Eczema product review: TOPICMedis Calming Lotion (traditional Chinese herbal)

My take on traditional Chinese medicine (TCM), of the herbal variety, is that the theory is bullshit. Yin/yang? The "five elements" being wood, fire, earth, metal, and water? "Energy meridians"? Medieval thinking.

Herbal medicine, though, is a major foundation of modern pharmacy. TCM herbs contain molecules that are biologically active--what Western medicine would call drugs.

This is why I doubt that the TCM practice of dosing with several (sometimes nine or ten) herbs in combination is a good idea. The potential for side effects and drug interactions is too high.

I acknowledge that empirical, practical knowledge is a powerful way to solve problems, and that TCM could work for certain conditions in the right circumstances. You would need to have a very experienced TCM practitioner treating a patient for a condition that the expert was familiar with. You could get results--even though the theory is bunk.

But I am skeptical when companies market TCM herb-containing products directly to consumers. The treatment can't be tailored to the patient. The dosing and quality control are dubious. How do you know what the active ingredients are, and are they consistent from batch to batch?

And most importantly, who has verified that these things work and aren't toxic?

The answer is: nobody.

Recently I was asked whether I would review TOPICMedis Calming Lotion, a product of the Israeli company Kamedis. The lotion contains four TCM herbal extracts. I was intrigued, and agreed--because I wanted to learn which TCM herbs might be useful in treating eczema.

So what's in TOPICMedis Calming Lotion?

The first three ingredients listed are "water, glycerin, dimethicone & cyclotetrasiloxane & polysilicone-11."

I like dimethicone. It's a rubbery polymer that Aveeno includes in their Daily Moisturizing Lotion and I find it seals moisture into my skin. Not exactly a traditional herb though.

The lotion contains extracts from four herbs: Rheum palmatum, Scutellaria baicalensis, licorice root, and Cnidium monnieri. I couldn't find any information about how much of any of these was actually in the product.

Right now I have eczema in a number of places including the backs of my hands. I rubbed Kamedis lotion into my left hand, and used the usual stuff on my right hand: Eucerin and Aveeno. I tried this for three days. I saw no difference between my right hand and my left. (No improvement in either.)

As weak as my trial was as a scientific exercise, I did better than Kamedis in one respect: I used a control. Kamedis tells me they have conducted a clinical trial that shows their lotion improves symptoms in 20 patients with eczema. They did not use a control group: either a group that received no treatment or a group that received a standard treatment. Therefore their trial is of no value.

This prompted me to look at how TCM herbs regulated in the United States. I hadn't thought about this before. I was surprised--and appalled--to learn that to a great degree TCM herbs are not regulated at all.

Amazing, isn't it? Drug companies pay huge settlements when it turns out that a new drug has a fatal side effect in a tiny subset of users. Drugs must undergo an enormous battery of tests to verify efficacy and non-toxicity in animals and humans. Drug manufacturers employ stringent quality control to ensure the same dose is in every pill or ointment. TCM herbs don't have to pass any tests. We're supposed to rely on folk wisdom and the goodwill of the company selling the product.

We can thank the Dietary Supplement Health and Education Act of 1994 (DSHEA) for tying the FDA's hands when it comes to regulating dietary supplements. The Kamedis lotion isn't a supplement, it's a cosmetic, and the FDA is supposed to regulate cosmetics, but TCM falls into a category that isn't controlled strongly if at all--and I am sure there are loopholes that companies can use to get pretty much any products on the shelves in stores or on the internet.

If anyone knows more than I do about TCM regulation in the United States, I would appreciate clarification.

I remain appreciative of TCM's potential, but it is a jungle out there. There's way too much potential for quackery (expensive placebos), danger for side effects and drug interactions with TCM components and conventional therapies. And even if you have the right TCM herb, how can you ensure the same amount of active ingredient is in each batch?

I appreciate the opportunity Kamedis gave me to test their lotion--at the very least, it alerted me to four herbs that (I'm guessing) TCM practitioners have used over the ages to treat eczema. Maybe one or more of them contain novel molecules that can be formulated to provide real, quantifiable benefit.