Shiunko

What is Shiunko?

Shiunko is a thick purple ointment used in Kampo, the Japanese herbal tradition. You spread it on the skin for small burns, cracked or chapped skin, minor cuts and grazes, dry itchy rashes, and painful piles (hemorrhoids, swollen veins around the back passage). It is for use on the skin only.

The purple colour comes from shikon (Lithospermum root). The rest is mostly sesame oil, beeswax, pork fat and touki (Angelica root), which together make a greasy salve that holds moisture against the skin and softens hard, split skin.

Shiunko sits on Japan's national health insurance list of 148 approved Kampo formulas, so doctors in Japan can prescribe it. Its Japanese romanised name is Shiunko, sometimes written Shiun-ko, and it means "purple cloud ointment".

Long traditional use and proof of effect are two separate things, and this is the one place we will say it: Shiunko has centuries of use behind it but very little solid human trial evidence. Treat it as a soothing skin salve, not a proven treatment for any condition.

How does Shiunko work?

The honest answer is that nobody has shown clearly how Shiunko works on human skin. Its most likely action is simple and physical: an oil-and-wax layer keeps water in, softens hard or split skin, and cuts down rubbing and stinging.

Laboratory studies point to shikonin and related purple pigments from shikon root as the main plant chemicals. In test dishes and in animals they damp down some inflammation (swelling and redness), slow some bacteria, and may help wounds close faster. None of that proves the same thing happens on your skin.

Touki (Angelica root) is added in the traditional recipe to "move blood", the old Kampo way of saying it was thought to improve circulation in the injured area. That is a traditional explanation rather than a measured effect.

Because skin absorbs very little from a heavy ointment like this, doctors generally do not expect Shiunko to act anywhere in the body except the patch of skin you put it on.

What forms does Shiunko come in?

Shiunko comes as one thing: a stiff, oily purple ointment, sold in small jars, tins or tubes.

In Japan it is available both as a prescription Kampo product covered by national health insurance and as an over-the-counter salve. Outside Japan it is usually sold as an imported cosmetic or herbal balm, and the strength and quality are not always stated.

It is often used spread on a sterile gauze pad, which is then laid over the sore area and held with a light dressing. This keeps the purple stain off clothes and bedding. There is no oral form, no capsule and no tea, and no reputable maker sells one.

Where it comes from:

Shiunko is credited to Hanaoka Seishu, a Japanese surgeon of the Edo period who worked around 1800. He adapted an older Chinese wound salve, Runji-gao, described in Ming-dynasty surgical writing.

Since then it has been a standard dressing ointment in Kampo practice for burns, chapped skin, ulcers and piles. Its place on Japan's insurance-approved list of 148 Kampo formulas shows how firmly it is established in that one tradition.

What does Shiunko help with?

• Minor burns and scalds: This is Shiunko's best-known traditional use in Kampo, where it was a first-choice dressing salve for small, shallow burns. An oily barrier can ease stinging and stop a dressing sticking, which is a real comfort benefit. Good human trials are lacking, and any burn that blisters, covers a wide area, or sits on the face, hands or genitals needs medical care, not ointment.
• Cracked, chapped or very dry skin: This is the use most likely to help, and the reason is plain: a thick grease layer holds water in and softens hard skin. People with split heels or chapped hands often feel easier within a few days. The effect is that of any rich ointment, so you are not getting anything the herbs alone have proven to add.
• Small cuts, grazes and healing scabs: Traditionally applied to keep a wound soft and stop a dressing pulling. Laboratory and animal work suggests shikonin may help wounds close, but that has not been confirmed in people. Clean the wound first, and never use it on a dirty, deep or punctured wound.
• Piles (hemorrhoids, swollen veins around the back passage): A long-standing Kampo use, applied to the outside skin around the back passage to reduce soreness and rubbing. Evidence is limited to tradition and small Japanese reports. Bleeding, a lump that will not go back, or pain that keeps getting worse needs a doctor's assessment, because other conditions look similar.
• Dry, itchy eczema-like patches: Used traditionally on dry, scaly, non-weeping patches, where the greasy base alone can reduce itch. It is the wrong choice for eczema that is wet, oozing or infected, because grease traps moisture and germs. It is not a substitute for a steroid cream or other treatment your doctor has prescribed.
• Chilblains (painful red swellings from cold): A classic Kampo use, matching the traditional idea that touki "moves blood" in cold, poorly supplied skin. There are no solid human trials for this. Do not use it on broken skin of the feet if you have diabetes (high blood sugar) or poor circulation.
• Skin reactions during radiotherapy (radiation treatment): Some Japanese hospitals have used Shiunko for sore, dry skin after radiotherapy, and small studies have looked at this. The published work is too limited to call it effective. Ask your cancer team first and follow their timing, because oils left on the skin during a session can raise the dose reaching the surface.
• Early pressure sores (bed sores): Used in Japan as part of nursing care for reddened or lightly broken skin. This is a condition where things go wrong quickly, so it belongs with a nurse or doctor, not self-care. Any sore that deepens, smells, or drains pus needs urgent professional treatment.

Which foods are rich in Shiunko?

1. Sesame oil: the base of the ointment, worth knowing if you react to sesame
2. Pork fat (lard): part of the classic recipe, which matters for allergy and for religious or vegetarian diets

What are the side effects of Shiunko?

• Purple staining of skin, nails, clothes and bedding
• A greasy, heavy feel on the skin
• Itchy red rash where you applied it (contact dermatitis, an allergic skin reaction)
• Stinging or burning on open or raw skin
• Blocked pores, spots or inflamed hair roots under the greasy layer
• A wet or infected wound getting worse because grease traps moisture
• Allergic reaction in people sensitive to sesame, pork fat or beeswax

Good to know:

Most people who use Shiunko on the skin have no problem beyond mess and staining. The main real side effect is an itchy rash from the ointment itself; if that happens, wash it off and stop. Serious harm comes mainly from using it in the wrong place, such as on a deep burn or an infected wound, rather than from the ointment being poisonous to skin.

How much Shiunko should you take?

• Recommended daily: Apply a thin layer to clean, dry skin one to three times a day. You want a light purple sheen, not a thick coat. A common Kampo method is to spread it on a sterile gauze pad and lay that over the sore area. Change the gauze each time you reapply. No official self-care dose exists outside Japan, so start low. Test a small patch once daily for two days to check your skin does not react. Expect purple staining on skin, nails, clothes and bedding.
• Best time of day: Any time of day works. Many people prefer bedtime with a gauze pad or cotton socks, because the ointment is greasy and stains. For chapped hands, reapply after washing and drying them.
• With or without food: This does not apply. Shiunko goes on the skin, not in your mouth, and you should never swallow it.
• Time to effect: Comfort from the greasy barrier is usually felt within minutes to a few hours. Cracked or chapped skin often looks better in three to seven days. If a wound or sore is not clearly improving within a week, stop and get it looked at.
• How long to take it: Use it short term. For chapped skin or a small healing graze, a few days to two weeks is normal. Stop and rethink if nothing has improved after one week, and see a doctor if you have used it for two weeks without real change. Long, continuous use on the same patch of skin is not something the evidence supports.