Dr. Anna Hsieh Gold is one of the Bay Area’s most sought after practitioners of TCM and the creator of Arcana herbal tinctures. She's also a key collaborator of star facialist Kristina Holey's — the two superwomen work together to crack the toughest skincare situations with internal and external protocols that have been life-changing for their clients. Here, they discuss their work together and how the Arcana tinctures fit in. We were delighted to interview these two and it's an honor to share this discussion with you!
Ayla: We love the story of how you two began working together and how that led to the creation of Arcana. Tell us how you think about working with these tinctures when you collaborate on clients.
KRISTINA: Incorporating these tinctures into my skincare practice is a way to replicate the custom work that Anna does with her patients, especially when we see clients together. They make that experience more widely available: we’re able to make use of Anna’s work without requiring her to actually be there.
ANNA: Ideally, someone’s seeing a practitioner in person, and they’re getting a specific diagnosis and herbs to go with that diagnosis. But because Kristina sees people from all over the world, this became an easier way for us to allow the herbs to help her clientele.
KRISTINA: It’s also a tried and true thing. It can be complicated when I’m working with someone whose acupuncturist isn’t Anna and that acupuncturist has a different approach; I’m so used to Anna’s style. For instance, I’ll ask what their acupuncturist is working on, and they’ll say, “My back,” but they’re not taking any herbs — and the main problem I see is eczema all over their face that doesn’t seem to be improving. And all that treatment adds up and gets expensive over time. The tinctures make it more approachable and, in the end, more affordable to treat a lot of conditions. They’re an awesome complement to the products I use on the skin.
Ayla: How does it usually work? Kristina, do you generally suggest the tinctures as something to be used after your treatments?
KRISTINA: Usually I’ll perform a treatment for atopic dermatitis, acne, or whatever it may be, and offer the tinctures as complementary follow up. With the way skin symptoms can be classified and broken down, most of the situations I see end up being easily classified into one of the four areas that the tinctures address. The great part of having them in combination with my practice is seeing the primary source of stress in the skin during a treatment and being able to then have a client take one of those tinctures immediately following the treatment for three or four days, three times per day. It puts my clients on a good path in their healing process.
ANNA: The hands on treatments involve the process of manipulating physical and energetic structures of the face and body. The herbs in these tinctures remedy whatever imbalances might exist, so they act like an extension of the hands-on treatment; topical treatments can work more effectively when used with treatments that address underlying imbalance.
We find that these tinctures strike the perfect note between being accessible to a lot of people and being personalized to the degree required for them to truly be effective.
KRISTINA: I think that’s the key to everything right now: we can’t all be accessible to everyone, but people still need semi-customized protocols. It’s a nice combination between me, Anna, and Ayla — wherever you find the tinctures, there are specialists who can recommend the right ones. They’re pretty foolproof, but will also really give you results.
ANNA: There’s such a trend towards adaptogens right now in wellness, and a lot of people are taking ONE thing that they’ve read about somewhere, but it’s not necessarily targeted for their specific situation. In Chinese medicine, herbs are all about synergy. They work together to correct imbalances — and can also help correct potential recurrences of that imbalance more quickly.
To that point, do you find that positive changes occur more quickly or more significantly with the tinctures when they’re added to a topical skincare protocol?
KRISTINA: I find that it accelerates the healing process and diminishes the symptoms, since we’re combining topical and internal work that’s been chosen strategically to address those specific symptoms. I haven’t charted a specific rate of recovery since it varies so much from person to person. But when someone has inflamed acne and takes Clear for a few days, for example, I’ll find that they’ll be in much better condition afterwards.
ANNA: I tend not to make specific measurements in terms of time, either. But because of the kind of medicine I practice, it’s always a combination of the external and the internal; it balances. Whatever shows up on the skin is a reflection of the inner harmony in the body. From a Chinese Medicine perspective, the outer expression on the skin is a reflection of the health of the Spleen/Stomach (digestion, integration of nutrients), Liver (blood, hormones, detoxification, and nervous system), Lung (guardian of the skin), and Kidney (genetics and chronic depletion). In Western terms, it’s a reflection of your microbiome and the different components that would show up in your bloodwork.
Tell us which types of situations each tincture is best suited for and what topical products tend to work well with them.
ANNA: I created this for someone who has flaky irritations on the skin, sometimes red and sometimes not — conditions like atopic dermatitis and psoriasis. I also find it works well on those who are prone to histamine reactions. The formula includes herbs that address that flaking and itchiness, which we describe in Chinese Medicine as “wind.” You see this when the superficial layer of the skin isn’t nourished or moisturized enough to protect the rest of the body. The formula also includes a lot of blood tonics because there’s an underlying blood deficiency, from a Chinese Medicine perspective, in these types of conditions.
KRISTINA: That’s something Anna and I started talking about a couple of years ago: the link between perioral dermatitis and blood quality (anemia, for example, is a common one). Usually it comes on during the postpartum or postmenstrual period. I find this tincture really beneficial for dry and scaly perioral dermatitis, or consistent redness you might see around the nose and eyes.
The person who uses Dispel is often using a classic combination of Balancing HypoTonic, Barrier Restore Serum, and Barrier Lipid Complex. I see it mostly for those lacking in that outer lipid layer, which then changes the skin’s microbial balance and the whole immune system response. To me, Dispel is a really helpful way of looking at and thinking about the skin system in a different way. I always used to think of skin that’s missing that lipid layer sort of like a system of ungrounded wires. Wind is a helpful way of thinking about it, too.
ANNA: For Elevate, I picture someone who is really drained, really fatigued from many years of overwork, overstress, and adrenal fatigue — someone sagging in body, spirit, and skin. This is someone with a kidney yin deficiency who tends to be dry and just has this overall sense of being dragged down. The formula contains what we call directional herbs in Chinese Medicine: spleen tonics whose overall direction is up.
KRISTINA: Elevate is great as a complementary treatment if someone’s postmenopausal or coming to me with a lot of depletion. Someone who needs energizing and a boost of circulation. For example, I have a friend in New York who’s just going into menopause — she works really hard, she’s super tall and super skinny. For her, Elevate has been really effective at reducing perimenopausal breakouts and also gives her a little more pizzazz. She felt that depletion in the nutrient quality of her skin as well.
Product wise, this person would probably be using Gentle Retinol Night Serum, Vitamins C+E+Ferulic Serum, the Rejuvenating Night Oil….all the thick formulas. They might also be using Barrier Restore and Balancing Hypotonic. And the Micronutrient Mask for sure.
ANNA: I find Elevate is also good for postpartum treatment, or any time body’s depleted. It’s deeply restorative. You won’t get that adrenaline pep that you’d get from a shot of espresso, but it’s a deep-seated energy that really builds your resources. It’s like lighting your pilot light. This formula is great for older clients who have puffy eyes or lack turgor on the skin. It can also help those experiencing hot flashes.
Note from Ayla: this really is an excellent puffy-eyes remedy!!
ANNA: This is a straightforward one — clear is for any kind of acne, whether it’s cystic or more superficial whiteheads. With hormonal acne, it works well in conjunction with Balance. And I think Kristina has been giving it to clients with really red rosacea, too — it’s helpful for someone who has a lot of heat and blood stagnation in their face.
KRISTINA: I can see that after a treatment - if a client gets too hot, too quick after a massage in the jowls and cheek and chest. I also suggest it to clients who respond to things with a histamine reaction. If you flush easily after eating lunch, this helps as well.
But for a more classic example, it works well with my 28 year old male client, for instance, with cystic acne all over his face — he loves it. Clear is more for breakouts than for something like atopic dermatitis, even though both of those conditions are about heat.
ANNA: This tincture can complement everything. It’s based on a formula that is over 1000 years old, with the addition of some Ayurvedic & naturopathic herbs. I picture the Balance person as someone who has PMS; someone who’s irritable, hurried and rushed; someone who’s really wound tight and notices that tightness especially in the neck, the upper back, the shoulders. We call that person a “wood type,” or a “liver stagnation type” with heat. It’s excellent for those who experience tension headaches or tension along the jaw and neck.
Balance is good for those who are prone to tears and overwhelm, or those who are easily angered or irritated. Type A people, too. It’s really for anyone who’s stressed out or doing too much.
KRISTINA: It’s basically for everyone who lives in San Francisco. I recommended it to someone last week who just had her second baby and works from 9am to 7pm and again after her kids go to sleep. And she thinks she’s fine...but she’s really not fine.
I take Balance a lot, too. I wouldn’t consider myself Type A, but before my period I can get anxious because I’m more tired and uptight. I find it really grounding and centering.
ANNA: Yes, it’s not just for that classically tightly wound person. From a Chinese Medicine perspective, to soothe the liver and make things flow, you have to tonify the blood — because the liver’s in charge of restoring the blood. Balance contains herbs with a heat-clearing component because heat builds up when there’s stagnation. And when things aren’t moving, there’s all this anxiety and emotional turmoil.
KRISTINA: Balance isn’t necessarily directly related to the skin, but keeps anxiety and heat down at specific times. I often suggest a preventative protocol 7 days before your period, and Balance goes hand in hand with that. So while it’s not directly indicated for skin conditions, it helps reduce those types of breakouts too.
Many people wonder if you have to use these tinctures indefinitely. Is it like your typical Chinese herbal remedy — you take it daily for a period of time until you forget to take it because you no longer really need it, and then top up when you do?
ANNA: Yes, you’d approach the tinctures like you would any Chinese herbs: If you’re breaking out, take the whole bottle of Clear, see where you are, and then try again if you need to.
If you’ve had cystic acne since puberty, you’ll need to be more consistent in dosing. If you’ve struggled with that condition for 20 years it might take 2-3 months until you get the point where you only take it as needed.
Balance is a little different; you can just have one on hand to take as you need it.
KRISTINA: They’re good to have on hand, they’re part of the toolkit.
ANNA: Yes – in Chinese Medicine, if you take herbs consistently and your body learns to rebalance, having them on hand is a good idea because if you get out of balance, you have a predisposition and it could come back. But when you have a relapse and you take the herbs again, it doesn’t take that long for your body to reset.
KRISTINA: With some conditions like atopic dermatitis, there are some specific types that are more chronic and part of your genetic makeup, but others that are more topical and where you should be able to get to the other side more easily. They’re different.
ANNA: It’s like teaching your body how to get to that point where you can tell your histamine levels to just cut it out! People think they need to take antibiotics to clear their skin, which gives them a break…but we’re trying to find a way to clear skin more naturally and get the body to learn that it can make that break happen without having to deplete itself or suffer unnecessary side effects.
How intriguing are these tinctures? So intriguing, we think. And truly, they WORK. Check out our Highlights to see some incredible before & after pictures. These take skincare supplements to a whole new level — you will absolutely notice a difference. Check them out here and read more tips from Dr. Anna Gold here.