Formula Ointment (Ruan Gao)

Huang Lian Gao

Huanglian Ointment · 黄连膏

A classic Chinese herbal ointment that cools Heat, dries oozing and itching, and soothes painful, inflamed skin. It is used topically on eczema, burns, boils, acne and other hot, red, swollen skin conditions, helping to reduce inflammation and speed the healing of damaged tissue.

Origin 《医宗金鉴》(Yi Zong Jin Jian), Volume 65 — Qing dynasty, 1742 CE
Category External formulas for External disorders Topical formulas for sores and wounds Externally-applied disease formulas (surgical formulas)
Therapeutic focus Skin health Eczema relief Burn care Wound healing Inflammatory skin conditions
Composition 5 herbs
Huang Lian
King
Huang Lian
Huang Bo
Deputy
Huang Bo
Di Huang
Deputy
Di Huang
Dang Gui
Assistant
Dang Gui
Jiang Huang
Assistant
Jiang Huang
Explore composition

Educational content • Consult qualified TCM practitioners for diagnosis and treatment

Patterns Addressed

In TCM, symptoms don't appear randomly — they cluster into recognizable patterns of disharmony that reveal what's out of balance in the body. Huang Lian Gao is designed to correct these specific patterns.

Why Huang Lian Gao addresses this pattern

Toxic-Heat is the primary pathological driver of boils, carbuncles, and infected skin ulcers — it creates intense local redness, swelling, heat and pain. Every herb in this ointment either clears Heat (Huang Lian, Huang Bo, Sheng Di Huang) or resolves Toxin (Huang Lian, Huang Bo), directly extinguishing the toxic fire at the site.

A practitioner would look for one or more of these signs

Skin Boils

Painful, red, swollen lumps on the skin, sometimes with pus

Burns

Red, hot, painful skin after thermal injury; may blister

Acne Vulgaris

Inflamed, pus-filled pimples on face or back

Commonly Prescribed For

These conditions can arise from the patterns above. A practitioner would consider Huang Lian Gao when these conditions are specifically caused by those patterns — not for all cases of these conditions.

Arises from: Damp-Heat Toxic-Heat

TCM Interpretation

In TCM, eczema is seen as a manifestation of Damp-Heat or Toxic-Heat that has penetrated the skin. The Dampness creates oozing and crusting, while Heat produces redness, swelling and itch. Over time, Blood may also become involved, causing dry, thickened, scaly plaques. The condition often originates from an internal imbalance—frequently involving the Spleen and Stomach—but the external ointment works locally to bring immediate relief by draining the pathogenic factors that are actively affecting the skin.

Why Huang Lian Gao Helps

Huanglian Gao directly addresses the two key pathogenic factors: Huang Lian and Huang Bo drain Dampness and cool Heat, while Sheng Di Huang cools the Blood and moistens the skin to prevent the dryness that can follow the use of strong drying herbs. Dang Gui Wei and Jiang Huang improve blood flow to the damaged area, speeding up the repair of the skin barrier. Modern research confirms that the berberine in Huang Lian reduces the release of IL-4, IL-6 and other inflammatory cytokines, and that the whole formulation shifts the local immune response toward healing.

Also commonly used for

Skin Boils

Drains Fire and resolves Toxin to eliminate painful, inflamed boils and folliculitis

Acne Vulgaris

Reduces inflammatory papules and pustules by clearing Heat and Dampness from the skin

Psoriasis

Cools Blood, moistens Dryness and relieves the itching and scaling of plaque psoriasis

Bedsore

Invigorates Blood and generates flesh to heal pressure sores in immobile patients

What This Formula Does

Every TCM formula has a specific set of actions — here's what Huang Lian Gao does in the body, explained in both everyday and TCM terms

Therapeutic focus

In practical terms, Huang Lian Gao is primarily used to support these areas of health:

Skin health Eczema relief Burn care Wound healing Inflammatory skin conditions

TCM Actions

In TCM terminology, these are the specific therapeutic actions that Huang Lian Gao performs to restore balance in the body:

Clears Heat and resolves Toxin Dries Dampness and relieves itching Cools the Blood and moistens Dryness Invigorates Blood and alleviates pain Promotes tissue regeneration and heals wounds

How It Addresses the Root Cause

TCM doesn't just suppress symptoms — it aims to resolve the underlying imbalance. Here's how Huang Lian Gao works at the root level.

This formula is designed for localised skin disorders caused by accumulation of Damp-Heat and Toxic-Heat in the body. These pathogenic factors may arise from internal organ imbalances—such as Heat in the Lung meridian pushing upward toward the nose—or from direct external attack. The Heat and Toxin cause redness, swelling, burning pain and, when mixed with Dampness, oozing, weeping or scaling. If the Heat enters the Blood level, it can damage the skin’s nourishment, leading to dryness and delayed healing. The ointment works topically to drain Fire, expel Dampness, cool the Blood and free up the local circulation, so inflammation resolves and new tissue can form.

Formula Properties

Every formula has an inherent temperature, taste, and affinity for specific organs — these properties determine how it interacts with the body

Overall Temperature

Cold

Taste Profile

Predominantly bitter and acrid — bitter to clear heat and dry dampness, acrid to move blood and disperse stagnation.

Target Organs

Lungs Stomach

Channels Entered

Heart Liver Stomach Large Intestine

Ingredients

5 herbs

The herbs that make up Huang Lian Gao, organized by their role in the prescription

King — Main ingredient driving the formula
Deputy — Assists and enhances the King
Assistant — Supports or moderates other herbs
King — Main ingredient driving the formula
Huang Lian

Huang Lian

Coptis rhizome

Dosage 9 - 12g
Temperature Cold
Taste Bitter (苦 kǔ)
Organ Affinity Heart, Liver, Stomach, Large Intestine, Gallbladder, Spleen

Role in Huang Lian Gao

Clears Heat, drains Fire, dries Dampness, and resolves Toxin. Directly targets the core pathomechanism of toxic heat and damp-heat in the skin.
View herb details
Deputies — Assists and enhances the King
Huang Bo

Huang Bo

Phellodendron bark

Dosage 9 - 12g
Temperature Cold
Taste Bitter (苦 kǔ)
Organ Affinity Kidneys, Urinary Bladder

Role in Huang Lian Gao

Reinforces the Heat-clearing and Dampness-drying action, and strongly resolves Toxin. Works synergistically with Huang Lian to control severe local inflammation.
View herb details
Di Huang

Di Huang

Rehmannia root

Dosage 30 - 37g
Temperature Cold
Taste Sweet (甘 gān), Bitter (苦 kǔ)
Organ Affinity Heart, Liver, Kidneys

Role in Huang Lian Gao

Cools the Blood, nourishes Yin, and moistens Dryness. Prevents the heat-clearing herbs from damaging Yin and Body Fluids, and addresses the skin dryness and cracking that accompany many hot-skin conditions.
View herb details
Assistants — Supports or moderates other herbs
Dang Gui

Dang Gui

Chinese Angelica root

Dosage 15 - 18g
Temperature Warm
Taste Sweet (甘 gān), Acrid / Pungent (辛 xīn)
Organ Affinity Liver, Heart, Spleen

Role in Huang Lian Gao

Activates the Blood, resolves Stasis, and promotes tissue regeneration. Improves circulation to the affected area to relieve pain, reduce swelling, and speed wound healing.
View herb details
Jiang Huang

Jiang Huang

Turmeric rhizome

Dosage 9 - 12g
Temperature Warm
Taste Acrid / Pungent (辛 xīn), Bitter (苦 kǔ)
Organ Affinity Spleen, Liver

Role in Huang Lian Gao

Moves Blood and Qi, breaks Stagnation, and alleviates pain. Assists the other herbs in penetrating the skin and reaching the site of lesion.
View herb details

Why This Combination Works

How the herbs in Huang Lian Gao complement each other

Overall strategy

The formula targets Damp-Heat and Toxic-Heat lodged in the skin by combining cold, bitter, and drying agents with Blood-moving and tissue-repairing substances. It is applied locally so the active constituents can penetrate the lesion directly without first being digested and absorbed.

King herbs

Huang Lian (Coptis) is the primary herb: intensely cold and bitter, it clears Heat, drains Fire, dries Dampness and resolves Toxin. Its berberine content provides strong anti-inflammatory and antimicrobial actions that form the backbone of the ointment’s effect.

Deputy herbs

Huang Bo (Phellodendron) doubles down on the Heat-clearing and Dampness-drying action and works particularly well on lower-body or deep-seated lesions. Sheng Di Huang (Rehmannia) cools the Blood and nourishes Yin — it counteracts the potential drying effect of the King herb and treats the redness and scaling that signal Heat in the Blood level.

Assistant herbs

Dang Gui Wei (Angelica tail) and Jiang Huang (turmeric) both invigorate Blood and break Stasis. They relieve pain, reduce swelling and promote the growth of healthy granulation tissue. Their warm, acrid nature also helps prevent the formula from becoming overly cloying or cold, ensuring the active ingredients are carried into the tissue.

Envoy herbs

The sesame oil and beeswax serve as the vehicle that binds the medicinal substances and keeps them in contact with the skin. They also moisten and protect the skin surface, providing a barrier that supports healing.

Notable synergies

The pairing of Huang Lian and Huang Bo is one of the classic combinations for damp-heat skin disorders, amplifying the drying and antidotal effect. Sheng Di Huang with Dang Gui Wei cools Blood while simultaneously moving Blood, so stagnation is resolved without generating dryness — an ideal combination for hot, painful, poorly healing lesions.

How to Prepare

Traditional preparation instructions for Huang Lian Gao

Soak the five medicinal ingredients in 360 g of sesame oil for one day. Heat slowly over a gentle flame until the herbs darken and become charred, then remove the residue and filter the oil. Add 120 g of melted beeswax to the warm oil and stir continuously until the mixture cools and solidifies into a uniform ointment. Spread onto a gauze pad and apply to the affected area, changing every 1–2 days.

Related Formulas

Formulas often compared to or combined with Huang Lian Gao, with a side-by-side look at how their compositions differ

Similar indication
Cool 10 herbs Plaster -external (Gao)

A classical external-use paste for treating hot, red, swollen, and painful skin conditions such as boils, abscesses, and soft tissue injuries. It clears Heat-toxin, reduces swelling, disperses stagnation, and relieves pain when applied topically to unbroken skin. Originally formulated as a powder (Ru Yi Jin Huang San), it is mixed with an oily base like sesame oil and beeswax to form the paste.

Therapeutic focus
Skin Health Skin and Wound Care Joint and Muscle Pain Relief

How it compares

Both are topical ointments for Toxic-Heat skin disorders. Jin Huang Gao emphasizes drying and swelling reduction with the inclusion of Da Huang and Tian Hua Fen, while Huanglian Gao places more weight on Blood-cooling and tissue regeneration. Huanglian Gao is preferred when there is more Dampness and weeping, or when the skin needs nourishing and regeneration.

Composition comparison

Shared (2)
Huang Bo Jiang Huang
Only in Huang Lian Gao (3)
Huang Lian Di Huang Dang Gui
Only in Jin Huang Gao (8)
Tian Hua Fen Da Huang Bai Zhi Cang Zhu Hou Po Chen Pi Tian Nan Xing Gan Cao

Educational content — always consult a qualified healthcare provider or TCM practitioner before using any herbal formula.

Contraindications

Situations where Huang Lian Gao should not be used or requires extra caution

Avoid

Yin-type sores (疮疡阴证) — cold, non-red, non-painful, deep abscesses without heat signs. The formula is cooling and will worsen cold patterns.

Avoid

Deep burns, severe trauma, or large open wounds — may allow excessive systemic absorption and irritation; requires professional assessment first.

Avoid

Known allergy to any ingredient, especially Huang Lian (Coptis), Huang Bai (Phellodendron), or sesame oil.

Avoid

Pregnancy — contains blood-moving herbs (Dang Gui Wei, Jiang Huang) and strong cold herbs that may affect the fetus; contraindicated especially in the first trimester.

Caution

Breastfeeding — use with caution and only on small intact skin areas; avoid application to large areas or broken skin due to possible systemic absorption.

Caution

Infants under 1 year — use only under direct practitioner supervision; skin is more permeable and sensitive.

Caution

Application near eyes or mucous membranes — may cause irritation.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

Contraindicated during pregnancy, especially in the first trimester. The formula contains blood-invigorating and blood-moving herbs (Dang Gui Wei, Jiang Huang) that may stimulate uterine contractions, and strong cold herbs (Huang Lian, Huang Bai, Sheng Di Huang) that can disrupt the pregnancy. No safe level has been established; avoid entirely.

Breastfeeding

No specific data on breast milk transfer exists for the herbs in this formula. As an external ointment, systemic absorption is generally low when applied to small intact skin areas. However, caution is advised: avoid applying to large areas, broken skin, or under occlusive dressings, as increased absorption could theoretically expose the infant to berberine and other compounds. Discontinue use and consult a practitioner if the nursing infant develops diarrhea, rash, or unusual symptoms.

Children

Use in children only under the guidance of a qualified practitioner. Infants under 1 year have more permeable skin and should not be treated without professional supervision. Apply sparingly to small areas only; avoid prolonged use and occlusive dressings. Monitor for local skin reactions. The formula has been used in clinical settings for neonatal red buttocks (diaper rash) and pediatric eczema with reported safety when properly supervised.

Drug Interactions

If you are taking pharmaceutical medications, be aware of these potential interactions with Huang Lian Gao

No well-documented drug interactions exist for topical application of Huang Lian Gao. Systemic absorption is minimal when applied to intact skin. However, if used on large areas of broken skin, berberine (the main alkaloid in Huang Lian) could theoretically be absorbed and interact with drugs metabolized by CYP3A4 and CYP2D6, or with P-glycoprotein substrates (e.g., digoxin, cyclosporine). Consult a healthcare provider before concurrent use with prescription medications, especially if applying to extensive or open wounds.

Usage Guidance

Practical advice for getting the most out of Huang Lian Gao

Best time to take

Apply to affected area as needed, typically 1–2 times daily. No specific time restriction; can be used at any convenient time.

Typical duration

Applied 1–2 times daily until symptoms resolve; typical course is 1–4 weeks depending on the condition. Acute conditions like mild burns or nasal sores may respond within days; chronic eczema may require longer use. Reassess if no improvement after 2 weeks.

Dietary advice

While using this ointment, avoid spicy, greasy, and heating foods (e.g., chili, alcohol, lamb, fried foods) that can aggravate internal heat and worsen skin inflammation. Also avoid seafood and other common allergens that may exacerbate eczema or dermatitis. A light, cooling diet with plenty of vegetables is beneficial.

Huang Lian Gao originates from 《医宗金鉴》(Yi Zong Jin Jian), Volume 65 — Qing dynasty, 1742 CE

Classical Texts

Key passages from the classical Chinese medical texts that first described Huang Lian Gao and its clinical use

《医宗金鉴》卷六十五 (Yī Zōng Jīn Jiàn, Volume 65):

“此证生于鼻窍内……内宜黄芩汤清之，外用油纸捻粘辰砂定痛散，送入鼻孔内。若干燥者，黄连膏抹之立效。”

Translation: “This condition arises inside the nasal cavity... Internally, one should clear it with Huang Qin Tang; externally, use an oiled paper twist dipped in Chen Sha Ding Tong San and insert it into the nostril. If it is dry, apply Huang Lian Gao and the effect is immediate.”

Historical Context

How Huang Lian Gao evolved over the centuries — its origins, lineage, and place in the broader tradition of Chinese medicine

Huang Lian Gao first appeared in the Yi Zong Jin Jian (医宗金鉴), the “Golden Mirror of Medicine,” an official medical compendium compiled by imperial physician Wu Qian (吴谦) and colleagues under the order of Emperor Qianlong. Completed in 1742, it became the standard textbook for the Qing imperial medical academy. The formula was recorded in Volume 65, within the “Essential Teachings of External Medicine” section, as a topical remedy for nasal sores caused by Lung heat. Over time, its use expanded to burns, eczema, hemorrhoids, diaper rash, and various inflammatory skin conditions. In modern TCM dermatology and surgery, it is regarded as a “sacred medicine” (圣药) for heat-toxin skin disorders, and remains one of the most widely used classical external ointments.

Modern Research

A published study investigating the pharmacological effects or clinical outcomes of Huang Lian Gao

1

Extraction process optimization and in vitro anti-inflammatory activity of Huang Lian Ointment (2020)

Wang YX, Han B, Wang D, et al. Extraction process optimization and in vitro anti-inflammatory activity of Huang Lian Ointment. Chinese Traditional Patent Medicine, 2020, 42(8): 1977-1982.

This study optimized the extraction process for Huang Lian Gao using orthogonal testing and evaluated its anti-inflammatory activity on HaCaT cells. The optimal process involved frying the crude herbs in sesame oil at 200°C for 4 hours. The resulting extract oil significantly reduced levels of TARC, MDC, RANTES, and IL-8 in a dose-dependent manner, demonstrating strong in vitro anti-inflammatory effects that support its traditional use for inflammatory skin conditions like eczema.

DOI

Research on TCM formulas is growing but still limited by Western clinical trial standards. These studies provide emerging evidence and should be considered alongside practitioner expertise.