The belief that “herbal remedies are naturally safe and traditional medicines have no side effects” remains relatively common in the community. However, in reality, any substance with biological activity has the potential to cause adverse reactions, particularly when its ingredients and origin are unknown or when it is used without proper medical guidance and supervision.

One of the most serious complications is Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)—rare but life-threatening drug hypersensitivity reactions associated with a high mortality rate.

According to medical literature, the incidence of SJS/TEN is estimated at approximately 1–2 cases per million people each year. Despite its rarity, the mortality rate ranges from 10% to 30%, and may be even higher in severe TEN cases involving extensive skin detachment, sepsis, or multiple organ failure. The underlying mechanism involves a T-cell-mediated immune response that triggers widespread death of skin cells, resulting in extensive epidermal detachment similar to that seen in severe burn patients. In addition to skin damage, patients may experience involvement of the eyes, oral cavity, respiratory tract, gastrointestinal tract, and other organs, potentially leading to serious long-term complications such as corneal scarring, vision impairment, blindness, or airway narrowing.

A Clinical Case That Serves as a Warning

Recently, Hai Phong International General Hospital admitted a 56-year-old female patient diagnosed with Toxic Epidermal Necrolysis (TEN), suspected to be associated with the use of traditional Chinese herbal medicine.

According to her medical history, the patient had consumed approximately 20 doses of herbal medicine of unknown origin before symptoms developed. Upon admission, she presented with skin detachment affecting more than 30% of her body surface area, multiple blisters, widespread erythema, severe burning pain, high fever, and involvement of the oral mucosa and conjunctiva of both eyes.

The patient received intensive treatment in the Department of Internal Medicine II with multidisciplinary support from Dermatology, Ophthalmology, and Otorhinolaryngology specialists. The treatment regimen included immunosuppressive therapy, comprehensive skin and mucosal care, and close monitoring for infection and systemic complications. After 17 days of treatment, the skin lesions gradually dried, epithelial regeneration progressed well, her overall condition stabilized, and she was discharged from the hospital.

According to the treating physicians, without early diagnosis and prompt intervention, the patient could have faced severe complications, including sepsis, multiple organ failure, irreversible corneal damage, and even death.

Are Traditional Herbal Medicines Truly Safe?

Medical experts emphasize that not all traditional herbal medicines cause allergic reactions. However, the unsupervised use of folk remedies, products of unknown origin, uncontrolled formulations, or medicines with unclear ingredients may significantly increase the risk of severe adverse reactions.

In practice, many traditional medicine preparations contain multiple herbal components, making it difficult to accurately identify all ingredients. Some products may also be contaminated with impurities, heavy metals, pharmaceutical substances, or preservatives. These factors make it more challenging to predict allergic reactions, drug interactions, and appropriate management should complications occur.

Individuals with a history of allergies, chronic medical conditions, or those taking multiple medications simultaneously should exercise particular caution when using any medicinal product, including herbal preparations.

Recommendations from Physicians

To reduce the risk of severe drug-related allergic reactions, physicians recommend that the public:

Do not purchase or use traditional herbal medicines or medicinal products of unknown origin or composition without professional guidance.

Only use medications prescribed and monitored by qualified physicians or licensed traditional medicine practitioners.

Avoid using folk remedies or prescriptions obtained from other individuals.

Inform healthcare professionals about any history of drug allergies and existing medical conditions before receiving treatment.

Stop taking the medication immediately and seek medical attention as soon as possible if symptoms such as fever, rash, red eyes, mouth ulcers, blistering, or skin peeling occur after medication use.

Whether conventional pharmaceuticals or traditional herbal medicines are used, all medications should be taken based on professional medical advice. No medication is completely safe when used improperly. Seeking timely medical consultation, following physicians’ instructions, and avoiding products of unknown origin remain the most effective ways to protect health and prevent serious complications.