Xiao Feng San (Eliminate Wind Powder from True Lineage)

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Indications

Western Uses:

• What is Xiao Feng San used for in modern practice?

  In modern practice, Xiao Feng San is reached for when a presentation fits its wind-damp-heat skin pattern — most often atopic dermatitis/eczema and urticaria (hives) during an active, weeping, intensely itchy flare, and sometimes contact dermatitis showing a similar damp-heat picture.

  These are pattern-based reference framings: the formula is selected because the presentation matches its wind-damp-heat pattern, not on the strength of the Western diagnostic label alone, and a qualified practitioner or dermatologist should confirm any diagnosis.

  Source: Bensky & Barolet, Formulas & Strategies (2nd ed.); reported uses corroborated by clinical-trial literature (PMID 21196758). Reference framing only; not a medical claim.

Originally Appeared In:

• True Lineage of External Medicine (Wai Ke Zheng Zong)

Notes:

• How does Xiao Feng San differ from other wind-skin formulas, and how is it modified?

  Xiao Feng San is the reference formula for an active, weeping, damp-heat-type skin eruption; its defining contrast is with formulas for the chronic, dry, blood-deficient stage of the same skin diseases.

  • vs Dang Gui Yin Zi (Tangkuei Drink): Dang Gui Yin Zi treats chronic, longstanding itchy skin driven by blood deficiency generating internal wind — dry, scaly, thickened skin without weeping, often in older or more depleted patients — and leans on blood-nourishing herbs (Dang Gui, Bai Shao, Shu Di Huang, He Shou Wu) rather than wind-dispersing/damp-draining ones. Xiao Feng San sits at the opposite, acute, damp-heat-heavy, weeping end of the same clinical spectrum.
  • vs Fang Feng Tong Sheng San: shares Fang Feng and Shi Gao and likewise addresses wind-heat with interior excess, but Fang Feng Tong Sheng San is built to simultaneously release the exterior and purge interior heat/constipation through the stool, for a broader systemic excess-heat presentation. Xiao Feng San is targeted specifically at the skin, with dedicated damp-draining and blood-nourishing herbs that Fang Feng Tong Sheng San does not include.

  Classical source: Wai Ke Zheng Zong ("True Lineage of External Medicine," also translated "Orthodox Manual of External Diseases"), the influential Ming-dynasty surgery and dermatology text by Chen Shi-Gong (1617) — matching the origin already recorded in the Sacred Lotus formula database. The generic title "Xiao Feng San" ("eliminate wind powder") has been used for more than one herb combination across the wider TCM formulary literature over the centuries; the version described here is specifically the Wai Ke Zheng Zong formula.

  Common modifications:

  • For more severe, unrelenting itch, Bai Xian Pi (Cortex Dictamni) or Di Fu Zi (Kochia fruit) are commonly added.
  • For pronounced redness and blood-level heat, Mu Dan Pi or Zi Cao may be added to strengthen the blood-cooling action.
  • For more prominent oozing/weeping, Che Qian Zi or Huang Qin may be added to reinforce damp-draining.

  Source: Bensky & Barolet, Formulas & Strategies (2nd ed.), comparisons, classical source, and modifications; cross-referenced against multiple online sources. Reference only.

Clinical Studies & Research:

• Is there modern research on Xiao Feng San?

  Yes — Xiao Feng San has a real clinical-trial literature specifically for atopic dermatitis, which is unusual for a classical formula. A randomized, double-blind, placebo-controlled trial in patients with refractory (treatment-resistant) atopic dermatitis found a substantially greater reduction in lesion-severity scores with Xiao Feng San than with placebo over eight weeks of treatment, with the improvement still present four weeks after stopping; no treatment-related adverse effects were reported, though some participants found the taste unpalatable. A more recent randomized trial combined Xiao Feng San with auricular acupuncture in adults with non-severe atopic dermatitis and found significantly greater improvement in SCORAD severity scores when acupuncture was added to the herbal formula, compared with the herbal formula plus sham acupuncture, over four weeks; adverse events in that trial were mild.

  Both trials evaluated atopic dermatitis specifically, against standardized severity scales (lesion scores, SCORAD). This is reported as research context on the formula's studied use, not as a treatment claim or a substitute for a dermatologist's evaluation.

  Sources: PMID 21196758 (Int Arch Allergy Immunol, 2011); PMID 41104111 (Integr Med Res, 2026). Research context, not a therapeutic claim.