Mediums used for topical preparations

Apart from tinctures and decoctions, use no more than 4 to 5 herbs/preparation e.g. ointments,
creams and decoctions are the most commonly used preparations.

Water – distilled or boiled and previously filtered, is commonly used in decoctions, steam
inhalations, mouth inhalations and suspensions; used to dissolve powdered herbs and for
moistening. Aqueous creams or water-based creams are usually used as cleansers. They have a thin
consistency and are easily washed off with water, and they can absorb quickly. The best product to
use in aqueous creams is raw powdered herbs, because they keep the volatile oils and the natural
active ingredients of the herbs and are the best for external washes and cleanses. This type of
preparation is only used to about 2-3min at a time, compared to ointments or oil based creams
which are used overnight. You need to ensure that the raw herbs are powdered very fine, otherwise
it can cause scratching of the skin. Instead of powdered herbs you can use tinctures that have the
alcohol burned off first and this will combine a lot more smoothly. The tinctures combine well with
all preparations: oil based, cream based, rather than just the water based aqueous preparations.

Cold pressed sesame oil is moistening – preferably use cold pressed and not refined oils which are
heated. Cooking grade sesame oil is heat processed and tends to become a darker colour. The
fragrance of the cold pressed sesame oil is much milder, and the colour is clear. Oil can go rancid
after opening and should be used within 6mths. Preferably use all the oil for one batch of
preparations, do not leave have empty bottles as the air oxidises the oils very quickly. Cold pressed
sesame oil is moistening and therefore should be used for dry conditions. Sesame in TCM is Yin
nourishing. It is not possible to get black sesame oil at the moment, only white sesame oil. Black
sesame oil is more nourishing. A small amount of oil combined with fine raw powdered herb and an
antioxidant such as VitE as a preservatice can go a long way. It can be purchased through western
herbalists, “Malrose” being a very common brand. You need to use 1:1 ratio, e.g. 10ml of sesame oil
to 10g of raw powder.

Almond oil, rice oil or vegetable oils are another common type of oils used, but mainly for massage.
You can add essential oils, powdered herbs, tinctures, etc. Almond or Xing Ren in TCM resolves
Phlegm and regulates LU Qi. When used as an external oil is nourishing, but not Yin nourishing like
sesame oil. It is a good base for poultices or other types of massage rubs.

Petroleum jelly, coconut oil, ointments and cosmetic grade beeswax are oily preparations. These
have nourishing dryness properties. Some people don’t like man-made products: petroleum jelly and
QV ointment, they prefer natural products such as the coconut oil, shea butter and the beeswax.
Coconut oil is Yin nourishing and will melt easily but also solidifies quickly. You need to place the
coconut oil in a double boil metal bawl and mix in powdered herbs and allow to solidify quickly in
the freezer. The QV ointment is easily mixed with powders as well, it is smooth and soft enough that
it can be used at room temperature. Beeswax is used to make lip balm and it is mixed in hot with
other herbs that have been boiled or steeped in oil.

VitE is another option for nourishing dryness but also acts a preservative due to its high antioxidant
content. This medium is creamed based not oil based and therefore not sticky. It absorbs well, it
doesn’t leave an oil residue and the moistening effects stays for longer than a water-based cream,
but not as long as an oil based preparation. Using tinctures with the alcohol burned off is the most
common way to prepare this cream. We should purchase VitE cream without fragrance to which
some people may be sensitive.
Honey is a medium used in macerations and massage rubs. It moisturizes the skin, but it is sticky.
You can combine raw powders at a 1:1 ratio of decoction to raw hervs to help nourish the skin, or
use it as an overnight wrap.

Alcohol is a common medium. Chinese medicine prefers rice wine as it dredges Wind from the
meridian, regulates Ying and Wei and warms the meridians. It can be purchased from Asian grocers.
There are different qualities of rice wines. A 40% alcohol wine is closed to the preferred ratio of 3
parts alcohol to 2 parts distilled water. 90% ethanol can also be purchased but you need a license
which can be acquired through TGA if you purchase more the 5 gallons and prepare it as 50%-70%
ethanol plus 30% distilled water in a 3:2 ratio, then you can steep raw or dried herbs in it for internal
or external use. Let the mixture sit for a month and then strain the drags out and use the
liquid/tincture. If you use it externally you need to boil off the alcohol first, bring it to a boil, simmer
for about 5min. For internal consumption, only 3-8ml should be ingested x2/daily.

Vinegar is astringing and Yin nourishing and goes to the LR meridian. We generally use either the
alcohol or coconut vinegar or white vinegar to steep herbs, similar to tinctures.

Aqueous solutions include

 Wet compresses, sitz bath in a decoction form, soaks – soaking specific area with a solution,
steam washes, douches, enema and mouthwashes; this are for short term use, between 5 to
15 min soaking and no more than 30min if it is a sitz bath
 Can be used for weeping skin lesions in the acute phase of contact dermatitis or herpes
zoster vesicles
 Have to be used at normal, comfortable temperature, particularly for children the
temperature has to be checked with the elbow
 There has to be a tight contact between the herbs and the surface of the skin, otherwise it is
not going to be effective
 These preparations have to be prepared as needed, the decoctions though can be prepared
2-3 days ahead and then warm them up when needed and keep the reminder in the fridge
 People with kin conditions may have open wounds from scratching or asepsis and there fore
they need to make sure that the herbs are clean and they haven’t gone off before
application

Powdered herbs are used and not granulated which are expensive and they might have lost the
volatile oils required for skin preparations. Raw powdered herbs can be used in acute inflammatory
conditions such as erosions, ulcerations, abscesses but shouldn’t be used in areas with lots of hair
because you don’t get a good powder to surface contact. They should not be used on vesicles such
as acute allergic dermatitis or pustules such as in acne, as it will form a crust and stop the natural
healing process. Powdered herbs can be sprinkled directly on the lesions or combined with honey.
For open wounds ensure that the powder is very fine.

Suspensions

Suspensions are where the powdered herbs – insoluble solids, are dispersed in a liquid (water, fat,
gel, or an aqueous oily liquid), usually more liquid than solids. The mixture thus formed is
heterogenous as the solids are not being dissolved. Suspensions should be used in acute
inflammatory skin conditions which have very little or no exudation or erosion such as acne or
miliaria rubra. E.g. of externally applied suspension: Calamine lotion. Suspensions need to be used
with caution in the elderly as they lose heat easily and should not be used on more than 1/3 of the
body.
Tinctures

Tinctures and infusions are prepared with alcohol, wine or vinegar. For infusions oils also can be
used. Tinctures have to be prepared one month prior to use then decanted and bottled with
appropriate labelling – record the date when it was prepared not when it was bottled. Tinctures are
used to resolve dampness, dispel wind and to kill warms and they are used in chronic skin conditions
such as itching, pruritic skin, urticaria and tinea. Should not be used in acute inflammatory skin
conditions, broken skin, erosions, fissures or chapped skin as it can give a burning sensation to
patients. It should be diluted before use.

Oil preparations

Oil preparations are powdered herbs infused into oils e.g. Qing Dai oil. What about tinctures,
decoctions? These preparations are used to clear Heat, moisten the skin, prevent cracks, generate
flesh, promote hair growth, etc. Often these preparations stain (not permantely) and are greasy,
therefor need to wrapped with a cloth and foil.

Emulsions

These are preparations containing a mixture of oil and water. You combine first the powdered herbs
with the oil into a paste then add the water gradually before applying it to the affected area. It is
applied on areas of acute inflammation, burns to disperse swelling and sooth the skin. In comparison
the oil based preparations are used more for dryness. These preparations deteriorate quickly so you
only make them when you need them and use quickly.

Rubs

Rubs are medicated powders combined with natural plant products or solid oils e.g. coconut oil.
Plants such as aloe vera, bitter gourd, eggplant, cucumber are often used wrapped in a cloth with
herbs (gauze, muslin, cheescloth), to rub the powders on the skin or hard masses to soften them.
They are usually used for atopic dermatitis with lichenification, stubborn tinea, chronic eczema,
psoriasis, vitiligo to relieve itching or increase pigmentation.

Message preps

Are very similar to rubs. Instead of using moist tubers, solid oils such as lard or coconut oil are mixed
with herbs to make a bolus and used on hardened areas. It can moisten skin, soften hardness,
alleviate itching, resolve scales in conditions such as neurodermatitis, lichenification. DO NOT RUB
TOO HARD, MAY CAUSE BLEEDING.

Ointments

Ointments are usually made with VitE cream, Vaseline, lanoline, honey, vinegar, wine, oil, lard, etc.
Powdered herbs, essential oils or tinctures are added and these preparations store well for up to 1
year as the alcohol and the oils are natural preservers. Ointments can be used to moisten skin,
disperse swelling, soften hard lumps, moisten chapped or fissured skin, clear toxic heat in
suppurative lesions. However, these preparations should not be used in skin lesions with profuse
weeping (oozing, exuding fluid) or severe erosion which are conditions with excess Damp.

Plasters

Plasters are hard to make. There are many commercial preparations and it is probably better to buy
them ready made. The ingredients usually involve camphor, menthol oil, or other volatile oils with
warming nature and various herbs. To make these preparation you boil the herbs down to a thick
consistency then add beeswax and place on a stretchy material to dry and then apply as needed.

How to make plasters

http://www.internalartsinternational.com/free/making-medicine-gaos-plasterspastes/

https://www.youtube.com/watch?v=U2YMGYj9LaI

Ingredients: Methyl Salicylate 6.3%, Camphor 1.2%, Menthol 5.7%, Tocopherol Acetate 2.0%.

Indications: For relief of aches and pains associated with muscle fatigue, painful stiff shoulders,
simple backache, bruises, sprains, strains and arthritis. Made in Japan

Fuming/Steaming

This method is used to treat chronic ulcers that don’t heal, thickened lichenificationof the skin, or
pruritus. These are hot decoctions that are used over a basin or pot with a towel over the head, or
using hot sauna sprays. It is contraindicated in patients with acute inflammatory diseases, asthma,
bronchitis, respiratory symptoms, weak constitution as the steam can be irritating to the mucous
membrane, mouth, nose, eyes in these patient.

http://istore.com.np/beauty-health-and-grocery/skin-care/skin-care-equipment/electrocare-hjot-
facial-sauna-spa-skin-renewal-sprayer-mist-sprayer-steamer-skin-care/

When considering using external herbal prep. we need to think whether the herbs need to be
heated
What is a Suspension?

A finely divided solid dispersed (suspended) in a liquid (the dispersing medium).

Some substances are insoluble in all acceptable media and must, therefore, be administered as a
suspension. Suspensions are intended for oral administration or for topical application where they
are referred to as "lotions”. Suspension are also used as formulations for parenteral routes of
administration (e.g., intraocular, intranasal, IV, IM, ID, SC). E.g. oral pharmaceutical suspensions
paracetamol, antacids, tetracycline, HCl. or parenteral suspensions e.g. insulin, penicillin, procaine,
cortison etc.

When used externally, suspensions act as protective agents. The active ingredients of herbs in
suspension are chemically more stable than in solution.

Suspensions also possess some disadvantages. The primary disadvantage is their physical instability;
i.e., that they tend to settle over time leading to a lack of uniformity of dose. This can, however, be
minimized by careful formulation and by shaking the suspension before each dose is delivered. An
additional disadvantage is that the texture of suspensions may be unpleasant to patients and should
be carefully considered during formulation by adding sweeteners.

Physical stability in suspensions is controlled by (1) the addition of flocculating agents to enhance
particle "dispersability" and (2) the addition of viscosity enhancers to reduce sedimentation rate in
the flocculated suspension. Viscosity enhancers include: natural hydrocolloids such as Acacia,
tragacanth, alginic acid, carrageenan, locust bean gum, guar gum, gelatin or clay such as Bentonite.

Gels can be used to administer medications orally, topically, vaginally, and rectally.

What is Shea butter?

Shea butter is a fat extracted from the nut of the African shea tree (Vitellaria paradoxa). It is usually
yellow in colour when raw, with unrefined, refined, and ultra-refined shea butter being ivory or
white in colour. It is widely used in cosmetics as a moisturizer, salve or lotion. Shea butter is edible,
occasionally being used in the chocolate industry mixed with other oils as a substitute for cocoa
butter, although the taste is noticeably different.

Shea butter extract is a complex fat that in addition to many non-saponifiable components
(substances that cannot be fully converted into soap by treatment with alkali) contains the following
fatty acids: oleic acid (40–60%), stearic acid (20–50%), linoleic acid (3–11%), palmitic acid (2–9%),
linolenic acid (<1%) and arachidic acid (<1%).

Shea butter is solid at room temperature but it melts at body temperature. Proponents of its use for
skin care maintain that it absorbs rapidly into the skin, acts as a "refatting" agent, and has good
water-binding properties. It is an excellent emollient for dry skin. No evidence shows it is a cure, but
it alleviates the pain associated with tightness and itching.

Shea butter is mainly used in the cosmetics industry for skin- and hair-related products (lip gloss,
skin moisturizer creams and emulsions, and hair conditioners for dry and brittle hair).

Shea butter can also be used as a base for medicinal ointments. Some of the isolated chemical
constituents are reported to have anti-inflammatory, emollient, and humectant properties. Shea
butter has been used as a sun blocking lotion and some of its components "have limited capacity to
absorb ultraviolet radiation".
In Ghana, shea butter is applied as a lotion to protect the skin during the dry season. In Nigeria, shea
butter is used for the management of sinusitis and relief of nasal congestion. It is massaged into
joints and other parts of the body where pain occurs.

Classification

In US shea butter is classified into five grades:

1. A (raw or unrefined, extracted using water)

2. B (refined)
3. C (highly refined and extracted with solvents such as hexane)
4. D (lowest uncontaminated grade)
5. E (with contaminants).

Commercial grades are A, B, and C. The colour of raw (grade A) butter ranges from cream (like
whipped butter) to greyish yellow. It has a nutty aroma which is removed in the other grades. Grade
C is pure white. While the level of vitamin content can be affected by refining, up to 95% of vitamin
content can be removed from refined grades (i.e., grade C) of shea butter while reducing
contamination levels to undetectable levels.

What is Cocoa butter?

Cocoa butter is a pale-yellow, edible vegetable fat extracted from the cocoa bean, which are
fermented, roasted, and then separated from their hulls. It has a cocoa flavour and aroma, being
used to make chocolate, as well as some ointments, toiletries, and pharmaceuticals.

Cocoa butter is solid at room temperature but it melts at body temperature (melting point of around
34–38 °C) as it contains a high proportion of saturated fats which are derived from stearic and
palmitic acids. Cocoa butter, unlike cocoa solids, has no more than trace amounts of caffeine and
theobromine (a bitter substance which can be tasted in cocoa). Typical fatty acids composition:
Arachidic acid (C20:0) 1.0%, Linoleic acid (C18:2) 3.2%, Oleic acid (C18:1) 34.5%, Palmitic acid (C16:0)
26.0%, Palmitoleic acid (C16:1) 0.3%, Stearic acid (C18:0) 34.5%, Other Fatty Acids 0.5%. Adulterated
cocoa butter is indicated by its lighter colour and its diminished fluorescence upon ultraviolet
illumination. Unlike cocoa butter, adulterated fat tends to smear and have a higher non-saponifiable
content.

Cocoa butter is one of the most stable fats known. This quality, coupled with natural antioxidants,
prevents rancidity – giving it a storage life of two to five years. The velvety texture, pleasant
fragrance and emollient properties of cocoa butter have made it a popular ingredient in products for
the skin, such as soaps and lotions.

As a nontoxic solid at room temperature that melts at body temperature, it is considered an ideal
base for medicinal suppositories. The moisturizing abilities of cocoa butter are frequently
recommended for prevention of stretch marks in pregnant women. However, the largest clinical
study regarding the effects of cocoa butter on stretch marks in pregnant women found that results
were no different from a placebo. Cocoa butter's moisturizing properties are also said to be effective
for treating mouth sores, for the treatment of chapped or burned skin and lips, and as a daily
moisturizer to prevent dry, itchy skin.

Making a herbal cream

https://www.youtube.com/watch?v=2gkDoMNz8RQ
https://www.youtube.com/watch?v=8J6o8GVKs58

https://www.youtube.com/watch?v=WOTXvwksUAU

https://www.youtube.com/watch?v=yycfw5U3wbk