active. |
| Increase in pigment issues: dark spots, red spots, etc. |
| Loss of elasticity: the ability for the skin to snap back in place. |
| Chinese perpective | Yin deficiency: thinning and dryness, deep wrinkles, fine lines, lack of elasticity |
| Yang deficiency: sagging and loss of muscle tone. No luster, edema |
| Jing deficiency: occurs with age- graying hair, bone loss, skin texture, wrinkles, thin skin |
| Dampness: puffy or swollen face features |
| Qi and blood circulation issues: age spots, uneven tone, dull complexion |
| Liver qi stagnation: wrinkles face tension and stress |
| Qi deficiency: withered appearance of face, tired, fatigued, lack tone, and firmness |
| Blood deficiency- pale, dry, cracked, lack luster, |
| Excess heat: red face |
| Water retention: puffiness |
| fluid deficient: wrinkles, |
| | Blood stagnation: dull uneven complexion, discoloration, dark spots, patches, poor circulation, spider veins. |
| Chinese organs | Wood: contraction of muscles |
| Fire: complexion/color |
| Earth: muscle integrity |
| Water: premature aging |
| Metal: Skin texture |
| Earth (spllen and stomach) | SP/ST: transform food into Qi and blood. SP deficiency there is loss of skin tone, face can get puffy if fluids not transported, bags under eyes, |
| Pensiveness can affect nose lines, thin lips are signs of SP deficiency, full lips are spleen excess. |
| Water (kidney and urinary bladder) | Kd/BL: Horizontal lines on forehead, fear raising the eyebrows. Puckered chin and chin wrinkles. Age accelerates with KI Jing deficiency. |
| Kidney yin deficiency can cause bags under eyes, kidney yang deficiency: puffiness around the eyes and lack firmness/tone in face. |
| Fire (Heart, Small intestines) | HT/Si/PC/TB: excess smiling causing crow feet, heart blood deficiency: wrinkles due to dryness, pale or dull complexion, lack firmness and tone |
| Heart Fire: facial tension, tightness, forehead, eyebrows, and jaw |
| Wood (Liver and Gall Bladder) | Anger: nose snarl, Liver qi stagnation: lines due to chronic muscle tension. Liver blood stagnation: dark, or purple spots, grey tone. |
| Liver blood deficiency: dry skin. |
| Metal (Lung and large intestine) | Skin is the 3rd lung, Impaired lung function can affect dryness, clogged pores, inelastic, thin skin. |
| Deep sadness can cause result in vertical lines in LU/LI areas of the face: Outer cantus of eye to cheeks from frown. |
| | Weak lungs may cause prone to low immunity and more prone to infection and skin sensitivities. |
| Western Anatomy Traits | |
| Fat | Below the forehead: above eye area, under eye area, along nasal groove, 2 along cheek, and center around zygomatic arch |
| Fat declines with age. Health is right amount of fat in the right places. Facial volume loss depends on fat. Some gain or lose fat in areas. Loss of plumpness. |
| Fat distribution- it shifts with age, usually downward with gravity like jowls and nasolabial folds |
| Fat volume- there can be decrease like sunken cheeks, or increase like double chin |
| CM: KD, yin, yang, sp qi def., |
| Treatment: cosmetic acupuncture, cupping and guasha. Improve blood circulation, active facial muscles, collagen production, lymphatic drainage |
| skin rejuvenation. |
| Muscles | Play a role in facial expressions, shape, contours, as we age they become shorter and tighter |
| Muscle atrophy: mass and strength loss |
| Reduce muscle tone: loss of muscle tone causes looseness. |
| Facial contours impacted: less defined and sculpted, cheeks and jawline, features can become less pronounced. |
| Sagging and drooping: lifting and firmness are lessened. |
| Facial expressions impacted: certain expressions become more challenging. |
| Tx: facial motor points, cupping, guasha, increase qi, blood, jing. : improve muscle tone, muscle activation, blood circulation, muscle relaxation, |
| collagen production, skin rejuvenation. |
| Bone | Significant bone loss and osteoporosis as we age. |
| Bone remodeling: bone remodeling as we age changes and there is gradual bone loss. |
| Hormonal changes in women at menopause. |
| Facial bone reabsorption: cheeks, jawline, orbital bones can change with age. Thinner and less dense. |
| Changes in Facial structure due to bone, levels a effect on skin and soft tissue |
| CM: jing, loss of jing as we age changes everything. |
| Tx: can help with blood circulation to face bones, muscle activation to support bones, collagen production for bone density |
| Lymphatic drainage reduce inflammation and fluid retention to support bone health. |
| Fascia | SMAS superficial musculoaponeurotic system: vital layer of fascia connection mimetic muscles to the skin. Provides structural framework. |
| SMAS may weaken with age, causing sagging, jowls, wrinkles. |
| Deep fascia is under the SMAS. It protects deep muscles of the face. Maintains position and control of muscles. |
| Adhesions can develop in both SMAS and deep fascia. |
| CM: qi and blood deficiency, KD and Liver imbalances, yin and yang imbalances, external pathogenic factors. |
| TX: Better nutrients to face, harmonize kd and liv, restore yin and yang to fascia, relax the face and fascia, collagen stimulation, stress reduction. |
| Tendons | Connect muscles to bones, support and stability to facial structures. |
| Loss of elasticity and strength like sagging and drooping, they can help support the fat padding maintaining the shape. |
| loss of elasticity will be drooping, jowls, sagging, wrinkles, lines, less youthful. |
| Loss of support and integrity: tendons help support fat padding, can lead to a hollowed-out appearance, |
| CM: jing deleption.blood and qi stagnation, yin and yang imbalance, dryness and stiffness, kidney deficiency. |
| Tx: acupuncture, guasha, cupping can promote blood and circulation assisting the collagen. Facial rejuvenation, relaxation release tension. |
| Ligaments: | Vital anchors to facial muscles and fascia to underlying bones, preserving the face shape and positioning of soft tissue. |
| Weak ligaments do not support and stabilize face structures. |
| Ligament laxity: loss of tension and shifting of structures. |
| Contours and proportions, symmetry can be affected by altered ligaments. |
| Loss of facial volume: distribution of fat causing sunken appearance. Ligaments lax can cause deepening of facial lines, expression altered. |
| Impact on bone reabsorption, affecting bone health. |
| CM: Improve blood circulation, stimulate collagen production, facial muscle relaxation, lymphatic drainage, skin rejuvenation. |
| Lymphatic system- | maintain fluid balance and wastes, toxins. As we age the lymphatic system loses ability. There can be a accumulation of toxins and waste. |
| Cellular damage, inflammation, oxidative stress. Inflammation and immune response. |
| Skin health and appearance, texture, tone, and vitality are all part of lymphatic health. |
| CM: Blood and qi circulation to prevent damp accumulation (fluids) that cause puffiness and swelling. |
| Improve circulation, guasha for lymph drainage, detoxification with acupuncture, cupping, guasha, reduce dampness, enhance immune function. |
| Circulatory system: | Vascular health and the aging face. Vascular changes as arteries become stiffer, less elastic, blood and oxygen can be compromised. |
| Reduced blood supply due to the decline of aging. Density and functionality of the blood vessels in the skin. |
| Crucial nutrients, oxygen, and other factors to the skin cells. Skin health and vitality affected. |
| Capillaries can become fragile which can cause leaking, spider veins, visible blood vessels, reddening, purple. |
| wound healing slows with age, scars, blemishes, skin imperfections may show more. |
| Laxity, fine lines, and wrinkles if there is less collagen support from blood supply. |
| CM: poor lifestyle choices, emotional stress, poor diet can contribute to blood stagnation causing discoloration, fine lines, and puffiness. |
| acupuncture will promote better blood circulation, guasha and facial cupping for blood flow and vessel integrity. |
| Enhance collagen production to help blood vessel walls, moisturizing and hydrating vital for healthy blood flow and nourishment. |
| Digestive system | Digestion goes through changes as we age, it needs to be efficient in gathering nutrients for the skin. We need nutrients like vitamins, minerals, |
| antioxidants for the skin. Nutrients to repair skin damage and complexion. |
| Digestion is what gives us hydration and moisture to the skin, dryness and cracking can occur, the stomach needs proper acid balance. |
| Gut health and inflammation, microbiome are beneficial bacteria are important for overall health. Microbiomes need diversity, |
| Inflammation of gut can cause acne, rosacea, skin aging, redness, swelling. |
| Detoxification and waste removal, leaky gut and liver issues like metabolism can effect the elimination of toxins from the body and skin. |
| CM: digestion is everything, it transforms food to blood, essential for all activities, fuel, vitality. |
| Acupuncture can facilitate spleen, liver, stomach, and small/large intestine functions, improving nutrient absorption, |
| Balance the digestive qi, reduce dampness like bloating and water retention, stress relief, support detoxification. |
| Endocrine system: | Various glands of the body change with age. |
| Sebaceous glands produce oil that protects and moisturizes skin. Dry skin is prone to wrinkles and fine lines. |
| Sweat glands help regulate temperature and hydration. This may decline with age. |
| Endocrine system like pituitary, pineal, thyroid, adrenals, all change with age affecting hormones and skin elasticity. |
| CM: TB and KD channels are regulated, harmonizing organ function hormonal regulation, stress will reduce for hormone balance. |
| Stress hormone vs happy hormone. Enhance blood circulation to distribute hormones to face tissues, support |
| of overall vitality to impact hormones, balance yin and yang fluids and body heat. |
| SP10 to balance blood, ST9 for thyroid, Li4, SP6, Liv3 for hormones as well. |
| Collagen: | Vital protein for skin strength, decrease with age, skin elasticity decreases, dermal thinning, wrinkles and sagging. |
| Elastin and HA (Hyaluronic acid) rely on collagen in their framework. |
| CM: kidney jing, qi, blood, yin and yang. Treatment will increase blood circulation to support collagen production. |
| Creating microtrauma to the skin with needles and cupping will create a natural healing response to repair collagen, regenerate skin. |
| Encourage fibroblast activity which produces more collagen. Improve lymphatic drainage for fluid movement and detoxification. |
| Good protein and vitamin C is crucial. 4-6 ounces for women, 6-9 for men. |
| Hyaluronic Acid (HA) | Appearance of skin, gel-like molecules for attracting and retaining the moisture for skin plumb, and supple. HA decreases with age. |
| Skin can get dehydrated when unable to retain moisture due to low HA levels. |
| HA levels help with the structural integrity of the skin, collagen, elastin, firmness and youthful appearance. |
| Topical HA products are available to enhance skin texture. |
| CM: yin and blood. Fluids. Improve blood circulation, increase hydration, activate collagen production, relax muscles, rejuvenating the skin. |
| Growth Factors: | Proteins used for cellular level growth, proliferation, and tissue repair. Fibroblasts, keratinocytes, immune cells. |
| They play a role in collagen production, cell turnover and regeneration, wound healing, antioxidant and anti-inflammatory effects. |
| | Qi and blood circulation with help the growth factors. |
| Cosmetic Acupuncture Intake | |
| Questions for Contraindication | Do you have high blood pressure? |
| Do you get migraine headaches? |
| Are you pregnant? |
| Do you have major health concerns like diabetes, seizures, epilepsy, cancer or coronary heart disease? |
| Have you had any recent facial procedures and surgeries? (Botox, dermal fillers, lasers, injections, microneedling, chemical peels, surgery) |
| find out when advisable to do cosmetic surgery after those facial procedures. Botox/neurotoxin: wait 3 weeks before needling the face. |
| Dermal fillers: hyaluronic acid (HA) Juvadern or Restalyn, Calicium hydroxylapatite (CaHA) Radiesse, Poly-L-latic acid (PLLA) Sculptra. |
| Fillers- wait 2 to 4 weeks. Contraindication with bruises or swelling, allergies to fillers. |
| Lasers, Laster resurfacing, hair removal, Intense pulsed light (IPL), Laser tattoo removal, Vascular laser treatments (veins) |
| Microneedling: stimulate collagen production, wait 1 to 2 weeks. |
| Chemical peels: fruit acid peels have no downtime, Chemical peels do. Wait until skin fully healed. |
| Facelift: wait until all healed, no neuropathy, scars healed, (up to a year). |
| Mole, Cancer removal or surgery: have patient find out from surgeon. |
| Precautions: | Vertigo- can exacerbate |
| Herpes: ask about outbreaks and where. |
| Bruising. Underlying skin conditions like eczema, psoriasis, poison ivy, etc. |
| Check for major events like weddings because of bruising. May want to do cupping and guasha only. |
| Set goals and experctations | Communicate well, listen, understand if patient has major issues like Bell’s palsy, Ptosis, etc. |
| Facial acupuncture can be used as a preventative in early 40’s. |
| allow patients to participate in the goals, create rapport. Set realistic expectations, maintain documentation, do a exam |
| Create treatment plan, schedule, and provide side effects, patient consent, and answer any questions. |
| Be ethical, keep information private and confidential, be aware of contraindications. |
| Listen without bias, remove the “I” and take spotlight off self, you cannot listen and think at same time. |
| The highest form of intelligence is observing without evaluating. Put self on mute and pause until patient is done talking. |
| Create an atmosphere of trust. Advice giving, interrogation, denial, and psychoanalysis are discouraging to patients. |
| Set real expectations: genetics, lifestyle, sun exposure, aging all play a role in improving wrinkles. |
| Lines and wrinkles | Wrinkles due to gravity, wrinkles due to emotions. |
| Forehead lines: usually due to anger |
| Crows feet- excess smiling or squinting |
| Lip areas: smoking, straw drinking, pursing lips, , some bitterness may be present. |
| Chin Area: loss of collagen can be a cause, some fear. |
| Jowls: sagging jawline, spleen qi deficiency, lack of elastin and collagen, loosening ligaments on the face. |
| Double chin and neck: spleen Qi deficiency, weight gain, kidney disharmony (necklace lines). |
| Scars: car accidents, animal bites, surgery, disease, traumatic events, emotions. Acne scars. “Surround the dragon” on scars. |
| Genetics and lifestyle: | Genetics, twin studies on stress and lifestyle show impact to face. |
| Lifestyle factor questions: is patients getting enough sleep? |
| Sun exposure daily, what is diet like, do you smoke?, how much water do you drink? |
| How much alcohol do you drink? Do you do drugs and for how long? Are you on medications? |
| Protein: wound healing, antioxidant enzymes, skin hydration, hair and nail health. |
| Alcohol: dehydration, inflammation, nutritional deficiency, blood vessel damage. |
| prolonged alcohol use can create skin disorders by weakened immunity, infections, dermatitis, candidiasis. Jaundice, poor wound healing, |
| and premature aging can also occur from alcoholism. |
| Medications that affect skin: anti-depressants may cause dryness, steroids may cause thinning, bruising, stretch marks and slow healing, , |
| NSAID’s gastrointestinal injury affecting overall skin health, Birth control affects pigmentation, Diabetic drugs may affect dryness and healing. |
| Blood thinners: bruising and bleeding risk. |
| amphetamines: vasoconstriction, skin pale, dull, dryness. Cocaine: reduce blood and oxygen, tissue death, ulcers, scarring, sleep issues. |
| painkillers/Opioids: constipation, dryness, rashes, hives, sleep issues. |
| Physical exam | pulse, tongue, questions, palpation, observation |
| Age 20-30’s: 3 to 6 weeks to see improvements with consistent facial acupuncture |
| Age 40-50’s: may take 2 to 3 months of consistent treatment |
| Age 60 and up: 3 to 6 months to see improvements. |
| Need to do 10 treatments once a week for several months, results may start to show by treatment 6 or 7. |
| Document well and use camera to take before and after photos. |
| Ask patient: biggest concern, other areas to concentrate on, bruising, acne, red/pale face, facial puffiness, allergies, |
| sensitive skin, pore size, any other concerns. |
| | Contract and consent. |
| Tools: | Tweezers |
| Arnica gel. Anti-inflammatory, healing bruises, analgesic, antimicrobial, soothing and tightening |
| intradermal needles: .4mm x7 DBC |
| Serin J-type needles: |
| sky blue .20mm for scalp |
| Lime green .14mm for face, 15mm for bony areas, 30mm in fleshy areas |
| Red: .16mm body, 15mm in bony area, .30mm in fleshy area |
| Dark green: .12mm for sensitive skin |
| Dark blue .10mm for crow’s feet |
| Cotton swabs |
| Techniques: | Threading: Intradermal or long wrinkle |
| Superficial, Not in muscle, just skin, just under the wrinkle, if seated above at head of table always needle up direction toward you. |
| Threading muscles, techniques for lifting the face |
| Lifting the face from gravity points: LI20 toward bitong, ST3.5 toward ST2, SI18, GB2, ST7, Serin J green 15mm |
| Hooded eyelids/drooping eyebrows: BL2, Yuyao (in line with pupil of eye), TB23. 15mm x .14mm, upward direction. Lift eyebrow up and needle. |
| GB18 (lateral to Du20): CNVI connection or occipital. In line with center of brow. |
| BL6: thread needle at BL4 toward BL6, lift eyebrows. |
| Needling Auricular muscles: related to temporalis muscle (connected to frontalis, galea aponeurotica, masseter, levator) |
| Protocol for Facial Acupuncture | |
| General advice | Patients: make-up free, clean face. Avoid areas prone to herpes outbreak. |
| Use CNT, guide tubes caution veins around ST5, ST6, GB1. no need to tonify and sedate needles or go for Du qi. |
| Protocol | *note some points are needled bilaterally and some are not. |
| mandatory points. Optional points are for patient needs. |
| First Treatment: | 1) Possession: treat their Aggressive energy (AE), clear the aggressive or mental energy out on first treatment. Worsley method on Back shu. |
| 2) give a mini facial treatment and apply arnica gel after. |
| 3) Perform facial cupping and guasha. |
| 4) reschedule and follow-up. |
| timing should be 30 min. intake, AE: 15 min. , Mini facial 45 min., total about 2 hours. |
| Mandatory points: ear: shenmen, sympathetic, kidney, endocrine. Optional: eyes, sinus, TMJ, face, low jaw, upper jaw, lips. |
| Mandatory body: GB41 (first), LI4, ST9, TB17,ST40, ST36, Sp6, Liv3, Ren6, GB34, Ren17, Lu7, Si16, GV20, GB18. |
| optional: Liv KD yin/yang issues: Kd3, Ren4 |
| Dark circles under eyes: Kd3, SP10 |
| Blood deficiency: SP10, Liv8, HT7 |
| Blood stasis: BL17, BL18, SP10 |
| SP Qi deficiency: Ren4, Ren12, SP3 |
| Hormonal issues: SP10 |
| Bags under eyes: SP9, SP10, ST43 |
| KD qi def: KD3, KD17, Ren4 |
| Liver qi stagnation: KD13, Liv14 |
| Neck wrinkles/double chin: Ren23, ST10 |
| Insert Intradermal needles into area from chin up to forehead, threading. |
| Wrinkles of Lower lip: .14 x15: St4, ST5, ST6, Du26, Ren24, Jia cheng Jiang. Intradermal toward red part of lips (never touch red part). |
| Wrinkles of upper lip: Intradermal toward red part of lips. .14 x30, ST4, DU24, LI19, Ren24 |
| Sagging Jowls and lifting cheeks: mandatory: LI20, ST3.5, Si18, ST7, GB2, ST8. Optional: Ren26, GB2, LI19. |
| Eye area: Tai yang, GB1. |
| Crow’s feet: Intradermal towards eye but not inside orbital rim. |
| Bags under eyes: BL2, Qiuhou, Jiang Ming. |
| Drooping eyelids/lift brow: BL6 threaded from BL4, GB14, BL2, TB23, yuyao (all upward). |
| Furrowed brow: intradermal, yintang and BL upward. |
| Forehead wrinkles: Intradermal needles, GB14 and GB15. |
| Large pores: Du25 |
| Keep patient in dark comfortable room for 15 to 30 minutes. Remove from head to feet, GB41 as last. Patients take time, get up slowly. |
| Advanced: | Overall sagging of the face. Temporalis muscle: motor point at GB8, Can submuscular needle. |
| Forehead and Frontalis muscle: submuscular needle frontalis with stimulating GB14 |
| Lines between eyebrows, the Corrugator muscle. Motor points are lateral to BL2. |
| Horizontal lines at bridge of nose, the Procerus muscle: motor point yintang upward, do not do submuscular. |
| Lines on Sides of eyes, Crow’s feet, Orbicularis Oculi muscle: 2 Motor points Quihou and one between ST1 and GB2. Do not go submuscular |
| Under eye wrinkles, Levator Labii superioris: Motor point between LI20 and ST2, do not go submuscular |
| Nasolabial folds, Zygomaticus major: motor point at SI18, do not go submuscular. |
| Chin wrinkles, Metalis muscle: motor point 0.5 cun lateral to Ren24. Do not needle submuscular. |
| Lip Lines, Orbicularis Oris: 2 motor points Li19, and midway between ST4 and Ren24, do not needle submuscular. |
| Marionette Lines, Risorius muscle: motor point is 0.5 lateral to ST4. Do not go submuscular. |
| Jowls and Lines on Neck and Sides of face, Modiolus: motor point is 0.5 to ST4. Important: 8 muscles connect here. |
| Marionette lines, jowls, neck, Depressor Anguli Oris: motor point below ST4 level with Ren24. do not do submuscular. |
| Sides of Face Masseter: 2 Motor points. One at ST6 in the muscle belly, second is inferior to ST7 in muscle belly |
| Under the Chin and Jowls, Anterior Digastric: motor point at ST5, can go submuscular. |
| | Neck lines, Platysma bands, Platysma and posterior digastric: Motor point at SI17, |
| teach patients to observe face in mirror while on phone and see the expressions they make. |
| Some people can have lines around lips and not even be smokers. |
| Teach patient awareness. Forward head posture can cause more neck wrinkles/necklace lines, muscle imbalance, increased tension, reduce blood flow. |
| Promote good posture to patients. Advise them on breathing with nose, if they mouth breathe. |
| Safety considerations | We lose 1% collagen at around age 30, every year, so needling should be careful to prevent bruising and bleeding. |
| Skin types: |
| I: Pale: always burns, never tans. |
| II: Fair skin: burns easily, tans minimally. |
| III: light to medium skin, sometimes burns, gradually tans. |
| IV: Medium to olive skin, rarely burns, tans easily. |
| V: Dark brown: very rarely burns, tans easily and substantially. |
| VI: Deeply pigmented skin, dark brown to black: never burns, rarely tans. |
| Seirin needles are very safe for the skin. |
| Caution with Trigeminal nerve CN V (sensory) (mandibular, Maxillary, Opthalmic branches) (mandibular is motor) |
| and Facial Nerve CN VII (motor facial muscles and taste) (temporal, Zygomatic, Buccal, Marginal, Cervical branches). TB17 origin area. |
| Bruising: caution on orbital rim, jawline, temples, neck, forehead. (mid face and scalp less prone) |
| ST5 (bruising, bleeding, facial nerve, transverse facial artery and vein) |
| ST6 (bruising, bleeding, facial nerve, transverse facial artery and vein) |
| ST2 (eyeball, black eye risk) |
| Yuyao (suprorbital vein, artery), tip: lift the brow, 15mm needle. |
| GB1: zygomatic orbital vein/artery |
| Taiyang: zygomatic orbital vein/artery |
| Qiuhou and Jiang Ming (between ST2 and inner canthus of eye): hematoma risk |
| SI19: facial nerve CN VII risk |
| ST9: carotid artery |
| ST10: carotid artery |
| Du24: supratrochlear vein, thread back along scalp. |
| TB17: needle toward the nose, facial nerve risk. |
| ST8: risk of superficial temporal veins. |
| Blood vessels | Use good lighting, adjust immediately if resistance. Feel for vessels, know where major vessels can be: carotid, jugular vein, ST5. |
| Yuyao, ST2, Qiuhou, GB1 all close: use fine needle. Arnica gel is useful. Seirin Elipease needles are great |
| Facial lines: | Hooded eyelids/Drooping eyelids: eclipse the iris of the eyes. |
| Stress lines: occur on sides of face |
| Vertical over-nurturing lines: occur above the lips. |
| Overworking lines: horizontal lines above the chin |
| Nasolabial folds: sides of nose and mouth |
| Marionette lines: corner of mouth and move down like a puppet |
| Frown lines aka 11’s: forehead at eyebrow |
| Bunny lines: bridge of nose |
| Crows feet at corner of eyes |
| | Necklace lines in the neck. |
| Marketing | Be transparent. Avoid hidden fees, exaggerations, overpromising results, downplaying possible effects. Avoid saying facelift acupuncture. |
| Try facial enhancement, facial renewal, facial rejuvenation. |
| Collect testimonials. Before/after pictures, have products on display, website or online presence, video content, social media forum. |
| | Newsletter, workshops and seminars, storytelling, collaborating with wellness practitioners, blog. |
| Common Facial skin conditions | key: ST (stomach), Liv (liver), KD (kidney), SP (Spleen), HT (heart), Li (large intestines), BL (Bladder) |
| Dry skin | rough, flaky, lacks moisture “Zao pi”, yin deficiency, blood and fluids. Lung, spleen , kidney in TCM. |
| Lu7 to moisturize skin, SP6 to nourish yin, ST36, tonify spleen, KD3 for skin hydration, LI11- clear heat, LI5 for itchy skin. |
| Oily skin | Shiny complexion, clogged pores, acne breakouts., Youpi excess oil, imbalance of yin and yang, Spleen and liver, excess heat and damp, hormones. |
| Li4 and Li11 to clear heat and toxins, ST40 clear damp/phlegm, SP6, spleen and liver harmonize, GB34 for liver qi. |
| Enlarged pores: | Prone to clogging and blackheads, maokong Kuoda or prominent pores. ST, SP and Liv systems, heat, damp, toxins. |
| Li4, Li11- clear heat and toxins reducing pores, SP6- harmonize SP and Liv, ST44- clear heat and toxins from stomach, |
| Ren17: regulates qi and harmonizes chest. |
| Sensitive skin: | Easily reactionary like redness, itching, irritable due to products, weather, allergy, triggers. Emotionally triggered easily. |
| Cuo yan skin prone to reactions. Yin and yang imbalance, weak weiqi (defense qi), poor qi and blood circulation. |
| Li11: clear heat and toxins, SP10 clear heat and damp from skin, ST36 tonify spleen and skin resilience, HT7 calms heart, clears heat, sensitive skin, |
| Liv3: harmonizes liver, reduce skin irritability. |
| Acne | Pimples, blackheads, white heads, cysts, nodules, boils. Clogged, dead skin, bacteria- inflammation. Fen Ci or white thorns in CM. |
| Heat and dampness accumulation, blood stagnation, LU, ST, SP imbalances, improper diet, stress, hormones. |
| Li4 and Li11 to clear heat and toxins, ST40 clear damp/phlegm, SP6, spleen and liver harmonize, SP10 balance hormones, LU5 disperse heat, ST9 for hormones. |
| Hyperpigmentation | Dark spots, patches, sun exposure, hormonal, skin inflammation. |
| Sesu Chenzhuo guodu- uneven pigmentation. Imbalance of yin yang, blood circulation, Liv, Sp, Kd. |
| BL13 for lung qi regulation, blood circulation and skin, SP10 clears heat and promotes blood circulation. SP6 KD, SP, Liv harmonize, |
| Li4, Liv3: harmonize qi and blood circulation. |
| Melasma | Hyperpigmentation usually symmetrical, cheeks and forehead, upper lip, hormonal changes suspected, sometimes in pregnancy. |
| Irregular brown patches, can be tough to treat, Huan He ban “irregular patches”, Liv, Sp, Kd imbalance, Liver qi stagnation, blood stasis, dampness. |
| SP6 for SP, Liv, Kd, Liv3 to clear heat and hyperpigmentation, ST36 for SP and overall skin, |
| Ren3 for kidney yin, hormones, HT7 calms heart and blood, skin health. |
| Hypopigmentation | Reduction in pigment, light patches, might be autoimmune related, genetic, or side effect from medication. |
| Sesu Chenzhuo Buzu, white skin, deficiency in yin and blood, insufficient nourishment |
| Du14: tonifies qi, nourished blood, assists weiqi, SP10, invigorates blood, harmonize spleen, ST36, tonify qi, SP/ST strengthen, vitality. |
| Rosacea | Chronic inflammation in the face, redness, sometimes vessels appear. Hot temp, sunlight, spicy foods, alcohol can flare it up. |
| Jiu Zao Feng: win dregs wind. CM heat and toxins in the body Lung , Stomach, liver, and spleen. |
| Li4 and Li11 to clear heat and toxins, SP6 to harmonize spleen and liver, ST36 to strengthen spleen, Liv3 reduce heat in skin. |
| Milia | Benign cyst, white or yellowish bump on skin. Mai men “wheat grain” in CM. Qi and blood circulation. |
| Li4 and Li11: clear heat and toxin |
| SP10: clear heat, cool blood, skin issues. ST44: clear heat from stomach and skin. GB20Dispels wind and heat from heat. |
| Facial Spider veins | aka Facial telangiectasia, dilated blood vessels, red, blue, purple, Mian bu Xue yu “blood stasis in face”. |
| Causes: qi and blood stasis, heat in blood, weakness of blood vessels, external pathogenic factors. |
| Li4, Sp10, SP6, Liv3, St36. |
| Eczema | Chronic inflammatory condition. Dry itchy skin that is white flakes, red skin. Allergens like pollen, dust, mites, detergents, soaps might trigger. |
| “Shi Zhen” damp eruptions. Heat, damp, and blood stasis. Lung and spleen disorder. |
| Li11 for skin conditions and alleviation., Sp10 invigorates blood, eliminates heat and damp, ST36 for spleen and stomach. |
| Psoriasis | Autoimmune skin condition, red and scaly patches, itching and burning. Genetic or response to medications. |
| Yin xie Bing, silver scaled disease. Bood heat or wind damp. Heat damp, blood stagnation. |
| Liv 3 to clear heat and promote blood circulation, Li4 to assiste autoimmune and inflammation, SP6 for blood circulation. |
| Vitiligo | Loss of skin pigment, autoimmune attacking melanocytes. Bai bo/Bai bi: white scales. |
| Qi and blood . Ren4 to tonify qi and blood. SP10- invigorates blood and pigmentation, BL13 strengthens the lung system. |
| Tinea Versicolor | Fungal skin infection. Patches or spots of discolored skin, |
| Internal imbalance in TCM. External pathogenic factor, spleen and stomach weakness, emotional factor. |
| | Li11 clear heat and resolve toxins, SP10 cool blood and skin, GB20 dispel wind and heat from head, SP6 harmonize blood, Lu7 clear heat from skin. |
| Neuromuscluar Facial conditions | Use of face and scalp points for Bell’s palsy, TMJ, Trigeminal neuralgia, stroke, MS, and others. |
| Scalp: Motor line and sensory lines. Sensory line is behind the motor line. Motor line: 1/3 top is low extremities, 2/3 is upper extremities, last 1/3 face. |
| Find the patten of the patient. |
| Motor is usually on the opposite side, sensory issue treat the same side. |
| Facial motor points | For neuromuscular conditions are beneficial. |
| Motor points for smile: zygomaticus major (si18), |
| Levator labii (between ST2 and Li20), Risorius (0.5 lateral to St4). |
| Submuscular points | Frontalis (GB14)- for eyelids, eye brows, restoring movement of forehead |
| Masseter (ST6, ST7)- TMJ, Jaw, Trigeminal neuralgia (TN) |
| Temporalis and Auricular muscles (GB8,9): TMJ , migraines, facial asymmetry, TN, |
| Corrugator (yintang)- eyebrow movement issues. |
| Auricular points: | Shen men, sympathetic, Face, TMJ, low jaw. |
| Facial cupping | Blood and Qi to the face. Relax tight muscles, move stagnant lymph, increase blood circulation, release facial adhesions, |
| Strengthen vascular integrity of the face. |
| Caution: can irritate damaged skin, shingles, nerve pain patients, open sores, bruise easily and pregnant. |
| Derma rolling | Use on someone without hypersensitivity. |
| Enhances blood circulation, stimulate nerve endings, assist collagen production, enhance absorption of topical treatments. |
| | Helps growth factors and peptides. |
| Treatment style | 1) Sitting up: insert scalp and ear points then lay them down, add body points and any submuscular points. |
| 2) Every 10 minutes twist needles. |
| 3) remove scalp and ear points, then remove remaining points. Perform quick method on motor points if necessary. |
| 4) perform face cupping. |
| Bell’s Palsy: | Facial paralysis, affects eye, mouth. CN VII facial nerve damage. CM: liver blood stagnation, Lung wind invasion, Spleen qi deficiency. |
| Blood stasis: Liv3, GB34, BL17, BL18, SP10, SP6 |
| Wind invasion: LU7, BL12, Du16, Li4, LU11, Du14, Du16, BL12, GB20 |
| Sp def: Ren12, ST36, Sp3, Sp6 |
| Eyes: BL2, GB14, GB1, ST2 |
| Cheeks: ST3, Si18, Li20 |
| Mouth: ST7 toward ST4, ST4 toward ST7, Du26 |
| Scalp: motor area lower 2/5, Sensory: lower 2/5. |
| Facial Cup, Derma roller, Face exercises |
| Ramsy Hunt Syndrome (RHS) | Rare, similar to Bell’s Palsy, affecting CN VII, accompanied with rash, affects ear, maybe tinnitus. Like facial shingles and paralysis. |
| Facial cupping and dermal roller most likely contraindicated due to the sensitivity of the skin. |
| TB17 and SI19 will be useful points. Otherwise follow the Bell’s palsy protocol. |
| Synkinesis | Described like a faulty wiring of musculature, with voluntary muscle movement, some other muscles may engage, like smile causing eyes to contract. |
| Lack of precision in muscle control. Damaged CN VII. |
| CN: Liver yang rising, liver wind, liver fire. |
| Use points to clear liver heat and wind. Cupping and guasha will be beneficial. |
| Stroke | Blood supply to brain is reduced. Blocked artery (ischemic stroke), blood vessel burst (hemorrhagic stroke), |
| Temporary blood block (Transient ischemic attack (TIA) like a clot. |
| CM causes: Kd and Liv disharmony, overworking, aging, diet, emotions. |
| SX: speech problems (Aphasia), facial paralysis, muscular paralysis (hemiplegia). |
| TX: clear wind (GB20, Liv3, Du20) restore consciousness (Du26), BL7 clear wind, ST36 strengthen qi, Kd3 tonify yin. |
| Local points face paralysis: ST4, ST6, ST7, Li4, Li20, BL2 |
| Scalp acupuncture for speech: Ren24, speech area 1, II, and III. |
| Ear: shen men, sympathetic, liver, kidney. |
| Facial cupping and guasha. Dermal roller |
| Temporomandibular Disorder | TMJ, joint and jaw problems, clicking, chewing, moving jaw. Grinding teeth, clenching, can be dislocated soft tissue, mental stress, pain, and tenderness. |
| CM: usually TB, SI, GB, and ST channels. |
| Local: ST6, ST7 to relax masseter. GB4, SI19, TB 17 and tai yang as local. |
| Distal: Li4 for face/jaw, TB5 and GB41 for moving qi in ear area, Liv3/Li4 4 gates for liver qi stagnation and grinding, GB34 for ligaments and tendons. |
| Scalp acupuncture: bilateral needle of sensory area for pain. |
| Motor points: Temporalis and masseter |
| Submuscular needling temporalis and masseter |
| Ear: shen men, TMJ, lower jaw |
| Cupping and guasha: |
| Trigeminal Neuralgia (TN) | Chronic pain CN V, largest nerve in the head. Extreme nerve pain, sensitivity to wind, mentally incapacitating. Usually one sided. |
| Upper branch of nerve supports scalp and forehead sensations, maxillary middle branch supports cheek, upper jaw, top lip, teeth gums, side of nose, |
| Lower branch the mandibular for lower jaw, teeth, lower lip. |
| CN: wind-cold pattern, liver or stomach fire, yin deficiency. |
| Supraorbital: Tai yang, GB14, BL2, yintang, distal: TB5, Li4 |
| Maxillary: ST2, SI18, Li20, distal Li4. |
| Mandibular: ST6, ST7, Jichenjiang (1 cun lateral to Ren24), Li4 |
| Wind cold: GB20, Liver fire: Liv3/Liv2, ST44, yin def.: KD6, SP6. |
| Scalp acu: sensory for face (lower 2/5 |
| Ear: shen men, sympathetic, places based on persons complaints. |
| Avoid cupping, dermal roller, and guasha. Too painful. |
| Multiple Sclerosis (MS) | Chronic and debilitating, attack to central nervous system (CNS), numbness in limbs, strange sensations, loss of movement, variable and unpredictable. |
| Cyclic that it can be in remission and then flare-up. Tingling, ticking, prickling, burning skin sensations. Visual problems, optic nerve. |
| Ms patients with TN might be bilateral. Fatigue, Numbness, muscle weakness, stiffness, balance issues, vision issues, pain, difficult swallowing, |
| Cognitive changes, emotional changes, bladder and bowel issues, heat sensitivity, sexual dysfunction. |
| Immune system targets myelin sheath around nerve fibers. |
| CM: qi and blood stagnation in SP and Liv. Heat and damp in Sp and ST, Kidney and Liver imbalances. |
| Stage I: qi and blood, SP6, SP9, ST36, ST40, Ren12, BL20, Du20, St8 |
| Stage II Damp: Du14, Li4, Li11, SP3, SP6, SP9, ST36, BL2, Du20 |
| Stage III: Sp deficiency: ST36, Ren12, SP3, SP6, SP9, Liv13, BL20, BL21, Du20 |
| Stage III Liver Blood deficiency: SP6, ST36, Liv8, Ren4, BL17, BL18, BL20, Du20 |
| Stage IV kidney deficiency: Ren4, Kd3, KD6, Du4, GB39, BL32, BL23 |
| Scalp: sensor and motor bilateral |
| Ear: shenmen and points corresponding to affected face areas. |
| Motor: only if weakness or tense in face, not for hypersensitive. |
| Submuscular: affected area if they can tolerate it. |
| Cupping and Guasha: only if weak and tense in face and they can tolerate. |
| Derma roller: if no pain is present. |
| Ptosis | Eye Ptosis is when the levator and superior tarsal muscles that rise eyelid are not strong enough. Might be congenital in some. |
| Bell palsy, stroke, or MS person may have. CN II ocular motor nerve. May be nerve disease due to diabetes, brain tumor or myasthenia gravis. |
| Horner’s syndrome or migraines may cause as well. |
| CM: spleen and kidney def., obstruction by wind-phlegm |
| SP and Kd def.: GB14, BL2, Yuyao, TB23, Du20, GB18, ST36, SP6, KD7 |
| SP def with wind-phlegm: BL2, yuyao, Du20, TB23, ST3, SP9, Sp3, ST40, BL4, GB18 |
| Scalp lower 2/5 motor points, Ear: shenmen, Motor points Between TB23 and GB1, Qihou |
| submuscular: frontalis (4 spots) two toward GB14 above BL2 and two above TB23. |
| Facial cup, guasha and derma roller. |
| Hemifacial spasms | Usually left side of face, eye twitching,, can increase in severity |
| CM: Liv Qi stagnation, Liv wind, Liv blood def., KD yin and yang def. |
| Vascular loops affecting facial nerve, at brainstem. |
| Treat according to pattern, cupping and guasha can be used if no pain. |
| Myasthenia Gravis | Autoimmune disease affecting nerve and muscles, weakness and muscle fatigue. Failure at neuromuscular junction. |
| Antibodies and acetylcholine. |
| CM: Blood stagnation, KD yang def, SP Qi def., SP yang def.: tx: deal with the underlying condition |
| Shingles, herpes Zoster | Unrelenting pain, burning, numbness, under skin, small fluid blisters. Usually people over 50 with weak immunity who had chicken pox. |
| 3 to 5 weeks. It can be contagious |
| CM: wind-heat condition, TX: Liv2, GB41, SP10, Li11, Li4, TB5, TB17, Du24, “Surround the dragon”, |
| Ear: shenmen, liver, sympathetic, face |
| Scalp: bilateral lower 2/5 sensor, motor foot area. |
| | Contra: motor points, cupping, dermal roller, guasha. |
| Facial motor points | Electrically excitable part of muscle. At the neuromuscular junction. Some are at or near acupuncture points. |
| They are not trigger points which are knots in the muscles. |
| 18 motor points in the face. |
| Not always necessary but good for stubborn areas. Use 16.. Needles, not past muscle or to bone. |
| Corrugator | Lateral to B2, good for 11’s, forehead paralysis, stroke patient, wrinkles in eyebrows. 0.2 to 0.3 cun. |
| Procurus | At yintang, 0.2 to 0.4 oblique, good for bunny lines, facial expression, lines on sides of nose. |
| Frontalis | GB14, can needle into muscle, but not through. For drooping eyelid, eyebrows, and forehead wrinkles. |
| Orbicularis Oculi | Quihou and between TB23 and GB1. Neuromuscular, eyelids, Ptosis, Bell’s Palsy. |
| Zygomaticus Major | Si18. Deep nasolabial lines, bell’s palsy. Perpendicular, get past fat to the muscle. |
| Zygomaticus minor | Between St2 and ST3. facial paralysis, nasolabial lines. perpendicular, get past fat to the muscle. |
| Levator Labii Superioris | Between Li20 and St2. Wrinkles vertically on side of nose. |
| Mentalis | 0.5 cun lateral to Ren24. For chin lines. |
| Depressor Anguli Oris | level with Ren24 just below ST4. Marionette lines, neck aging. Superficial but not through muscle. |
| Depressor Labii Inferioris | Jiachengjiang. Between Ren24 and Depressor Anguli Oris motor point. Difficult chewing, pursed lips, chin lines. Oblique insertion. |
| Modiolus | Central fibromuscular bundle. 16 muscles directly and indirectly attach there. ST4. All facial disorders. Like the ST36 of the face. |
| Risorius | 0.5 cun lateral to ST4. for crooked smile, facial asymmetry, downward turned mouth. |
| Temporalis | 1 cun anterior to GB8. Drooping skin, TMJ, jaw pain, GB headaches, Tension headaches, tinnitus, hair loss. Do not needle through muscle. |
| Masseter | ST6 and QianZheng. The thick muscle elevates mandible. Facial wrinkles, tight jaw, TMJ, jaw pain, stiffness, teeth grinding, headaches, ear popping, tinnitus. |
| Misshapen face. Qian Zheng is located at lower border of ear lobe anterior and below ST7. |
| Orbicularis Oris | LI19 and between ST4 and Ren24. Lip wrinkles, facial paralysis involving lips and mouth. |
Yongnian Tai Chi 