Recently, traditional chinese medicine (TCM) natural products have been used to produce impressive responses in atopic eczema and related dermatological disorders that have proved resistant to orthodox treatments. The increasing popularity of TCM natural products has also produced fear about their toxicity and uncertainty about their ingredients. In the western world, very little is known of the efficacy and safety of TCM, and the legal responsibilities of practitioners are undefined. In this article Kelvin Chan overviews the TCM practitioners' concepts of how TCM natural products work and attempts to suggest the pharmacological interpretation of their mechanisms of action. The future of TCM is discussed by critically assessing the authenticity, quality, toxicity and clinical efficacy of these natural products.