Topical Applications

Not only can the remedies be used internally, but the whole array of topical
formulations developed over the years become relevant. Herbs offering a
range of actions that directly impact the skin can be applied directly by
choosing the most relevant method from the list below.

For details of techniques, please refer to the pharmacy section and and
the supplemental reading of The Herbal Medicine-Makers Handbook,
by James Green. Actions that may be used this way include can be divided
into two broad groupings:

1. Actions to specifically act locally on the areas of the skin the herbs
   are applied to. Relevant actions include: anti-inflammatory, anti-microbial,
   anti-pruritic, astringent, emollient, rubefacient,
   vulnerary
   

2. Actions intended primarily for internal effect but utilizing absorption
   through the skin as an entry point. This would potentially include all of
   the actions, but most commonly the alteratives have been used this way.
   

Bath/Balneotherapy: One of the pleasanter forms of apply medications
to the skin! They are especially useful in treating widespread eruptions
of the skin, removing crusts, scales and relieving inflammation and itching.
Basically anything added to a bath would count as balneotherapy. Commonly
used are:

• Salts. Ranging from simple table salt or epsom salts to important
  salt from the Dead Sea.
  

• Oils. Essential oils can be added to supply the wide range of
  properties these offer, acting through the skin but also via the nose. Fixed
  oils may be used as well for their lubricating and softening properties.
  

• Extracts. These can be infusions, decoctions, tinctures etc.
  
  

• Colloidal Oatmeal. This can be very anti-pruritic and drying
  in conditions such as weeping eczema or psoriasis.
  

Open Wet Dressing/Fomentation/Compress: This is the application
of a liquid formulation locally. It has the advantage of conveniency and
relative cleanliness (as compared to a poultice). Infusions, decoctions,
tinctures, oils etc. can all be used in this way.

Poultice: Similar to the above but uses the herb in some solid form.
This might be whole leaf, mashed cut herb or any relevant form applied directly
to the skin and held in place with a cloth.

Lotion: Liquid formulations for carrying the herbs. The specific
effects will depend upon both herbs and vehicle. There will usually be a
cooling effect because of evaporation, whatever the remedies contained.
They rarely need washing off, as part will be absorbed & the rest evaporate.

Cream: These are suspensions of oil in water, and can be formulated
to be greasy or non-greasy. They are primarily emollient and protective.
An advantage of creams is that they do not insulate the skin too much, thus
not causing a localized rise in skin temperature. Over-heating will aggravate
the itching in many skin problems.

Ointments: These are semi-solid lipid based applications. Because
of the fats used as bases, e.g. cocoa butter and beeswax, they extract plant
constituents well, soften at skin temperature and thus make the extracted
material available to the skin. As with creams they are emollient and protective,
but stay on the skin longer. This tenacity will have a warming effect locally.

Pastes: Mixtures of powder in an ointment base. A traditional pharmaceutical
formulation that is, unfortunately, becoming rarer. This is largely a matter
of convenience for dispensers because they can be very time consuming to
make. Indicated when the effects of the herbs are wanted on the surface
for extended periods of time. Their contents are not absorbed well, but
impact the surface. Useful in conditions such as psoriasis where they facilitate
the removal of scales.

Powders: This are dry fine powdered herbs or minerals. Examples
are colloidal oatmeal, lycopodium powder, cornstarch and various clays.
Their primary benefit is that they take up moisture (being hygroscopic).
This might be an exudate in eczema or perspiration. They may also be anti-pruritic
and anti-microbial.


Tonics for wellness

Actions for the system

Alteratives
As with the musculo/skeletal system, the skin is often the focus for manifestations
of systemic illness. For the phyto-therapist it is no surprise therefore
that alteratives are again the cornerstone for any fundamental healing
transformation. Please review the section concerning alteratives.

The therapist is constantly faced with the challenge of selecting appropriate
alteratives for any particular individual. The selection model helps through
its focus on secondary actions and system affinity, but sometimes this does
not help. I have found the following generalization to be helpful. Bear
in mind, however, that as with all generalization there are many exceptions.

It is possible to broadly group the alteratives based on their botany and
also on their impact on elimination.

Part used: (Primary elimination pathway:)

Example:

Leaf (Kidney: Diuretic)

Galium aparine

Urtica dioica

Root/Rhizome/Wood (Liver: Hepatic)

Arctium lappa

Hydrastis canadensis