Most people notice wrinkles, dark circles, or a tired complexion and assume they are simply signs of stress, lack of sleep, or getting older.
But according to traditional Chinese medicine (TCM), subtle changes in the face may sometimes provide early clues about what is happening inside the body—from cardiovascular problems and hormonal imbalances to metabolic dysfunction.
While facial features alone cannot diagnose disease, practitioners say they can serve as valuable warning signs, encouraging people to pay closer attention to their health before more serious symptoms emerge.
“Many changes appear on the face long before people realize something is wrong,” said Chou Tsung-Han, an attending physician at Han Ming Tang Clinic in Taiwan, during the “Health 1+1” program on NTD, a sister outlet of The Epoch Times.
Signs of Cardiovascular Disease
According to Chou, certain facial features may offer clues about cardiovascular function.
“In some people, shortly before a stroke occurs, the face may suddenly look dull or darkened,” he said. “This is a warning sign that should not be ignored.”
When evaluating patients, Chou often begins by observing the forehead, ears, and the area between the eyebrows—even before the patient speaks.
Earlobes
One feature that has attracted attention from both TCM practitioners and modern researchers is a diagonal crease running across the earlobe, commonly known as Frank’s sign.
In TCM, this crease is sometimes referred to as the “coronary heart disease groove” because it has long been associated with poor cardiovascular health.
According to Chou, a pronounced earlobe crease may prompt physicians to take a closer look at a person’s cardiovascular health, particularly if it is accompanied by symptoms such as chest tightness, palpitations, shortness of breath, or reduced exercise tolerance.
Research has also found a connection. A 2014 study reported that individuals with diagonal earlobe creases were more likely to have coronary artery disease, even after accounting for age, sex, and other cardiovascular risk factors.
While an earlobe crease is not proof of heart disease, it may be a reason to pay closer attention to cardiovascular health.
Area Between the Eyebrows
The area between the eyebrows, known anatomically as the glabella, may offer additional health clues.
In TCM, a vertical line between the eyebrows, sometimes called a “worry line,” may suggest insufficient oxygen supply to the heart.
The color of the glabella—the area of skin located between the eyebrows, and above the nose—can also serve as a health indicator. From a TCM perspective, a dull or darkened appearance in this area is usually linked to excessive stress, insufficient sleep, and poor cardiovascular circulation.
Redness in the glabella often suggests increased pressure in the head. During the summer, it may also be related to heatstroke. A bluish appearance in this area is often associated with gastrointestinal problems.
These observations are not diagnostic, but they may provide clues that warrant a closer look at overall health habits.
Forehead
In TCM, the forehead is believed to correspond to the heart.
A forehead that consistently appears dull, yellowish, or lacking in luster may indicate poor circulation.
Frequent small rashes on the forehead or skin that alternate between oily and dry may also indicate circulatory problems.
Lips and Tongue
In addition to the forehead and glabella, the lips and tongue can also offer clues about the circulation of qi (vital energy) and blood throughout the body.
For example, pale lips are commonly seen in people with a TCM pattern known as energy (qi) deficiency, often associated with a weaker body, fatigue, and a slower metabolism.
If the lips appear dark red or have dark patches, it may reflect internal “stagnation,” meaning that blood circulation is not flowing smoothly. In such cases, a TCM physician may pay closer attention to risk factors such as high blood pressure, high blood sugar, and high cholesterol.
The underside of the tongue may also provide clues. If the sublingual veins (blood vessels under the tongue) appear unusually dark or dusky, TCM considers this a possible sign of blood stasis.
However, these are only warning signs, Chou said. The presence of lines, pimples, or changes in lip color does not necessarily mean a person has heart disease.
A patient’s condition should be assessed comprehensively through consultation, pulse diagnosis, and an overall evaluation of the person’s constitution.
What the Eyes May Reveal About Internal Health
After examining the ears, glabella, and forehead, Chou said he usually observes the eyes, which are among the most telling areas in TCM visual diagnosis.
Details such as eye bags, dark circles, the color of the whites of the eyes, and the degree of visible redness can often reflect the body’s overall condition.
Eye Bags and Dark Circles
Puffiness around the eyes is usually associated with excessive “dampness” or “cold-dampness” in the body, which may manifest as fluid retention and slower metabolism.
If the puffiness is accompanied by dullness or darkening, a TCM physician may also consider kidney qi deficiency.
In TCM theory, the kidneys are viewed as the body’s “energy storehouse” and are closely related to metabolism, aging, vitality, and the body’s ability to repair itself.
Dark circles, a common concern, can be caused by many factors, including excessive worrying, insufficient sleep, eye strain, and allergies.
In children, Chou said he has observed that dark circles are often related to allergies. Once the allergies are addressed, the dark circles often fade naturally.
Whites of the Eyes
Aside from oxygen deprivation caused by wearing contact lenses, obvious redness or bloodshot eyes may indicate excessive “heart fire.”
In TCM, excessive heart fire is often associated with prolonged stress, staying up late, or emotional tension. Symptoms may manifest as irritability, poor sleep, dry mouth, and bloodshot eyes.
If the redness persists and is accompanied by shoulder and neck stiffness or tightness in the muscles at the back of the neck, it may signal elevated pressure in the head. In TCM, acupuncture is sometimes used to improve circulation in the brain.
A yellowish tint in the whites of the eyes may point to poor liver function or impaired bile circulation. In more serious cases, it may even be associated with jaundice, and further liver function testing is recommended.
How the Lower Face May Reflect Hormonal Health
In TCM facial diagnosis, the upper face is often used to assess circulation and digestive function, while the lower face may offer clues about the endocrine system.
The philtrum—the area below the lower lip, between the mouth and chin—has a slight natural prominence. Swelling in this area, especially when accompanied by heavy menstrual bleeding or irregular periods, may indicate a possible risk of uterine fibroids.
In TCM, a philtrum that appears overly flat, with little or no groove, may suggest greater difficulty in conceiving.
In young women, a flat philtrum with fine hair growth may be associated with polycystic ovary syndrome or endocrine imbalance. This is often accompanied by signs such as oily skin, enlarged pores, and noticeable weight fluctuations.
Frequent acne on the chin before menstruation may indicate pronounced hormonal fluctuations rather than simply poor sleep or diet alone.
Not a Diagnosis
After reading about signs that may appear on the ears, the area between the eyebrows, the eyes, the nose, and the chin, many people may instinctively check the mirror and wonder whether those signs apply to them.
However, visual diagnosis does not mean every line, wrinkle, or pimple indicates a health problem. These observations are not meant to cause unnecessary alarm, Chou said.
Chou said his philosophy as a physician is that doctors should not simply point out every possible problem to patients, as doing so may create unnecessary worry.
What matters most, he said, is first addressing the symptoms currently causing the patient the most discomfort, such as menstrual pain or palpitations, while quietly taking into account any warning signs observed through visual diagnosis when developing a treatment plan.
Overall Changes in Complexion Matter Most
Rather than focusing on a single line, wrinkle, or pimple, TCM emphasizes long-term changes in the face as a whole.
“Most people can tell when their complexion does not look right. There is no need to deceive yourself,” Chou said.
“Stand in front of the mirror and look at your face. If you notice that your complexion is getting worse, it may be time to consider whether your daily routine has become irregular, your diet has gone off track, or you are not exercising enough. In many cases, the body may already be showing clues on the face.”