The Aztec Empire, one of the most powerful pre-Hispanic civilizations, demonstrated a remarkable understanding of medicine, particularly in dermatology. Despite their reliance on religious beliefs and deities, the Aztecs developed sophisticated treatments for various skin conditions and established a unique medical terminology. Xipe Totec, the God of skin diseases, was believed to cause ailments like scabies, abscesses, and even smallpox. To appease him, those afflicted participated in rituals seeking cures. The Aztecs treated these conditions using herbal remedies and balneotherapy. Additionally, the Aztecs practiced cosmetology, using cacao and achiote to treat xerosis, wounds, and provide sun protection. The legacy of Aztec dermatology emphasizes their advanced approach to medicine, integrating cultural and religious practices with empirical knowledge. This historical insight enriches our understanding of how ancient civilizations addressed health and disease, offering a valuable perspective on the evolution of dermatological practices.

Aztec Empire, Skin diseases, Herbal remedies, Balneotherapy, Dermatology, Mexican civilization.

The Aztec Empire was one of the most powerful Mexican civilizations of the pre-Hispanic era.[1] When the Spaniards arrived in Mexico in the 16th century, they were amazed by the advanced civilization and great knowledge that the Aztecs possessed in different areas, particularly in medicine, including dermatology.[2] Even when many medical basics in the Aztec empire relied on religious beliefs, deities, and evil spirits, the Aztecs demonstrated an understanding of skin diseases, developed treatments, and coined medical terminology.[2,3]

Among the Aztec gods used to describe health and disease, Xipe Totec was the God of skin diseases (Figure 1).[3,4] A traditional belief was that Xipe Totec would punish people in the form of “sarna” (scabies), “mal de ojo” (the devil’s eye), and “postema” (pus and abscesses).[2,3] To appease  Xipe Totec’s wrath, people with skin infections and rashes would march during festivities to appease the God and obtain a cure.[1] Eventually, Xipe Totec was known as the God of smallpox due to the smallpox outbreak after the Spanish arrival.[3] Venereal disease was also well-known among Aztecs because they believed the God of heaven and earth, Tezcatlipoca, would punish “indecent” people with such disease, with syphilis being the most prominent.[2] Xochiquetzal, the goddess of love, would also punish in the form of scabies, skin rashes, and other skin infections.¹ Another God related to skin diseases was Nanahuatl or Nanahuatzin, the God of Leprosy.[3]

Figure 1: Depiction of Xipe Totec – the god of skin diseases and smallpox

Aztecs developed specialized terminology for various skin diseases, enabling them to classify and treat these conditions systematically (Table 1).[1-4] The Aztecs treated dermatoses using herbalism and balneotherapy.[2,3] Herbalism treatment in Aztec medicine included the shrub flower Cassia occidentalis, which was used to treat psoriasis.[4] Liquidambar styraciflua, xochiocotzoquahuatl in Nahuatl, and known today as sweetgum or American storax, was used as an ointment in the treatment of scabies.[3,4] Infected wounds were treated with a mixture of maize with fungi since it was known to have antibacterial properties. Regarding balneotherapy, the most recognized treatment among the Aztecs for syphilis was steam baths, or temazcalli in Nahuatl, because it was believed these would clean the body and purify the spirit.[1,2] There was also some evidence of cosmetology within the Aztec Empire. For instance, theobroma cacao, or simply cacao, was used by Aztecs to treat xerosis and wounds due to its natural oils.² They would mix the cacao with achiote, or Bixa orellana, to give their people a red facial tone for festivities, but it was also thought to be used as sunscreen.[2]

Table 1: Specialized terminology for skin diseases in the Aztec Empire

The Aztec Empire’s contributions to the field of dermatology reflect a sophisticated understanding of medical science, deeply integrated with cultural and religious practices. Their knowledge of skin diseases, along with their unique treatments and terminology, highlights their approach to disease that was advanced for its time. The legacy of Aztec dermatology not only shows the importance of historical medical practice but also enriches our understanding of how ancient civilizations approached medicine and disease.

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Corresponding Author:
Melissa Marchan-Martinez
Department of Medicine
John Sealy School of Medicine, University of Texas Medical Branch, USA
Email: memarcha@utmb.edu

Co-Authors:
Diana Bonilla, Chinenye Onejeme
Department of Medicine
John Sealy School of Medicine, University of Texas Medical Branch, USA

All authors contributed to the conceptualization, investigation, and data curation by acquiring and critically reviewing the selected articles. They were collectively involved in the writing – original draft preparation, and writing – review & editing to refine the manuscript. Additionally, all authors participated in the supervision of the work, ensuring accuracy and completeness. The final manuscript was approved by all named authors for submission to the journal.

Not applicable

The author declares no conflict of interest.

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https://doi.org/10.63096/medtigo30622450

Melissa M-M, Diana B, Chinenye O. Exploring the Origins of Dermatology in the Aztec Empire. medtigo J Med. 2024;2(4):e30622450. doi:10.63096/medtigo30622450 Crossref